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Cited by 324

The DOI matches its Crossref record; 10 of the 10 references it cites were found in a registry or an index.

Oral versus intravenous iron replacement therapy distinctly alters the gut microbiota and metabolome in patients with IBD

Open access
Lee, Thomas, Clavel, Thomas, Smirnov, Kirill, Schmidt, Annemarie, Lagkouvardos, Ilias, Walker, Alesia, Lucio, Marianna, Michalke, Bernhard, Schmitt-Kopplin, Philippe, Fedorak, Richard, Haller, Dirk·2017·Gut
DOI 10.1136/gutjnl-2015-309940
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Abstract

Objective: Iron deficiency is a common complication in patients with IBD and oral iron therapy is suggested to exacerbate IBD symptoms. We performed an open-labelled clinical trial to compare the effects of per oral (PO) versus intravenous (IV) iron replacement therapy (IRT). Design: The study population included patients with Crohn's disease (CD; N=31), UC (N=22) and control subjects with iron deficiency (non-inflamed, NI=19). After randomisation, participants received iron sulfate (PO) or iron sucrose (IV) over 3 months. Clinical parameters, faecal bacterial communities and metabolomes were assessed before and after intervention. Results: Both PO and IV treatments ameliorated iron deficiency, but higher ferritin levels were observed with IV. Changes in disease activity were independent of iron treatment types. Faecal samples in IBD were characterised by marked interindividual differences, lower phylotype richness and proportions of Clostridiales. Metabolite analysis also showed separation of both UC and CD from control anaemic participants. Major shifts in bacterial diversity occurred in approximately half of all participants after IRT, but patients with CD were most susceptible. Despite individual-specific changes in phylotypes due to IRT, PO treatment was associated with decreased abundances of operational taxonomic units assigned to the species Faecalibacterium prausnitzii , Ruminococcus bromii , Dorea sp. and Collinsella aerofaciens . Clear IV-specific and PO-specific fingerprints were evident at the level of metabolomes, with changes affecting cholesterol-derived host substrates. Conclusions: Shifts in gut bacterial diversity and composition associated with iron treatment are pronounced in IBD participants. Despite similar clinical outcome, oral administration differentially affects bacterial phylotypes and faecal metabolites compared with IV therapy. Trial registration number: clinicaltrial.gov ( NCT01067547 ).

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Cited by

Metadata

Authors
Lee, T., Clavel, T., Smirnov, K., Schmidt, A., Lagkouvardos, I., Walker, A., Lucio, M., Michalke, B., Schmitt-Kopplin, P., Fedorak, R., & Haller, D.
Venue
Gut
Publisher
BMJ
Published
2016-02-04
Volume
66
Issue
5
Pages
863-871
ISSN
  • 0017-5749 (ISSN-L)
  • 1468-3288
DOI
10.1136/gutjnl-2015-309940
OpenAlex
W2253470142
Cited by
324
References
10
FWCI
14.90
Type
journal article
Language
en
Open access
hybrid

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