Fungal dysbiosis predicts the diagnosis of pediatric Crohn's disease

AIM: To investigate the accuracy of fungal dysbiosis in mucosa and stool for predicting the diagnosis of Crohn’s disease (CD). METHODS: Children were prospectively enrolled in two medical centers: one university hospital and one private gastroenterology clinic in the city of Riyadh, Kingdom of Saudi Arabia. The children with confirmed diagnosis of CD by standard guidelines were considered cases, and the others were considered non-inflammatory bowel disease controls. Mucosal and stool samples were sequenced utilizing Illumina MiSeq chemistry following the manufacturer’s protocols, and abundance and diversity of fungal taxa in mucosa and stool were analyzed. Sparse logistic regression was used to predict the diagnosis of CD. The accuracy of the classifier was tested by computing the receiver operating characteristic curves with 5-fold stratified cross-validation under 100 permutations of the training data partition and the mean area under the curve (AUC) was calculated. RESULTS: All the children were Saudi nationals. There were 15 children with CD and 20 controls. The mean age was 13.9 (range: 6.7-17.8) years for CD children and 13.9 (3.25-18.6) years for controls, and 10/15 (67%) of the CD and 13/20 (65%) of the control subjects were boys. CD locations at diagnosis were ileal (L1) in 4 and colonic (L3) in 11 children, while CD behavior was non-stricturing and non-penetrating (B1) in 12 and stricturing (B2) in 3 children. The mean AUC for the fungal dysbiosis classifier was significantly higher in stools (AUC = 0.85 ± 0.057) than in mucosa (AUC = 0.71 ± 0.067) (P < 0.001). Most fungal species were significantly more depleted in stools than mucosal samples, except for Saccharomyces cerevisiae and S. bayanus, which were significantly more abundant. Diversity was significantly more reduced in stools than in mucosa. CONCLUSION: We found high AUC of fungal dysbiosis in fecal samples of children with CD, suggesting high accuracy in predicting diagnosis of CD. Key Words: Fungiome, Mycobiome, Crohn’s disease, Inflammation, Saudi children Core tip: We found high accuracy of fungal dysbiosis in predicting diagnosis of Crohn’s disease (CD), a finding similar to bacterial dysbiosis. However, the higher area under the curve for the fungal dysbiosis classifier in stool (0.85 ± 0.057) than in mucosa (0.71 ± 0.067) (P < 0.001), contrasts with bacterial studies, suggesting higher accuracy of stool samples. Although the clinical application of this finding is limited at present by the high cost of fungal analysis, such information is important from a scientific viewpoint, to increase the understanding of the role of fungal flora in CD and to stimulate further studies.The authors extend their appreciations to the Deanship of Scientific Research at King Saud University in Riyadh, Kingdom of Saudi Arabia for funding this work through Research Group No [RGP-1436-007]. This work was also supported by a grant from the Simons Foundation [No. 409704] to Kirill Korolev) and by the startup fund from Boston University to Kirill Korolev. Simulations were carried out on Shared Computing Cluster at Boston University. Rajita Menon was partially supported by a Hariri Graduate Fellowship from Boston University. Harland Winter, MD received support from Martin Schlaff and the Diane and Dorothy Brooks Foundation. (RGP-1436-007 - King Saud University in Riyadh, Kingdom of Saudi Arabia; 409704 - Simons Foundation; Boston University; Hariri Graduate Fellowship from Boston University; Diane and Dorothy Brooks Foundation)Published versio

MicroRNA-124 Regulates STAT3 Expression and Is Down-regulated in Colon Tissues of Pediatric Patients With Ulcerative Colitis

