P870 Faecal microbiota in treatment-naive ulcerative colitis and its relation to treatment escalation
Bibliographic record
Abstract
Ulcerative colitis (UC) is a chronic inflammatory disease affecting the large intestine. The disease course varies from an indolent disease to an aggressive disease, requiring early introduction of biologics and colectomy in treatment refractory individuals. There is a clinical need of biomarkers that can be used to predict the future disease course already at diagnosis. Microbiota signatures might be of help in this respect and could potentially become a tool for the implementation of personalised medicine. Fecal samples were collected at diagnosis from 47 treatment-naïve UC patients in the IBD-character cohort. Extent of inflammation was defined according to the Montreal classification. Fecal microbiota composition was assessed using the GA-map™ Dysbiosis Test [Casén et al., 2015] Patients were followed prospectively for up to 5 years and information on treatment escalation and surgery was collected. Patients were categorised into two groups based on need of treatment escalation, defined as introduction of biologics and/or colectomy during the study period. Differences between groups were compared by using the Wilcoxon test. Among 47 UC patients, 38 (81%) were classified as dysbiotic (12 mild and 26 severe). A total of 6 (13%) patients required treatment escalation. Patients with extensive colitis (E3) seemed to be more likely to require treatment escalation than patients with left-sided colitis (E2) or proctitis (E1) [OR = 4.8, 95% CI (0.78–30.0); p = 0.09)]. No significant association was found between the severity of dysbiosis and treatment escalation during follow-up (p > 0.05). The total abundance of bacteria (p = 0.008) as well as the abundance of Ruminococcus gnavus (p = 0.03), Lactobacillus spp. (p = 0.03), Mycoplasma hominis (p = 0.04), and Streptococcus spp. (p = 0.04) was significantly lower in patients who required treatment escalation compared with patients who did not require escalation (p = 0.008). Decreased abundance of Ruminococcus gnavus, Lactobacillus spp., Mycoplasma hominis, and Streptococcus spp. at diagnosis of UC seems to be associated with a more aggressive disease, requiring the introduction of biological therapies or colectomy.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".