Perfil dos metabólitos intestinais em indivíduos com doença inflamatória intestinal

Abstract

Introduction: Inflammatory bowel disease (IBD) is represented by Crohn's disease (CD) and idiopathic ulcerative colitis (IUC). It presents as an autoimmune condition with unknown etiology. It has a chronic nature with periods of remission and exacerbation. The diagnosis is made through clinical symptoms, imaging tests and colonoscopy. For follow-up, the fecal calprotectin is used as a biomarker. Another possibility with the potential to identify biomarkers for follow-up is metabolomics. This analytical technique is part of the omics sciences, used to find metabolites in biological materials and can be used to identify pathological factors. Objective: To analyze the fecal metabolomics profile of patients with IBD and correlate it with disease activity by fecal calprotectin levels. Methodology: Observational, cross-sectional, convenience sampling study of patients with IBD. Clinical data were collected, measurements of fecal calprotectin were performed to assess disease activity and fecal metabolomics through mass spectrometry using the GC-MS technique. Patients with active disease were considered to be those with calprotectin greater than 200μg/g. Statistical tests were performed using SPSS v21 for chi-square analysis/Fisher's test, being considered significant when p<0,05. For analysis of fecal metabolomics, the MetaboAnalyst 5.0 software was used, with multivariate analysis. Results: 52 patients were analyzed (n=29 with IUC and n=23 with CD). Inflammatory activity was identified in 36 (69.2%) patients. 56 metabolites were identified through fecal metabolomics. In the population of our study, the most sensitive metabolites to differentiate CD from ICU were: hexadecanoic acid, squalene and octadecanoic acid. The metabolites that best correlated with disease activity among patients with ICU were octadecanoic acid, 11- hexadecen-1, hexadecanoic acid and pentadecanone. Among patients with CD, the metabolites were octadecanoic acid, cyclodecasilloxona, oleic-1 acid and cyclopentadecanoic. octadecanoic acid, 11-hexadecen-1, pentadecanone and oleic-2 acid were the most sensitive to assess a higher degree of disease activity between ICU and CD.