Role of Intestinal Microbiota in Ulcerative Colitis

Role of Intestinal Microbiota in Ulcerative Colitis Role of Intestinal Microbiota in Ulcerative Colitis

05.02.2013 Views

depending the level of disease activity. Finally, and for the first time, the prevalences of seven selected species of Bifidobacterium in healthy controls and UC patients were under study. Denaturing Gradient Gel Electrophoresis (DGGE) and quantitative PCR (qPCR), both of which are culture‐independent methods, were applied. Although not generating data as extensive as the costly metagenomic‐analysis [41], these methods have recently proven very useful for analyzing the qualitative and quantitative diversity of human fecal microbial communities [8,56]. Additionally, qPCR is a useful tool for quantifying very low concentrations of bacterial targets [56,60]. The primers chosen for qPCR analysis targeted a broad range of selected bacteria taxa, presumed to play a role in the homeostasis of the colonic microbial ecosystem. Our finding should help elucidate compositional differences in the fecal microbiota in patients with ulcerative colitis and in healthy controls. Methods Subjects and fecal sampling Fecal samples were obtained from 12 patients with UC and 6 healthy controls. Within the UC group, 6 patients were in clinical remission and 6 patients had active disease at the time of sampling according to clinical and endoscopical criteria [6]. The patients were previously diagnosed with UC according to standardised diagnostic criteria at the Department of Gastroenterology, Herlev Hospital [26]. The study was performed in accordance with the Second Helsinki Declaration, reported to the Danish Data Protection Agency and approved by the Regional Ethics Committee. Written, informed consent was obtained from each participant under a protocol approved by the Danish National Committee on Biomedical Research Ethics. Four of 6 patients with inactive UC received maintenance treatment with oral mesalazine in a dosage of 1.6‐ 2.4 gram daily and one also azathioprine 100 mg daily. One patient received oral olsalazine (1 gram daily) and one no treatment. All six patients with active UC were treated with oral mesalazine in a dosage of 2.4‐3.2 gram daily as well as topical mesalazine 1 gram daily either as an enema (n = 5) or as a suppository (n = 1). One patient also received azathioprine 100 mg daily. One patient had active extensive UC, one left sided colitis, and the rest either active proctitis or proctosigmoiditis. None of the participants had been treated with antibiotics for at least 2 months 4

efore enrolment and there was no significant difference (P > 0.10) in the mean age of the participants comparing the 3 groups. Sample collection and processing The stool samples were collected at home by the participants in airtight containers and kept at 4 °C (limited storage time was encouraged [35] ) until delivery to the laboratory, where they were processed immediately. 200 mg wet weight feces were collected in triplicates in the middle of each stool sample for DNA extraction. Extraction of bacterial DNA from fecal samples DNA was extracted from the feces samples using the QIAamp DNA Stool Mini Kit (Qiagen, Hilden, Germany) with an added bead‐beater step as described previously [28]. The purified DNA was stored at – 20 °C until use. PCR amplification for DGGE Aliquots (10 μL) of purified DNA were applied to the following to give a 50 μL PCR reaction mixture: 20 μL of 5 PRIME MasterMix (2.5×) (VWR & Bie & Berntsen) and 10 pmol of each of the primers (Eurofins MWG Synthesis GmbH, Ebersberg, Germany). Universal bacterial primers HDA1‐ GC/HDA2 [55] targeting 16S rRNA genes were used in a touchdown PCR. Initial denaturation was at 96 °C for 5 min, amplification was carried out using 20 cycles including denaturation at 94 °C for 1 min, annealing at 65°C for 1 min decreased by 0.5°C for each cycle, and extension at 72°C for 1 min. This was followed by additional 5 cycles of denaturation at 94°C for 1 min, annealing at 55°C for 1 min, extension at 72°C for 1 min, and a final extension at 72°C for 5 min. Analysis of fecal microbiota by DGGE DGGE was carried out as described previously [5] using a DcodeTM Universal Mutation Detection System instrument and gradient former model 475 according to the manufacturer’s instructions (Bio‐Rad Labs, Hercules, California). The 9% polyamidegels were made with denaturing gradients ranging from 25% to 65%. The 100% denaturant solution contained 40% formamide and 7M urea. Thirteen microlitres PCR products were mixed with 3 µL loading dye before loading. Gels were run 5

efore enrolment and there was no significant difference (P > 0.10) <strong>in</strong> the mean age <strong>of</strong> the<br />

participants compar<strong>in</strong>g the 3 groups.<br />

Sample collection and process<strong>in</strong>g<br />

The stool samples were collected at home by the participants <strong>in</strong> airtight conta<strong>in</strong>ers and kept at 4<br />

°C (limited storage time was encouraged [35] ) until delivery to the laboratory, where they were<br />

processed immediately. 200 mg wet weight feces were collected <strong>in</strong> triplicates <strong>in</strong> the middle <strong>of</strong><br />

each stool sample for DNA extraction.<br />

Extraction <strong>of</strong> bacterial DNA from fecal samples<br />

DNA was extracted from the feces samples us<strong>in</strong>g the QIAamp DNA Stool M<strong>in</strong>i Kit (Qiagen, Hilden,<br />

Germany) with an added bead‐beater step as described previously [28]. The purified DNA was<br />

stored at – 20 °C until use.<br />

PCR amplification for DGGE<br />

Aliquots (10 μL) <strong>of</strong> purified DNA were applied to the follow<strong>in</strong>g to give a 50 μL PCR reaction<br />

mixture: 20 μL <strong>of</strong> 5 PRIME MasterMix (2.5×) (VWR & Bie & Berntsen) and 10 pmol <strong>of</strong> each <strong>of</strong> the<br />

primers (Eur<strong>of</strong><strong>in</strong>s MWG Synthesis GmbH, Ebersberg, Germany). Universal bacterial primers HDA1‐<br />

GC/HDA2 [55] target<strong>in</strong>g 16S rRNA genes were used <strong>in</strong> a touchdown PCR. Initial denaturation was<br />

at 96 °C for 5 m<strong>in</strong>, amplification was carried out us<strong>in</strong>g 20 cycles <strong>in</strong>clud<strong>in</strong>g denaturation at 94 °C for<br />

1 m<strong>in</strong>, anneal<strong>in</strong>g at 65°C for 1 m<strong>in</strong> decreased by 0.5°C for each cycle, and extension at 72°C for 1<br />

m<strong>in</strong>. This was followed by additional 5 cycles <strong>of</strong> denaturation at 94°C for 1 m<strong>in</strong>, anneal<strong>in</strong>g at 55°C<br />

for 1 m<strong>in</strong>, extension at 72°C for 1 m<strong>in</strong>, and a f<strong>in</strong>al extension at 72°C for 5 m<strong>in</strong>.<br />

Analysis <strong>of</strong> fecal microbiota by DGGE<br />

DGGE was carried out as described previously [5] us<strong>in</strong>g a DcodeTM Universal Mutation Detection<br />

System <strong>in</strong>strument and gradient former model 475 accord<strong>in</strong>g to the manufacturer’s <strong>in</strong>structions<br />

(Bio‐Rad Labs, Hercules, California). The 9% polyamidegels were made with denatur<strong>in</strong>g gradients<br />

rang<strong>in</strong>g from 25% to 65%. The 100% denaturant solution conta<strong>in</strong>ed 40% formamide and 7M urea.<br />

Thirteen microlitres PCR products were mixed with 3 µL load<strong>in</strong>g dye before load<strong>in</strong>g. Gels were run<br />

5

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