Oral versus intravenous iron replacement therapy distinctly alters the gut microbiota and metabolome in patients with IBD
Autor: | Kirill S. Smirnov, Bernhard Michalke, Ilias Lagkouvardos, Thomas Lee, Richard N. Fedorak, Annemarie Schmidt, Marianna Lucio, Philippe Schmitt-Kopplin, Dirk Haller, Alesia Walker, Thomas Clavel |
---|---|
Rok vydání: | 2016 |
Předmět: |
0301 basic medicine
medicine.medical_specialty Faecalibacterium prausnitzii Administration Oral Gut flora Iron sucrose Gastroenterology Ferric Compounds 03 medical and health sciences chemistry.chemical_compound Feces Glucaric Acid 0302 clinical medicine Collinsella aerofaciens Crohn Disease Oral administration Internal medicine RNA Ribosomal 16S medicine Humans Ferric Oxide Saccharated biology Anemia Iron-Deficiency Iron deficiency Iron Deficiencies biology.organism_classification medicine.disease Gastrointestinal Microbiome ddc Iron sulfate 030104 developmental biology chemistry Immunology Ferritins Hematinics Metabolome Quality of Life Population study 030211 gastroenterology & hepatology Administration Intravenous Colitis Ulcerative medicine.drug |
Zdroj: | Gut 66, 863-871 (2016) |
Popis: | Objective Iron deficiency is a common complication in patients with IBD and oral iron therapy is suggested to exacerbate IBD symptoms. We performed an open-labelled clinical trial to compare the effects of per oral (PO) versus intravenous (IV) iron replacement therapy (IRT). Design The study population included patients with Crohn9s disease (CD; N=31), UC (N=22) and control subjects with iron deficiency (non-inflamed, NI=19). After randomisation, participants received iron sulfate (PO) or iron sucrose (IV) over 3 months. Clinical parameters, faecal bacterial communities and metabolomes were assessed before and after intervention. Results Both PO and IV treatments ameliorated iron deficiency, but higher ferritin levels were observed with IV. Changes in disease activity were independent of iron treatment types. Faecal samples in IBD were characterised by marked interindividual differences, lower phylotype richness and proportions of Clostridiales. Metabolite analysis also showed separation of both UC and CD from control anaemic participants. Major shifts in bacterial diversity occurred in approximately half of all participants after IRT, but patients with CD were most susceptible. Despite individual-specific changes in phylotypes due to IRT, PO treatment was associated with decreased abundances of operational taxonomic units assigned to the species Faecalibacterium prausnitzii , Ruminococcus bromii , Dorea sp. and Collinsella aerofaciens . Clear IV-specific and PO-specific fingerprints were evident at the level of metabolomes, with changes affecting cholesterol-derived host substrates. Conclusions Shifts in gut bacterial diversity and composition associated with iron treatment are pronounced in IBD participants. Despite similar clinical outcome, oral administration differentially affects bacterial phylotypes and faecal metabolites compared with IV therapy. Trial registration number clinicaltrial.gov (NCT01067547). |
Databáze: | OpenAIRE |
Externí odkaz: |