Adherent-invasive Escherichia coli in inflammatory bowel disease

Gut. 2018 Mar;67(3):574-587. doi: 10.1136/gutjnl-2017-314903. Epub 2017 Nov 15.

Abstract

Intestinal microbiome dysbiosis has been consistently described in patients with IBD. In the last decades, Escherichia coli, and the adherent-invasive E coli (AIEC) pathotype in particular, has been implicated in the pathogenesis of IBD. Since the discovery of AIEC, two decades ago, progress has been made in unravelling these bacteria characteristics and its interaction with the gut immune system. The mechanisms of adhesion of AIEC to intestinal epithelial cells (via FimH and cell adhesion molecule 6) and its ability to escape autophagy when inside macrophages are reviewed here. We also explore the existing data on the prevalence of AIEC in patients with Crohn's disease and UC, and the association between the presence of AIEC and disease location, activity and postoperative recurrence. Finally, we highlight potential therapeutic strategies targeting AIEC colonisation of gut mucosa, including the use of phage therapy, bacteriocins and antiadhesive molecules. These strategies may open new avenues for the prevention and treatment of IBD in the future.

Keywords: bacterial adherence; chronic ulcerative colitis; crohn’s disease; e. coli; inflammatory bowel disease.

Publication types

  • Review

MeSH terms

  • Adhesins, Escherichia coli / metabolism
  • Antigens, CD / metabolism
  • Bacterial Adhesion
  • Cell Adhesion Molecules / metabolism
  • Epithelial Cells / immunology
  • Epithelial Cells / metabolism
  • Escherichia coli / immunology*
  • Escherichia coli / physiology
  • Escherichia coli Infections / epidemiology
  • Escherichia coli Infections / immunology*
  • Escherichia coli Infections / therapy*
  • Fimbriae Proteins / metabolism
  • GPI-Linked Proteins / metabolism
  • Gastrointestinal Tract / immunology
  • Humans
  • Immunity, Innate / genetics
  • Immunity, Mucosal
  • Inflammatory Bowel Diseases / epidemiology
  • Inflammatory Bowel Diseases / genetics
  • Inflammatory Bowel Diseases / microbiology*
  • Inflammatory Bowel Diseases / therapy*
  • Macrophages / immunology

Substances

  • Adhesins, Escherichia coli
  • Antigens, CD
  • CEACAM6 protein, human
  • Cell Adhesion Molecules
  • GPI-Linked Proteins
  • fimH protein, E coli
  • Fimbriae Proteins