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. 2015 Jun 1;3:23.
doi: 10.1186/s40168-015-0085-6. eCollection 2015.

Inflammation-associated Microbiota in Pediatric Eosinophilic Esophagitis

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Free PMC article

Inflammation-associated Microbiota in Pediatric Eosinophilic Esophagitis

Alain J Benitez et al. Microbiome. .
Free PMC article

Abstract

Background: Eosinophilic esophagitis (EoE) is an allergic disorder characterized by eosinophil-predominant esophageal inflammation, which can be ameliorated by food antigen restriction. Though recent studies suggest that changes in dietary composition may alter the distal gut microbiome, little is currently known about the impact of a restricted diet upon microbial communities of the oral and esophageal microenvironments in the context of EoE. We hypothesize that the oral and esophageal microbiomes of EoE patients are distinct from non-EoE controls, that these differences correspond to changes in esophageal inflammation, and that targeted therapeutic dietary intervention may influence community structure. Using 16S rRNA gene sequencing, we characterized the bacterial composition of the oral and esophageal microenvironments using oral swabs and esophageal biopsies from 35 non-EoE pediatric controls and compared this cohort to samples from 33 pediatric EoE subjects studied in a longitudinal fashion before and after defined dietary changes.

Results: Firmicutes were more abundant in esophageal samples compared to oral. Proportions of bacterial communities were significantly different comparing all EoE esophageal microbiota to non-EoE controls, with enrichment of Proteobacteria, including Neisseria and Corynebacterium in the EoE cohort, and predominance of the Firmicutes in non-EoE control subjects. We detected a statistically significant difference between actively inflamed EoE biopsies and non-EoE controls. Overall, though targeted dietary intervention did not lead to significant differences in either oral or esophageal microbiota, reintroduction of highly allergenic foods led to enrichment in Ganulicatella and Campylobacter genera in the esophagus.

Conclusions: In conclusion, the esophageal microbiome in EoE is distinct from that of non-EoE controls, with maximal differences observed during active allergic inflammation.

Figures

Figure 1
Figure 1
Flow chart of the experimental design.
Figure 2
Figure 2
Heatmap of esophageal and oral microbiome. Each column corresponds to a specific sample, each row to a type of bacteria identified in the sequence data. The proportions that each lineage contributed to the full population within each sample are indicated with the color scale to the right of the figure (values from 0 to 1). Metadata is color-coded at the top, including site sampled, disease status, and number of eos/hpf (eosinophils per high power field) reported in the biopsies at the time of endoscopy. Time-points: Samples were obtained at single time-points in non-EoE controls (C.T1), and EoE subjects had two separate sample collections (first: E.T1, second: E.T2).
Figure 3
Figure 3
Comparison of lineages enriched in EoE (28) versus non-EoE control (31) esophageal samples using LEfSe. (A) Comparison of active EoE (21) versus non-EoE control (31). (B) Comparison of inactive EoE (20) versus non-EoE control (31). The “denovo” indication shows the OTU number.
Figure 4
Figure 4
Relative abundance plots for Neisseria (A) and Corynebacterium (B) in active EoE samples compared to non-EoE controls.
Figure 5
Figure 5
Comparison of lineages enriched under different diet regimens. D = addition of food from the six-food elimination diet (SFED) (10); OD = open diet (4); RD = restricted diet (13); d = removal of food from the SFED (7).
Figure 6
Figure 6
Relative abundance for Granulicatella (A) and Campylobacter (B) in non-EoE controls and subjects before (RD) and after (D) addition of food from the SFED.

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References

    1. Muir AB, Lim DM, Benitez AJ, Modayur Chandramouleeswaran P, Lee AJ, Ruchelli ED, et al. Esophageal epithelial and mesenchymal cross-talk leads to features of epithelial to mesenchymal transition in vitro. Exp Cell Res. 2013;319(6):850–9. doi: 10.1016/j.yexcr.2012.12.002. - DOI - PMC - PubMed
    1. Liacouras CA, Furuta GT, Hirano I, Atkins D, Attwood SE, Bonis PA, et al. Eosinophilic esophagitis: updated consensus recommendations for children and adults. J Allergy Clin Immunol. 2011;128(1):3–20. doi: 10.1016/j.jaci.2011.02.040. - DOI - PubMed
    1. Kelly KJ, Lazenby AJ, Rowe PC, Yardley JH, Perman JA, Sampson HA. Eosinophilic esophagitis attributed to gastroesophageal reflux: improvement with an amino acid-based formula. Gastroenterology. 1995;109(5):1503–12. doi: 10.1016/0016-5085(95)90637-1. - DOI - PubMed
    1. Spergel JM, Brown-Whitehorn T, Beausoleil JL, Shuker M, Liacouras CA. Predictive values for skin prick test and atopy patch test for eosinophilic esophagitis. J Allergy Clin Immunol. 2007;119(2):509–11. doi: 10.1016/j.jaci.2006.11.016. - DOI - PubMed
    1. Gonsalves N, Kagalwalla AF. Dietary treatment of eosinophilic esophagitis. Gastroenterol Clin North Am. 2014;43(2):375–83. doi: 10.1016/j.gtc.2014.02.011. - DOI - PubMed

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