炎症性腸疾患の初期段階における腸内細菌の変化を発見(Gut bacteria changes at the earliest stages of inflammatory bowel disease)

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2025-12-23 バーミンガム大学

英国バーミンガム大学の国際共同研究チームは、炎症性腸疾患(IBD)(クローン病・潰瘍性大腸炎)のごく初期段階における腸内細菌の変化を初めて大規模に解析し、重要な知見を得た。治療開始前の診断直後の患者1,700人以上の腸内微生物データを統合した解析で、健康な腸内で豊富な嫌気性の有益細菌が急減し、その代わりに口腔由来で酸素耐性の細菌が増加する共通パターンを発見した。これらの変化は腸粘膜の酸素レベル上昇を反映しており、「酸素仮説」を支持するものである。酸素耐性菌の増加は腸内環境の乱れと炎症を促進しうると考えられ、こうした早期の微生物シフトに基づいた早期診断法や治療標的の開発が期待される。国際共同データ分析は年齢層・地域差・検体タイプ間の違いも明らかにし、腸内微生物叢研究の標準化の重要性も示している。

炎症性腸疾患の初期段階における腸内細菌の変化を発見(Gut bacteria changes at the earliest stages of inflammatory bowel disease)

<関連情報>

炎症性腸疾患発症時の腸内マイクロバイオーム:系統的レビューと統合バイオインフォマティクス合成 The Gut Microbiome at the Onset of Inflammatory Bowel Disease: A Systematic Review and Unified Bioinformatic Synthesis

Peter Rimmer ∙ Fan Zhang ∙ Gregor Scott ∙ … ∙ Morris Gordon ∙ Tariq H. Iqbal ∙ Richard Hansen …
Gastroenterology  Published:December 23, 2025
DOI:https://doi.org/10.1053/j.gastro.2025.09.014

Abstract

Background & Aims

Few studies describe gut microbiome signatures in treatment-naïve new-onset inflammatory bowel disease (IBD). We present a novel secondary bioinformatic reanalysis of sequence outputs mapped to the latest microbial taxonomy.

Methods

MEDLINE and Embase searches were performed for microbiome studies in treatment-naïve IBD. Appraisal was completed with Risk Of Bias In Non-randomized Studies – of Exposures (ROBINS-E). Available 16S ribosomal RNA sequence data sets were downloaded and missing data sets requested. Integrated data were run through a unified QIIME2 bioinformatics pipeline. Multivariable models adjusting for methodologic differences were developed using MaAsLin2.

Results

There were 36 eligible studies; 18 contributed to bioinformatic reanalysis and 24 to supplementary meta-analysis. Samples from 1743 patients were included, comprising 678 from individuals with Crohn’s disease (CD), 399 with ulcerative colitis (UC), 130 healthy controls (HCs), and 405 symptomatic controls (SCs); 990 of which were biopsy samples. Alpha diversity was reduced: feces-pediatric UC vs SCs, adult CD and UC vs HCs, and pediatric SCs vs HCs; pediatric biopsy samples-CD vs SCs, CD vs UC, and UC vs SCs. Beta diversity demonstrated clear distinctions between fecal and mucosal biopsy communities, least evident in UC, in addition to community separation by geography. Multivariate modeling revealed depletion of anaerobic and enrichment of aerobic and facultative anaerobic bacteria, alongside enrichment of oral genera across both CD and UC.

Conclusions

Core microbial perturbations at onset of CD and UC are depletion of anaerobes and enrichment of oxygen-tolerant, orally associated bacteria. As we place greater emphasis on early diagnosis and prediction of IBD risk, this finding may support innovative diagnostic approaches. Microbiome-targeted intervention and alteration of luminal oxygen availability may offer novel therapeutic avenues for new-onset patients and identified high-risk groups.

医療・健康
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