Bacterial colonization of colonic crypt mucous gel and disease activity in ulcerative colitis

Ann Surg. 2010 Nov;252(5):869-75. doi: 10.1097/SLA.0b013e3181fdc54c.

Abstract

Objective: To optimize total bacterial 16S rRNA quantification in microdissected colonic crypts in healthy controls and patients with ulcerative colitis (UC) and to characterize the findings with disease activity.

Background: Microscopic and molecular techniques have recently converged to allow bacterial enumeration in remote anatomic locations [eg, crypt-associated mucous gel (CAMG)]. The aims of this study were to combine laser capture microdissection (LCM) and 16S rRNA-based quantitative polymerase chain reaction (qPCR) to determine total bacterial copy number in CAMG both in health and in UC and to characterize the findings with disease activity.

Methods: LCM was used to microdissect CAMG from colonic mucosal biopsies from controls (n = 20) and patients with acute (n = 10) or subacute (n = 10) UC. Pan-bacterial 16S rRNA copy number per millimeter square in samples from 6 locations across the large bowel was obtained by qPCR using Desulfovibrio desulfuricans as a reference strain. Copy numbers were correlated with the UC disease activity index (UCDAI) and the simple clinical colitis activity index (SCCAI).

Results: Bacterial colonization of CAMG was detectable in all groups. Copy numbers were significantly reduced in acute UC. In subacute colitis, there was a positive correlation between copy number and UCDAI and SCCAI in the ascending, transverse and sigmoid colon.

Conclusions: This study describes a sensitive method of quantitatively assessing bacterial colonization of the colonic CAMG. A positive correlation was found between CAMG bacterial load and subacute disease activity in UC, whereas detectable bacterial load was reduced in acute UC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Analysis of Variance
  • Area Under Curve
  • Case-Control Studies
  • Colitis, Ulcerative / microbiology*
  • Colitis, Ulcerative / pathology
  • DNA, Bacterial / analysis
  • Desulfovibrio / isolation & purification*
  • Female
  • Humans
  • Intestinal Mucosa / microbiology*
  • Intestinal Mucosa / pathology
  • Lasers
  • Male
  • Microdissection / methods
  • Middle Aged
  • Mucus / microbiology
  • Polymerase Chain Reaction
  • RNA, Ribosomal / analysis
  • Sensitivity and Specificity
  • Statistics, Nonparametric

Substances

  • DNA, Bacterial
  • RNA, Ribosomal