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Breaking the Vicious Cycle

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Abstract of the Rush University SCD Study

April 15th, 2014

Here is the abstract of the recently published Rush University study on SCD!

The Bacterial Microbiome of IBD Patients on the Specific Carbohydrate Diet (SCD)
Samir Kakodkar, MD, Susan Mikolaitis, RD, Phillip Engen, BS, Ece Mutlu, MD, MBA, MSCR, FACG.
Rush University Medical Center, Chicago, IL, Chicago, IL.
Purpose: Specifi c carbohydrate diet (SCD) is a widely practiced diet used in the treatment of infl ammatory
bowel disease (IBD) by patients, and anecdotal evidence suggests it may be an eff ective for treatment
of Crohn’s disease (CD) or ulcerative colitis (UC). Th e main mechanism by which SCD is postulated to
work is by alteration of the bacterial microbiome. Our aim was to compare the fecal microbiome in IBD
patients on SCD to control IBD cases not on SCD.
Methods: Fecal samples of 20 IBD patients on SCD and 20 IBD patients as controls who are not on SCD
(n=20 UC and CD each) were collected aft er IRB approval. DNA was extracted and the bacterial microbiome
was examined with 16S rDNA pyrosequencing on the Roche 454 platform using titanium kits.
Sequences were denoised, quality and chimera fi ltered and rarifi ed prior to analysis using USEARCH,
Qiime 1.6, and Chimera Slayer.
Results: The mean age of the patients was 39.2 years (yrs); the mean duration of illness was 7.25 yrs, and
12 were male. Fift een subjects had active disease, and 20 were on immunosuppressive therapy. Bacterial
diversity, as assessed by the Shannon, Richness, Chao_1, PD_Whole_tree indeces, was higher in the
SCD group compared to controls, but did not reach statistical signifi cance except for the PD_Whole_Tree
metric (p=0.05; T-test). Th ere was a visual separation of the SCD and control groups using principal coordinates
analysis, with the Unifrac metric at the operational taxonomic unit level (Figure 1). Th e observed
diff erences were statistically signifi cant by PERMANOVA (p=0.01). Although compositional changes were
noted for subtypes of IBD, visual diff erences appeared more striking for CD compared to UC patients.
Conclusion: IBD patients on SCD may have a differing microbiome compared to control IBD subjects.
Studies with a larger number of patients are warranted to further characterize the changes in the microbiome
as a result of SCD.

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