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Antibiotics and probiotics in chronic pouchitis: a comparative proteomic approach.

ABSTRACT: AIM:To profile protein expression in mucosal biopsies from patients with chronic refractory pouchitis following antibiotic or probiotic treatment, using a comparative proteomic approach. METHODS:Two-dimensional polyacrylamide gel electrophoresis and matrix-assisted laser desorption/ionization-time of flight mass spectrometry were used to characterize the changes related to antibiotic therapy in the protein expression profiles of biopsy samples from patients with chronic refractory pouchitis. The same proteomic approach was applied to identify differentially expressed proteins in the non-inflamed pouch before and after probiotic administration. RESULTS:In the first set of 2D gels, 26 different proteins with at least 2-fold changes in their expression levels between the pouchitis condition and antibiotic-induced remission were identified. In the second set of analysis, the comparison between mucosal biopsy proteomes in the normal and probiotic-treated pouch resulted in 17 significantly differently expressed proteins. Of these, 8 exhibited the same pattern of deregulation as in the pouchitis/pouch remission group. CONCLUSION:For the first time, 2D protein maps of mucosal biopsies from patients with ileal pouch-anal anastomosis were provided, and differentially expressed proteins following antibiotic/probiotic treatment were identified.

SUBMITTER: Turroni S

PROVIDER: S-EPMC2799914 | biostudies-literature | 2010 Jan

REPOSITORIES: biostudies-literature

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Antibiotics and probiotics in chronic pouchitis: a comparative proteomic approach.

Turroni Silvia S Vitali Beatrice B Candela Marco M Gionchetti Paolo P Rizzello Fernando F Campieri Massimo M Brigidi Patrizia P

World journal of gastroenterology 20100101 1

<h4>Aim</h4>To profile protein expression in mucosal biopsies from patients with chronic refractory pouchitis following antibiotic or probiotic treatment, using a comparative proteomic approach.<h4>Methods</h4>Two-dimensional polyacrylamide gel electrophoresis and matrix-assisted laser desorption/ionization-time of flight mass spectrometry were used to characterize the changes related to antibiotic therapy in the protein expression profiles of biopsy samples from patients with chronic refractory ...[more]

PMID: 20039446

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Project description:Background:In limited retrospective series, infliximab, adalimumab and vedolizumab have demonstrated efficacy in chronic antibiotic-refractory pouchitis. Here, we report single-centre data of all biological therapies in refractory pouchitis. Methods:We retrospectively assessed all records from patients with ulcerative colitis and ileal pouch -anal anastomosis who received infliximab, adalimumab or vedolizumab for pouchitis. Clinically relevant remission, defined as a modified Pouchitis Disease Activity Index?<5 and a reduction of modified Pouchitis Disease Activity Index ?2 points from baseline, was assessed at week 14. Results:Thirty-three unique patients were identified. Prior to colectomy, patients had been exposed to cyclosporine (n?=?14), infliximab (n?=?12), adalimumab (n?=?3), and/or vedolizumab (n?=?3). All developed chronic antibiotic-refractory pouchitis, for which they received infliximab (n?=?23), adalimumab (n?=?13) or vedolizumab (n?=?15). Clinically relevant remission was observed in 43.5% of patients in the infliximab group, and in 38.5% and 60.0% in the adalimumab and vedolizumab group, respectively. In the long-term, significantly more patients continued vedolizumab compared to anti-tumour necrosis factor (anti-TNF) therapy (hazard ratio 3.0, p?=?0.04). Adverse events (mainly infusion reactions) explained 40.7% of the patients discontinuing anti-TNF therapy, whereas discontinuation of vedolizumab was only related to insufficient efficacy. Four patients eventually required a permanent ileostomy. Conclusion:In this case series of chronic antibiotic-refractory pouchitis, biological therapy was effective in the majority of patients and only a minority eventually required a permanent ileostomy. The use of anti-TNF agents was hampered by a high rate of adverse events, partly related to immunogenicity as some patients had been exposed to anti-TNF prior to colectomy. Vedolizumab was also efficacious and may provide a safe alternative in these chronic antibiotic-refractory pouchitis patients.

Dataset Information

Antibiotics and probiotics in chronic pouchitis: a comparative proteomic approach.

Publications

Antibiotics and probiotics in chronic pouchitis: a comparative proteomic approach.

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