P0077 Identification of symbiote candidates for pouchitis in patients with ulcerative colitis

Abstract Background Ulcerative colitis (UC) has been recognized as a life-long inflammatory disease. Although several novel treatments for UC has been developed, medication-uncontrollable UC patients require the surgical treatment. The surgical operation could improve the quality of life of the patients, but requires intensive medical following, because more than 40% develop to pouchitis. We have explored the symbiote candidates for Ileoanal pouch through comprehensive microbiome and metabolome analysis to prove the mechanism of pouchitis. Methods The fecal samples in patients with or without pouchitis were collected. 16S rRNA amplicon meta-analysis and metabolome analysis for 170 patients were performed. Results The alfa diversity in microbiome was significantly decreased with developing pouchitis. Several bacterial genera which include Lachnospiraceae, Bifidobacteriaceae, Prevotellaceae, Clostridiaceae, Ruminococcaceae, and Veillonellaceae were statistically reduced in correlation with inflammatory clinical score and were shown having significant relation with protective metabolites. In addition, the extent of decrease in these candidates was strikingly prominent in medication-refractory pouchitis. Additionally, some pouchitis revealed the increasing of Enterobacteriaceae, unclassified Lactobacillas, or Propionibacteriaceae. Conclusion Thus, our data show these bacterial taxa as symbiote candidates and could be attractive targets for maintenance of Ileal pouch in UC.