Journal Article

A Distinctive Urinary Metabolomic Fingerprint Is Linked With Endoscopic Postoperative Disease Recurrence in Crohn’s Disease Patients

Ammar Hassanzadeh Keshteli, Robert Tso, Levinus A Dieleman, Heekuk Park, Karen I Kroeker, Juan Jovel, Patrick M Gillevet, Masoumeh Sikaroodi, Rupasri Mandal, Richard N Fedorak and Karen L Madsen

in Inflammatory Bowel Diseases

Volume 24, issue 4, pages 861-870
Published in print March 2018 | ISSN: 1078-0998
Published online February 2018 | e-ISSN: 1536-4844 | DOI: https://dx.doi.org/10.1093/ibd/izx070
A Distinctive Urinary Metabolomic Fingerprint Is Linked With Endoscopic Postoperative Disease Recurrence in Crohn’s Disease Patients

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  • Medicine and Health
  • Clinical Medicine
  • Gastroenterology
  • Patient Education and Information
  • Gastro-intestinal and Colorectal Surgery

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Abstract

Background

Crohn’s disease (CD) patients who undergo ileocolonic resection frequently have disease recurrence. The aim of this preliminary study was to identify urinary metabolomic profiles associated with disease recurrence in order to identify underlying mechanisms of recurrence and possible disease biomarkers.

Methods

Biopsies from the neoterminal ileum were collected from CD patients (n = 38) after ileocolonic resection in order to assess mucosa-associated microbiota using 16S rRNA multitag pyrosequencing. Urine samples were collected, and metabolomic profiling was done using high-resolution nuclear magnetic resolution spectroscopy and a combined direct infusion liquid chromatography tandem mass spectrometry. The Rutgeerts scoring system was used to assess endoscopic postoperative recurrence of CD.

Results

There were 28 (73.7%) patients with endoscopic CD recurrence. CD patients who were in endoscopic remission had a higher abundance of Bacteroidetes and lower abundance of Fusobacteria and Proteobacteria in comparison with CD patients who had endoscopic recurrence. In addition, metabolomic profiling could also discriminate between these 2 groups of patients. Endoscopic recurrence was associated with increased concentration of urinary levoglucosan. Rutgeerts score was positively correlated with levoglucosan and propylene glycol levels.

Conclusions

CD patients who present with endoscopic disease recurrence after surgery have a unique urinary metabolomic fingerprint that can differentiate them from CD patients who are in endoscopic remission after ileocolonic resection. In addition, mucosal-associated microbiota in CD patients with or without disease recurrence after surgery differs and correlates with some urinary metabolites.

Keywords: Crohn’s disease; postoperative recurrence; microbiome; metabolomics; biomarkers

Journal Article.  5529 words.  Illustrated.

Subjects: Medicine and Health ; Clinical Medicine ; Gastroenterology ; Patient Education and Information ; Gastro-intestinal and Colorectal Surgery

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