Oral versus intravenous iron replacement therapy distinctly alters the gut microbiota and metabolome in patients with IBD

摘要: Objective Iron deficiency is a common complication in patients with IBD and oral iron therapy suggested to exacerbate symptoms. We performed an open-labelled clinical trial compare the effects of per (PO) versus intravenous (IV) replacement (IRT). Design The study population included Crohn9s disease (CD; N=31), UC (N=22) control subjects (non-inflamed, NI=19). After randomisation, participants received sulfate or sucrose over 3 months. Clinical parameters, faecal bacterial communities metabolomes were assessed before after intervention. Results Both PO IV treatments ameliorated deficiency, but higher ferritin levels observed IV. Changes activity independent treatment types. Faecal samples characterised by marked interindividual differences, lower phylotype richness proportions Clostridiales. Metabolite analysis also showed separation both CD from anaemic participants. Major shifts diversity occurred approximately half all IRT, most susceptible. Despite individual-specific changes phylotypes due was associated decreased abundances operational taxonomic units assigned species Faecalibacterium prausnitzii , Ruminococcus bromii Dorea sp. Collinsella aerofaciens . Clear IV-specific PO-specific fingerprints evident at level metabolomes, affecting cholesterol-derived host substrates. Conclusions Shifts gut composition are pronounced similar outcome, administration differentially affects metabolites compared therapy. Trial registration number clinicaltrial.gov (NCT01067547).