Systematic review and meta-analysis of the role ofFaecalibacterium prausnitziialteration in inflammatory bowel disease

Background and Aim We comprehensively carry out a systematic review and meta-analysis of previous studies to determine the association between intestinalFaecalibacterium prausnitzii(F. prausnitzii) and inflammatory bowel disease (IBD) in human studies. Methods A systematic literature search of PubMed, Embase, and the Cochrane Library database was conducted until April 1, 2020. Inclusion criteria were studies involving patients with Crohn's disease (CD) or ulcerative colitis (UC) with abundance ofF. prausnitzii. The quality of the studies was assessed by the modified Newcastle-Ottawa scale. Results A total of 1669 subjects (427 CD patients, 560 UC patients, and 682 healthy controls) were enrolled from 16 studies. Both CD (standardized mean difference [SMD]: -1.36; 95% CI, -1.74 to -0.98;P < 0.00001) and UC patients (SMD: -0.81; 95% CI, -1.21 to -0.42;P < 0.0001) had a lower abundance ofF. prausnitziithan the healthy controls. Compared with the IBD remission patients, the IBD active patients had lower levels ofF. prausnitzii(SMD: -0.56; 95% CI, -0.91 to -0.21;P = 0.002). In the subgroup analyses, the abundance ofF. prausnitziiwas reduced in both active CD patients (SMD: -0.78; 95% CI, -1.51 to -0.04;P = 0.04) and active UC patients (SMD:-0.44; 95%CI, -0.81 to -0.07;P = 0.02) when compared with the patients with CD or UC in remission, respectively. Conclusion A negative association between abundance ofF. prausnitziiand IBD activity is observed, but a cut-off level ofF. prausnitziito diagnose and/or to start treating IBD is not determined.

Automated summary

A systematic review and meta-analysis found a negative association between abundance of F. prausnitzii and IBD activity, but a cut-off level of F. prausnitzi for diagnosing and treating IBD has not been determined.