OP22 Crohn’s disease exclusion diet reduces bacterial dysbiosis towards healthy controls in paediatric Crohn’s disease
Bibliographic record
Abstract
Abstract Background Dietary therapy with the Crohn’s disease Exclusion Diet (CDED) or Exclusive Enteral Nutrition (EEN) induces remission, reduces inflammation and is associated with compositional changes in the microbiome. We performed metagenome analysis to elucidate whether diet induces remission via correction of dysbiosis and/or community structure. Methods Whole metagenome and 16S rDNA sequences were obtained in 178 samples from 70 participants at 3 time points (baseline, week 6, week 12) from the two study groups (CDED+PEN/EEN). For metagenome analysis, we divided the groups further into samples of patients achieving ITT-remission at week 6 (CDED+PEN: 31/38 and EEN: 23/32) and those who did not. Results Dietary therapy decreased the relative abundance of genera from Proteobacteria towards healthy controls. CDED+PEN remission is associated with a significant increase (p < .05) in Clostridiales, and a significant decrease (p < .05) in Proteobacteria (particularly Γproteobacteria). Microbiome comparison of all baseline CD samples with healthy controls showed significant (p < .05) increases in Proteobacteria in an active CD at baseline. Healthy controls had increased Firmicutes species notably Roseburia, Oscillibacter and Anaerostipes, as well as increased Bacteroides and Ascomycota (driven by Saccharomyces). Proteobacteria decreased when diet-induced remission was achieved (with either CDED+PEN or EEN) at week 6: relative abundance of Proteobacteria (including Α- and Γproteobacteria (e.g. Escherichia, Klebsiella and Citrobacter) were significantly lower compared with baseline but were still more abundant in CD patients, whereas Bacilli and Firmicutes remained more predominant in healthy samples. Continued dietary treatment with CDED+PEN between week 6 and week 12 was associated with a further decrease in Proteobacteria: although improving with dietary treatment, only Escherichia remained more abundant in CD. Faecalibacterium became more abundant in CD by week 12, as did Blautia and Sutterella. Anaerostipes, Ruminococcus, Bacilli, Porphyromonadaceae, Bifidobacteriales, Ascomycota and Caudovirales were more abundant in healthy samples compared with week 12 of CDED+PEN. Bayesian analysis of the 16S rDNA data training on patients in remission at week 6 compared with baseline (week 0) samples identified seven assemblages. Predominate taxa identified in these assemblages (Posterior Probability >.01) are shown as a connected network, with taxa (nodes) found in the same assemblage connected to each other by edges (Figures). Conclusion Dietary therapy corrected dysbiosis towards healthy controls. Sustained dietary therapy beyond 6 weeks with CDED+PEN avoids the ‘rebound’ in disease-associated species, notably Proteobacteria, when the oral diet is reintroduced.
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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 | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 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".