Impact of biological treatment on intestinal microbiom in children with Crohn’s disease

Crohn’s disease (CD) is a chronic, inflammatory illness of the digestive tract, characterized by alternating periods of remission and recurrence. The pathogenesis of CD is still unclear but probably is a result of a complex interaction between immunological, genetic and microbiological disorders. In recent years, there has been an increasing extent of evidence that gut microbiota plays a very important role in the pathogenesis of CD. Currently, the most effective treatment is biological therapy using anti-TNF monoclonal antibodies. It is interesting whether biological drugs resulting in fast remission, contributes to the normalization of the gut microbiota. Due to the fact that the children’s population is a significant percentage of all patients with CD, it is important to pay close attention to the problem of microbiological disorders in this age group. The aim of this study was to investigate whether there are quantitative changes of chosen bacteria species and fungi of the genus Candida in children with Crohn's disease relative to healthy children and assesment of quantitative changes in patients after biological treatment. In the group of children with Crohn’s disease, the numbers in Candida were significantly higher (9.74×1017 CFU/g) than in the control group (9.35×1010 CFU/g, p = 0.011). Biological therapy led to a significant reduction in the amount Candida (5.91×1011) and was comparable with the number in the control group. In the case of bacteria, we observed an increase in S. marcescens (3,4×108) in the patients group compared to the controls (1,85×108) and an increase in L. fermentum (2,34×1010) in relation to healthy children (3,31×108, p = 0,048) Biological treatment had an impact on the decrease in L. fermentum (4,76×109, p = 0.05).