Background & Aims - Altered levels and functions of microRNAs (miRs) have been associated with inflammatory bowel diseases (IBDs), although little is known about their roles in pediatric IBD. We investigated whether colonic mucosal miRs are altered in children with ulcerative colitis (UC). Methods - We used a library of 316 miRs to identify those that regulate phosphorylation of STAT3 in NCM460 human colonocytes incubated with interleukin-6. Levels of miR-124 were measured by real-time PCR analysis of colon biopsies from pediatric and adult patients with UC and patients without IBD (controls), and of HCT-116 colonocytes incubated with 5-aza-2’-deoxycytidine. Methylation of the MIR124 promoter was measured by quantitative methylation-specific PCR. Results - Levels of phosphorylated STAT3 and the genes it regulates (encoding VEGF, BCL2, BCLXL, and MMP9) were increased in pediatric patients with UC, compared to control tissues. Overexpression of miR-124, let-7, miR-125, miR-26, or miR-101 reduced STAT3 phosphorylation by ≥75% in NCM460 cells; miR-124 had the greatest effect. miR-124 was downregulated specifically in colon tissues from pediatric patients with UC and directly targeted STAT3 mRNA. Levels of miR-124 were decreased whereas levels of STAT3 phosphorylation increased in colon tissues from pediatric patients with active UC, compared to those with inactive disease. Furthermore, levels of miR-124 and STAT3 were inversely correlated in mice with experimental colitis. Downregulation of miR-124 in tissues from children with UC was attributed to hypermethylation of its promoter region. Incubation of HCT-116 colonocytes with 5-aza-2’ deoxycytidine upregulated miR-124 and reduced levels of STAT3 mRNA. Conclusions - MiR-124 appears to regulate the expression of STAT3. Reduced levels of miR-124 in colon tissues of children with active UC appear to increase expression and activity of STAT3, which could promote inflammation and pathogenesis of UC in children

Multi-omics of the gut microbial ecosystem in inflammatory bowel diseases.

Inflammatory bowel diseases, which include Crohn's disease and ulcerative colitis, affect several million individuals worldwide. Crohn's disease and ulcerative colitis are complex diseases that are heterogeneous at the clinical, immunological, molecular, genetic, and microbial levels. Individual contributing factors have been the focus of extensive research. As part of the Integrative Human Microbiome Project (HMP2 or iHMP), we followed 132 subjects for one year each to generate integrated longitudinal molecular profiles of host and microbial activity during disease (up to 24 time points each; in total 2,965 stool, biopsy, and blood specimens). Here we present the results, which provide a comprehensive view of functional dysbiosis in the gut microbiome during inflammatory bowel disease activity. We demonstrate a characteristic increase in facultative anaerobes at the expense of obligate anaerobes, as well as molecular disruptions in microbial transcription (for example, among clostridia), metabolite pools (acylcarnitines, bile acids, and short-chain fatty acids), and levels of antibodies in host serum. Periods of disease activity were also marked by increases in temporal variability, with characteristic taxonomic, functional, and biochemical shifts. Finally, integrative analysis identified microbial, biochemical, and host factors central to this dysregulation. The study's infrastructure resources, results, and data, which are available through the Inflammatory Bowel Disease Multi'omics Database ( http://ibdmdb.org ), provide the most comprehensive description to date of host and microbial activities in inflammatory bowel diseases

