Rifaximin modulates the colonic microbiota of patients with Crohn's disease: an in vitro approach using a continuous culture colonic model system
Open Access
- 18 September 2010
- journal article
- research article
- Published by Oxford University Press (OUP) in Journal of Antimicrobial Chemotherapy
- Vol. 65 (12), 2556-2565
- https://doi.org/10.1093/jac/dkq345
Abstract
Rifaximin, a rifamycin derivative, has been reported to induce clinical remission of active Crohn's disease (CD), a chronic inflammatory bowel disorder. In order to understand how rifaximin affects the colonic microbiota and its metabolism, an in vitro human colonic model system was used in this study. We investigated the impact of the administration of 1800 mg/day of rifaximin on the faecal microbiota of four patients affected by colonic active CD [Crohn's disease activity index (CDAI > 200)] using a continuous culture colonic model system. We studied the effect of rifaximin on the human gut microbiota using fluorescence in situ hybridization, quantitative PCR and PCR–denaturing gradient gel electrophoresis. Furthermore, we investigated the effect of the antibiotic on microbial metabolic profiles, using 1H-NMR and solid phase microextraction coupled with gas chromatography/mass spectrometry, and its potential genotoxicity and cytotoxicity, using Comet and growth curve assays. Rifaximin did not affect the overall composition of the gut microbiota, whereas it caused an increase in concentration of Bifidobacterium, Atopobium and Faecalibacterium prausnitzii. A shift in microbial metabolism was observed, as shown by increases in short-chain fatty acids, propanol, decanol, nonanone and aromatic organic compounds, and decreases in ethanol, methanol and glutamate. No genotoxicity or cytotoxicity was attributed to rifaximin, and conversely rifaximin was shown to have a chemopreventive role by protecting against hydrogen peroxide-induced DNA damage. We demonstrated that rifaximin, while not altering the overall structure of the human colonic microbiota, increased bifidobacteria and led to variation of metabolic profiles associated with potential beneficial effects on the host.Keywords
This publication has 54 references indexed in Scilit:
- Commensal bacteria, traditional and opportunistic pathogens, dysbiosis and bacterial killing in inflammatory bowel diseasesCurrent Opinion in Infectious Diseases, 2009
- Active Crohnʼs disease and ulcerative colitis can be specifically diagnosed and monitored based on the biostructure of the fecal floraInflammatory Bowel Diseases, 2008
- Molecular-phylogenetic characterization of microbial community imbalances in human inflammatory bowel diseasesProceedings of the National Academy of Sciences of the United States of America, 2007
- Antibiotic treatment of Crohn's disease: results of a multicentre, double blind, randomized, placebo‐controlled trial with rifaximinAlimentary Pharmacology & Therapeutics, 2006
- Reduced diversity of faecal microbiota in Crohn's disease revealed by a metagenomic approachGut, 2006
- Rifaximin, a Poorly Absorbed Antibiotic: Pharmacology and Clinical PotentialChemotherapy, 2005
- Host-Bacterial Mutualism in the Human IntestineScience, 2005
- The Role of Antibiotics in the Management of Crohnʼs DiseaseInflammatory Bowel Diseases, 2004
- Antibiotics and azathioprine for the treatment of perianal fistulas in Crohn's diseaseAlimentary Pharmacology & Therapeutics, 2003
- RifaximinDrugs, 1995