Role of Intestinal Microbiota in Ulcerative Colitis

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Methodology part Paper 3 Introduction The aim of this study was to examine potential prebiotic properties of arabino‐oligosaccharides from sugar beet pulp using mixed cultures of human fecal bacteria from healthy subjects, and UC patients in either remission or relapse in a small scale in vitro model. Flow diagram The author, Louise K. Vigsnæs, participated in the design of the study, conducted the experiments, performed the data analyzes and drafted the manuscript. 98
APPLIED AND ENVIRONMENTAL MICROBIOLOGY, Dec. 2011, p. 8336–8344 Vol. 77, No. 23 0099-2240/11/$12.00 doi:10.1128/AEM.05895-11 Copyright © 2011, American Society for Microbiology. All Rights Reserved. In Vitro Fermentation of Sugar Beet Arabino-Oligosaccharides by Fecal Microbiota Obtained from Patients with Ulcerative Colitis To Selectively Stimulate the Growth of Bifidobacterium spp. and Lactobacillus spp. � † Louise Kristine Vigsnæs, 1 * Jesper Holck, 2 Anne S. Meyer, 2 and Tine Rask Licht 1 National Food Institute, Technical University of Denmark, Mørkhøj Bygade 19, 2860 Søborg, Denmark, 1 and Department of Chemical and Biochemical Engineering, Technical University of Denmark, 2800 Kgs. Lyngby, Denmark 2 Received 19 June 2011/Accepted 24 September 2011 The potential prebiotic properties of arabino-oligosaccharides (AOS) derived from sugar beet pulp was studied using mixed cultures of human fecal bacteria from patients with ulcerative colitis (UC), in remission or with active disease, and in healthy controls. These results were compared to those for fructo-oligosaccharides (FOS), which are known to have a prebiotic effect. Fermentation studies were carried out using a small-scale static batch system, and changes in the fecal microbial communities and metabolites were monitored after 24 h by quantitative real-time PCR and short-chain fatty acid analysis. With a few minor exceptions, AOS affected the communities similarly to what was seen for FOS. Quantitative real-time PCR revealed that Bifidobacterium spp. and Lactobacillus spp. were selectively increased after fermentation of AOS or FOS by fecal microbiota derived from UC patients. The stimulation of growth of Lactobacillus spp. and Bifidobacterium spp. was accompanied by a high production of acetate and hence a decrease of pH. The fermentation of AOS may help improve the inflammatory conditions in UC patients through stimulation of bacteria eliciting antiinflammatory responses and through production of acetate. AOS may therefore represent a new prebiotic candidate for reduction of the risk of flare-ups in UC patients. However, human trials are needed to confirm a health-promoting effect. During the twentieth century a significant increase in the incidence of inflammatory bowel diseases has occurred in Western Europe and North America (33). Ulcerative colitis (UC) is an idiopathic inflammatory bowel disease characterized by chronic inflammation of the colonic mucosa. UC is usually associated with chronic remissions, which are periods in which patients are completely symptom free, and relapse periods, characterized by diarrhea with passage of blood or mucus, occasional abdominal cramping, and pain as well as, in severe cases, systemic symptoms, including fever and weight loss (3, 4). The etiology of inflammatory bowel disease remains unclear, and no causal infectious agent has been identified. The commensal bacterial intestinal community represents the environmental factor most frequently implicated in the development of UC (4, 60). Evidence for this implication is provided by the complete lack of enterocolitis in genetically engineered germfree mice, rats, and guinea pigs, which reproducibly develop intestinal inflammation within 1 to 4 weeks if they are colonized with conventional gut bacteria (61). Thus, a dysbiosis in the composition of the gut microbiota may influence key mechanisms involved in the inflammatory process of the intestinal mucosa (4, 21, 60). Earlier studies have shown differences between the intestinal microbiotas of UC patients and those of * Corresponding author. Mailing address: National Food Institute, Technical University of Denmark, Mørkhøj Bygade 19, 2860 Søborg, Denmark. Phone: 45 35 88 70 24. Fax: 45 35 88 70 28. E-mail: lokv @food.dtu.dk. † Supplemental material for this article may be found at http://aem .asm.org/. � Published ahead of print on 7 October 2011. 8336 healthy subjects (45, 64). In particular, the patients with UC in relapse are reported to have a small amount of bifidobacteria (64) and we have observed that the prevalence of lactobacilli in UC patients is also low compared to that in healthy subjects (L. K. Vigsnæs et al., submitted for publication). Bifidobacteria and lactobacilli are believed to play an important role in maintaining intestinal health due to their effect on maturation and balancing of the immune system (43, 59, 71) and to their inhibition of pathogens (8, 17, 53). Hence, an underrepresentation of bifidobacteria and lactobacilli may compromise the colon health and contribute to a higher risk of flare-up in patients with UC. Maintenance of a healthy gut microbiota and homeostasis can be promoted by the consumption of indigestible carbohydrates or dietary fibers (11, 27, 37). However, a sufficient fiber intake is required for the desired effect (14). Prebiotics are defined as “selectively fermented ingredients that cause specific changes in composition and/or activity in the gastointestinal microbiota, which confer benefits upon host well-being and health” (47). The selective stimulation of specific colonic bacteria is explained by the capability of these bacteria to break down the glycosidic linkages in the prebiotic carbohydrates. These bacteria are able to grow on particular carbon sources, which are less easily fermented by other members of the intestinal community. This provides them with a selective advantage when competing with other bacterial species in a mixed bacterial community such as the human colon (58). Thus, the monosaccharide composition, glycosidic linkage, and length of the prebiotics contribute to the relative increase of beneficial bacteria, including bifidobacteria and lactobacilli (29, 46, 57). Metabolites produced by bacterial Downloaded from http://aem.asm.org/ on November 28, 2011 by guest
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Role of Intestinal Microbiota in Ul
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Role of Intestinal Microbiota in Ul
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Preface Preface This thesis present
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Summary Summary The microbiota of t
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Dansk sammendrag Dansk sammendrag M
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Introduction and objectives Introdu
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List of Manuscripts Not included in
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List of contents List of Centents P
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List of Centents Methodology append
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1. The intestinal environment Theor
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Theoretical part 5 1. The intestina
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2. The colonic environment Theoreti
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Theoretical part 9 2. The colonic e
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Table 1: The presence of glycoside
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Theoretical part Figure 3: The colo
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3. Inflammatory Bowel disease Theor
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Theoretical part 17 3. Inflammatory
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Theoretical part 19 4. Modulation o
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Table 4: Clinical trials on the pre
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Theoretical part 5. Production of p
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Methodology part
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Methodology part 6. Methodology, co
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Introduction Methodology part 42 Pa
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Abstract Background Detailed knowle
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depending the level of disease acti
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Page 74 and 75: Acknowledgements The authors thank
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Page 91 and 92: Introduction The mucus layer lining
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Page 103 and 104: Table 1 ‐ 16S rRNA gene of phylum
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Methodology part 150
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Methodology part 152 Appendix 1 hor
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Appendix 3 Methodology part Appendi
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Methodology part 156 Appendix 3
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7. Discussion and perspectives Disc
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Discussion and conclusion 161 7. Di
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References References Abreu,M.T., V
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References Derrien,M., Vaughan,E.E.
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References Haarman,M. and Knol,J. (
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References Lantz,P.G., Matsson,M.,
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References Matsuki,T., Watanabe,K.,
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References Pullan,R.D., Thomas,G.A.
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References Tannock,G.W. (2010). Ana
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National Food Institute Technical U
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Role of Intestinal Microbiota in Ulcerative Colitis

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