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The potential role of tap water bacteria in inflammatory bowel disease

Microbial dysbiosis is implicated to play a substantial part in several pathophysiological processes, and one disease receiving great attention in recent years owing to its affiliation with an abnormal microbial state of the gut is inflammatory bowel disease. Being a multifactorial disease, other factors implicated to contribute to its commence include genetics, components of the immune system and environmental factors. Albeit suggestions of tap water serving as an environmental trigger in the aetiology of IBD has been made, its potential impact on the gastrointestinal microbiota remains an untouched area of investigation. Thus, in this study we sought to investigate associations of tap water on the microbiota of gastrointestinal mucosa that could substantiate research conducted to unveil environmental and microbial factors contributing to the onset and/or maintenance of this disease. A total of 426 biopsies and 227 water samples retrieved from 129 and 223 patients respectively, served as material for analysis, and included both adult and pediatric patients from Norwegian IBD and control cohorts. The V3-V4 region of the 16S ribosomal ribonucleic acid gene was amplified using a nested approached to polymerase chain reaction, and sequenced by use of the Illumina MiSeq sequencing platform. Our findings exposed significant associations between tap water and biopsies with respect to an operational taxonomic unit belonging to Enterobacteriaceae at a p-value of 0,016 using Fisher exact as statistical approach. We further disclosed highly significant increases of the same OTU in pediatric IBD sufferers, especially in the ulcerative colitis cohort compared to cohorts of both age groups. This gave a p-value <0,05 when pairwise comparisons with the Conover-Inman method was employed on the median percentagewise prevalence of this OTU. Further analysis by Conover-Inman test also revealed augmented levels of this OTU in biopsies of inflamed origin compared to biopsies of normal state at a p-value of 0,000. Thus, our results serve as important contributors to research on the environmental aspects of IBD, and also with respect to the role of Enterobacteriaceae as a potential microbial key player in the onset and/or maintenance of this disease.