Case 27-2011: A 17-Year-Old Boy with Abdominal Pain and Weight Loss

Pr e sen tat ion of C a se Dr. Nina Mayer (Medicine-Pediatrics): A 17-year-old boy was seen in the pediatric gastroenterology clinic of this hospital because of abdominal pain and weight loss. The patient had been well until approximately 6 weeks earlier, when intermittent crampy abdominal pain developed. Approximately 3 weeks later, nonbloody diarrhea developed and lasted for a week, associated with one episode of emesis. Thereafter, abdominal pain occurred daily, was predominantly located in the right lower quadrant, radiated to the right flank, and was associated with lower back discomfort, borborygmi, and constipation. During the fourth week of illness, after the diarrhea had resolved, the patient saw his primary care physician. Serum levels of glucose, alanine aminotransferase, and thyrotropin were normal, as were tests of renal function. Tests for tissue transglutaminase IgA antibodies, hepatitis A virus, hepatitis C virus, and the human immunodeficiency virus (HIV) were negative. Results of tests for serum antibodies to Epstein-Barr virus (EBV) were consistent with past infection; testing was positive for hepatitis B virus surface antibody and negative for hepatitis B surface antigen, indicating immunity or past infection. Other results are shown in Two weeks later, the patient was seen in the pediatric gastroenterology clinic at this hospital. He rated the abdominal pain at 5 on a scale of 0 to 10, with 10 indicating the most severe pain. He reported one bowel movement of hard stool daily, and one episode of blood streaking on the stool after straining, with no mucus. He reported that he had lost 18.2 kg during the previous 2 years. The first 11 to 12 kg was intentional; however, during the 6 weeks before this evaluation, additional weight loss had occurred unintentionally. The body-mass index (the weight in kilograms divided by the square of the height in meters) had reportedly decreased from 27.0 (&gt;95th percentile for his age) to 20.5 (25th to 50th percentile). He reported night sweats with chills but no fever. The patient had visited relatives in Haiti approximately 4 years earlier for 1 week; he reported no exposure to persons with respiratory or gastrointestinal symptoms while there or recently. Skin tests for tuberculosis were reportedly negative befor

Academic Arrhythmia: Disruption, Dissonance and Conflict in the Early-Career Rhythms of CMS Academics

Starting a career on the margins of the neoliberal business school is becoming increasingly challenging. We contribute to the understanding of the problems involved and to potential solutions by developing a theoretically-informed approach to the rhythms of academic life and drawing on interviews with 32 Critical Management Studies (CMS) early-career academics (ECAs) in 14 countries. Bringing together Lefebvre’s rhythmanalysis (and his concepts of polyrhythmia, eurhythmia and arrhythmia), Zerubavel’s sociology of time, and identity construction literature, we examine the rhythm-identity implications of the recent HE changes. We show how the dynamics between the broader pressures, institutional strategies, and our interviewees’ attempts to reassert themselves are creating a vicious circle of arrhythmia – a debilitating condition characterized by rhythmic disruption, dissonance and conflict. Within the circle, identity insecurity and regulation, CMS ECAs’ identity work, and arrhythmia are mutually co-constructive, so that it is hard for individuals to break out. We consider the possibilities and limitations of individual coping strategies and, drawing out lessons for business schools, advocate for more collective and structural solutions. In so doing, we contribute to the reimagining of business schools as more eurhythmically polyrhythmic places where ECAs of all intellectual orientations have the time to learn and develop

Searches for the Zγ decay mode of the Higgs boson and for new high-mass resonances in pp collisions at √s=13 TeV with the ATLAS detector

This article presents searches for the Zγ decay of the Higgs boson and for narrow high-mass resonances decaying to Zγ, exploiting Z boson decays to pairs of electrons or muons. The data analysis uses 36.1 fb−1 of pp collisions at √s=13 recorded by the ATLAS detector at the CERN Large Hadron Collider. The data are found to be consistent with the expected Standard Model background. The observed (expected — assuming Standard Model pp → H → Zγ production and decay) upper limit on the production cross section times the branching ratio for pp → H → Zγ is 6.6. (5.2) times the Standard Model prediction at the 95% confidence level for a Higgs boson mass of 125.09 GeV. In addition, upper limits are set on the production cross section times the branching ratio as a function of the mass of a narrow resonance between 250 GeV and 2.4 TeV, assuming spin-0 resonances produced via gluon-gluon fusion, and spin-2 resonances produced via gluon-gluon or quark-antiquark initial states. For high-mass spin-0 resonances, the observed (expected) limits vary between 88 fb (61 fb) and 2.8 fb (2.7 fb) for the mass range from 250 GeV to 2.4 TeV at the 95% confidence level

Search for W W/W Z resonance production in ℓνqq final states in pp collisions at √s=13 TeV with the ATLAS detector

