Pouch inflammation after surgery for ulcerative colitis can significantly alter quality of life and thus ideally should be prevented.
Dysbiosis or altered microflora is suspected to be the key pathogenic factor for pouchitis.
However, dysbiosis in pouchitis has not been characterized carefully.
This is because of a lack of available sensitive microbiological technology suitable for in vivo studies in human beings.
Dr Srinadh Komanduri and colleagues from Illinois evaluated techniques for studying microflora patterns in patients with pouchitis.
The research team used the length heterogeneity polymerase chain reaction technique for studying microflora in human beings.
The team assessed the use of the technique to characterize the microfloral patterns in the ileal pouch of patients with pouchitis.
|Fusobacter and enteric species were associated with the disease state|
|Clinical Gastroenterology & Hepatology|
Microfloral patterns initially were assessed using a 16S ribosomal RNA technique.
This technique determined the qualitative changes in the luminal and mucosal intestinal flora.
The team cloned and sequenced the length heterogeneity polymerase chain reaction amplification products from RNA in patients and controls.
The team then identified the microbial species involved in pouchitis, and found unique microfloral patterns in pouchitis.
The researchers found the persistence of fusobacter and enteric species associated with the disease state.
The team also observed the absence of specific bacteria such as Streptococcus species in the inflamed pouch.
Dr Komanduri's team concludes, “We have shown that the length heterogeneity polymerase chain reaction technique is suitable for studying microflora in human beings.”
“By using this technique and the clone sequences, we have shown dysbiosis in the microbial biofilm adherent to the mucosa in pouchitis.”
“Our data provide direct evidence of the role of bacteria in the pathogenesis of pouchitis.”