Systematic review: ileoanal pouch microbiota in health and disease.
File(s)
Accepted version
Accepted version
Author(s)
Type
Journal Article
Abstract
BACKGROUND: The resident gut microbiota is essential for physiological processes; the disturbance of its balance is linked to intestinal inflammation. The ileoanal pouch is a model for the study of intestinal inflammation, as inflammation of the pouch is common and mostly develops within 12 months following ileostomy closure. This allows the longitudinal study of the microbiota, giving insight into the microbiota changes during transition from a normal to an inflamed pouch. AIM: To explore the literature on the microbiota of the ileoanal pouch in health and disease. METHODS: A systematic computer search of the on-line bibliographic databases MEDLINE and EMBASE was performed between 1966 and February 2017. Randomised controlled trials, cohort studies and observational studies were included. Studies were included if they reported microbiota analysis on faecal samples or tissue from the ileoanal pouch. RESULTS: Twenty-six papers were eligible. Following ileostomy closure, anaerobic bacteria are the abundant species in the ileoanal pouch with presence of a diverse microbiota key to maintaining a healthy ileoanal pouch. Acute pouchitis is associated with an increase in Clostridia species, while chronic pouchitis is associated with an increase in Staphylococcus aureus. In the treatment of pouchitis, a decrease in Clostridia species appears to be associated with treatment response. CONCLUSION: The microbiota plays an important role in both the inflamed and the healthy ileoanal pouch. A direct causal relationship between individual microbiota changes and inflammation has not yet been established, but manipulation of the ileoanal pouch microbiota may be a novel therapeutic avenue to explore.
Date Issued
2017-12-05
Date Acceptance
2017-11-14
Citation
Alimentary Pharmacology and Therapeutics, 2017, 47 (4), pp.466-477
ISSN
0269-2813
Publisher
Wiley
Start Page
466
End Page
477
Journal / Book Title
Alimentary Pharmacology and Therapeutics
Volume
47
Issue
4
Copyright Statement
This is the peer reviewed version of the following article: Segal JP, Oke S, Hold GL, Clark SK, Faiz OD, Hart AL. Systematic review: ileoanal pouch microbiota in health and disease. Aliment Pharmacol Ther. 2017;00:1–12., which has been published in final form at https://dx.doi.org/10.1111/apt.14454. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving.
Subjects
1103 Clinical Sciences
1115 Pharmacology And Pharmaceutical Sciences
Gastroenterology & Hepatology
Publication Status
Published