Evidence of Disturbed Gut Microbial Metabolic Activity in Pediatric Crohn’s Disease

Abstract

Abstract Background Dysbiosis, that is, disturbed gut microbial balance, is well documented in Crohn’s disease (CD). We aimed at studying CD-linked dysbiosis in children by analyzing fecal microbe-associated characteristics, previously not reported in children. Methods This observational study included 28 children with active CD and healthy controls. We assessed the following three indicators of gut microbiota metabolism in the feces: the presence of tryptic activity, the conversion of cholesterol to coprostanol, and the conversion of bilirubin to urobilinogen. Results The fecal tryptic activity was significantly higher in children with active CD compared to the control group (P < 0.01). The fecal coprostanol of the CD children was close to zero and differed significantly from the controls (P < 0.001). Furthermore, the children with CD had very low fecal urobilinogen, differing significantly from the control group (P < 0.001). Conclusions The significant differences in levels of fecal bacterial metabolites in patients with active CD compared to healthy controls reflect major perturbation of gut microbial functions and have not previously been reported in children. This fits well with the prevailing concept of a dysbiotic gut microbiota in CD and may have important clinical implications by bringing the dysbiosis back into balance.