- Title
- Does the microbiome play a role in the pathogenesis of colonic diverticular disease? A systematic review
- Creator
- Cameron, Raquel; Duncanson, Kerith; Hoedt, Emily C.; Eslick, Guy D.; Burns, Grace L.; Nieva, Cheenie; Keely, Simon; Walker, Marjorie M.; Talley, Nicholas J.
- Relation
- Journal of Gastroenterology and Hepatology Vol. 38, Issue 7, p. 1028-1039
- Publisher Link
- http://dx.doi.org/10.1111/jgh.16142
- Publisher
- John Wiley & Sons
- Resource Type
- journal article
- Date
- 2023
- Description
- Background and Aims: The role of the microbiota in diverticulosis and diverticular disease is underexplored. This systematic review aimed to assess all literature pertaining to the microbiota and metabolome associations in asymptomatic diverticulosis, symptomatic uncomplicated diverticular disease (SUDD), and diverticulitis pathophysiology. Methods: Seven databases were searched for relevant studies published up to September 28, 2022. Data were screened in Covidence and extracted to Excel. Critical appraisal was undertaken using the Newcastle Ottawa Scale for case/control studies. Results: Of the 413 papers screened by title and abstract, 48 full-text papers were reviewed in detail with 12 studies meeting the inclusion criteria. Overall, alpha and beta diversity were unchanged in diverticulosis; however, significant changes in alpha diversity were evident in diverticulitis. A similar Bacteroidetes to Firmicutes ratio compared with controls was reported across studies. The genus-level comparisons showed no relationship with diverticular disease. Butyrate-producing microbial species were decreased in abundance, suggesting a possible contribution to the pathogenesis of diverticular disease. Comamonas species was significantly increased in asymptomatic diverticulosis patients who later developed diverticulitis. Metabolome analysis reported significant differences in diverticulosis and SUDD, with upregulated uracil being the most consistent outcome in both. No significant differences were reported in the mycobiome. Conclusion: Overall, there is no convincing evidence of microbial dysbiosis in colonic diverticula to suggest that the microbiota contributes to the pathogenesis of asymptomatic diverticulosis, SUDD, or diverticular disease. Future research investigating microbiota involvement in colonic diverticula should consider an investigation of mucosa-associated microbial changes within the colonic diverticulum itself.
- Subject
- colonic; diverticular disease; diverticulitis; diverticulosis; microbiota
- Identifier
- http://hdl.handle.net/1959.13/1485429
- Identifier
- uon:51590
- Identifier
- ISSN:0815-9319
- Rights
- © 2023 The Authors. Journal of Gastroenterology and Hepatology published by Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. (http://creativecommons.org/licenses/by/4.0/).
- Language
- eng
- Full Text
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