A search is conducted for new resonances decaying into a W W or W Z boson pair, where one W boson decays leptonically and the other W or Z boson decays hadronically. It is based on proton-proton collision data with an integrated luminosity of 36.1 fb −1 collected with the ATLAS detector at the Large Hadron Collider at a centre-of-mass energy of s=13 TeV in 2015 and 2016. The search is sensitive to diboson resonance production via vector-boson fusion as well as quark-antiquark annihilation and gluon-gluon fusion mechanisms. No significant excess of events is observed with respect to the Standard Model backgrounds. Several benchmark models are used to interpret the results. Limits on the production cross section are set for a new narrow scalar resonance, a new heavy vector-boson and a spin-2 Kaluza-Klein graviton.[Figure not available: see fulltext.]

Search for heavy resonances decaying into WW in the eνμν eνμν final state in pp collisions at √s=13 TeV with the ATLAS detector

A search for neutral heavy resonances is performed in the WW→eνμν decay channel using pp collision data corresponding to an integrated luminosity of 36.1fb−1, collected at a centre-of-mass energy of 13TeV by the ATLAS detector at the Large Hadron Collider. No evidence of such heavy resonances is found. In the search for production via the quark–antiquark annihilation or gluon–gluon fusion process, upper limits on σX×B(X→WW) as a function of the resonance mass are obtained in the mass range between 200GeV GeV and up to 5TeV for various benchmark models: a Higgs-like scalar in different width scenarios, a two-Higgs-doublet model, a heavy vector triplet model, and a warped extra dimensions model. In the vector-boson fusion process, constraints are also obtained on these resonances, as well as on a Higgs boson in the Georgi–Machacek model and a heavy tensor particle coupling only to gauge bosons

Measurement of the Higgs boson coupling properties in the H → ZZ* → 4 decay channel at √s = 13 TeV with the ATLAS detector

The coupling properties of the Higgs boson are studied in the four-lepton (e, μ) decay channel using 36.1 fb−1 of pp collision data from the LHC at a centre-of-mass energy of 13 TeV collected by the ATLAS detector. Cross sections are measured for the main production modes in several exclusive regions of the Higgs boson production phase space and are interpreted in terms of coupling modifiers. The inclusive cross section times branching ratio for H → ZZ∗ decay and for a Higgs boson absolute rapidity below 2.5 is measured to be 1. 73 − 0.23 + 0.24 (stat.) − 0.08 + 0.10 (exp.) ± 0.04(th.) pb compared to the Standard Model prediction of 1.34±0.09 pb. In addition, the tensor structure of the Higgs boson couplings is studied using an effective Lagrangian approach for the description of interactions beyond the Standard Model. Constraints are placed on the non-Standard-Model CP-even and CP-odd couplings to Z bosons and on the CP-odd coupling to gluons

Measurement of inclusive jet and dijet cross-sections in proton-proton collisions at s √ =13 TeV with the ATLAS detector

Inclusive jet and dijet cross-sections are measured in proton-proton collisions at a centre-of-mass energy of 13 TeV. The measurement uses a dataset with an integrated luminosity of 3.2 fb−1 recorded in 2015 with the ATLAS detector at the Large Hadron Collider. Jets are identified using the anti-kt algorithm with a radius parameter value of R = 0.4. The inclusive jet cross-sections are measured double-differentially as a function of the jet transverse momentum, covering the range from 100 GeV to 3.5 TeV, and the absolute jet rapidity up to |y| = 3. The double-differential dijet production cross-sections are presented as a function of the dijet mass, covering the range from 300 GeV to 9 TeV, and the half absolute rapidity separation between the two leading jets within |y| < 3, y∗, up to y∗ = 3. Next-to-leading-order, and next-to-next-to-leading-order for the inclusive jet measurement, perturbative QCD calculations corrected for non-perturbative and electroweak effects are compared to the measured cross-sections