Antibiotics associated with increased risk of inflammatory bowel disease


Date:
August 17, 2020
Source:
Karolinska Institutet
Summary:
Antibiotics use, particularly antibiotics with greater spectrum
of microbial coverage, may be associated with an increased risk
of new-onset inflammatory bowel disease (IBD) and its subtypes
ulcerative colitis and Crohn's disease, according to a new study.



FULL STORY ========================================================================== Antibiotics use, particularly antibiotics with greater spectrum of
microbial coverage, may be associated with an increased risk of new-onset inflammatory bowel disease (IBD) and its subtypes ulcerative colitis
and Crohn's disease.

That is according to a study by researchers at Karolinska Institutet in
Sweden and Harvard Medical School in the U.S., published in the journal
The Lancet Gastroenterology & Hepatology. The association remained when patients were compared with their siblings.


==========================================================================
IBD is becoming more common, particularly in Europe, the U.S. and
other parts of the world undergoing rapid economic development,
increased sanitation, and more frequent use of antibiotics. With growing appreciation for the gut microbiome's role in maintaining human health,
concern has risen that antibiotics may perturb and permanently alter
these fragile microbial communities. This could potential impact the
risk of gastrointestinal disease.

In what is the largest study thus far linking antibiotic therapy and risk
of IBD, researchers in Sweden and the U.S. were able to more definitively demonstrate that more frequent use of antibiotics was associated with
the development of IBD and its subtypes, ulcerative colitis and Crohn's disease.

"I think this affirms what many of us have suspected -- that antibiotics,
which adversely affect gut microbial communities, are a risk factor
for IBD," said lead author, Dr. Long Nguyen at Massachusetts General
Hospital and Harvard Medical School, Boston, U.S. "However, despite this compelling rationale and seemingly intuitive presumption, there have
been no population-scale investigations to support this hypothesis until
now." Two-times increased risk Through the Epidemiology Strengthened
by histoPathology Reports in Sweden (ESPRESSO) study, the researchers identified almost 24,000 new IBD cases (16,000 had ulcerative colitis
and 8,000 Crohn's disease) and compared them with 28,000 siblings, and
117,000 controls from the general population. Prior use of antibiotics
(never vs. ever) was associated with a nearly two-times increased risk
of IBD after adjusting for several risk factors. Increased risk was
noted for both ulcerative colitis and Crohn's disease with the highest estimates corresponding to broad-spectrum antibiotics.

According to the researchers, earlier studies in the field have been
small, and few have had a follow-up beyond a few years. In contrast,
the researchers in this study were able to enroll all consecutive,
eligible patients with new- onset IBD from a population-based register
over a ten-year study period, limiting selection bias.

"In Sweden, there is universal medication coverage with virtually
complete information on all drug dispensations, including antibiotics, minimizing ascertainment bias," says senior author, Professor Jonas F Ludvigsson, pediatrician at O"rebro University Hospital, and professor
at the Department of Medical Epidemiology and Biostatistics, Karolinska Institutet. "This makes Swedish registers ideal for the study of risk
factors for IBD." Nearly 1 percent affected in Sweden IBD affects
nearly 1 percent of the Swedish population and can have a substantial
effect on patients' life. It has been linked to an increased risk of
both death and cancer.

"To identify risk factors for IBD is important, and ultimately our aim
is to prevent the disease," adds Ludvigsson. "Our study provides another
piece of the puzzle and even more reason to avoid using antibiotics needlessly." Funding for this study was provided by the National
Institutes of Health, the Crohn's and Colitis Foundation, the American Gastroenterological Association, the Massachusetts General Hospital and Karolinska Institutet.


========================================================================== Story Source: Materials provided by Karolinska_Institutet. Note: Content
may be edited for style and length.


========================================================================== Journal Reference:
1. Long H Nguyen, Anne K O"rtqvist, Yin Cao, Tracey G Simon, Bjorn
Roelstraete, Mingyang Song, Amit D Joshi, Kyle Staller, Andrew
T Chan, Hamed Khalili, Ola Ole'n, Jonas F Ludvigsson. Antibiotic
use and the development of inflammatory bowel disease: a national
case-control study in Sweden. The Lancet Gastroenterology &
Hepatology, 2020; DOI: 10.1016/ S2468-1253(20)30267-3 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/08/200817191743.htm

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