{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T10:56:53Z","timestamp":1794049013542,"version":"4.8.0"},"reference-count":86,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2024,12,14]],"date-time":"2024-12-14T00:00:00Z","timestamp":1734134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","award":["MC_PC_12025"],"award-info":[{"award-number":["MC_PC_12025"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"name":"UK Consortium for MetAbolic Phenotyping"},{"DOI":"10.13039\/501100000272","name":"National Institute for Health Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100013342","name":"Imperial Biomedical Research Centre","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100013342","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,2,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>We conducted a single-arm interventional study, to explore mucosal changes associated with clinical remission under oral vancomycin (OV) treatment, in primary sclerosing cholangitis-associated inflammatory bowel disease (PSC-IBD); NCT05376228.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Fifteen patients with PSC and active colitis (median fecal calprotectin 459 \u00b5g\/g; median total Mayo score 5) were treated with OV (125\u00a0mg QID) for 4 weeks and followed-up for a further 4 weeks of treatment withdrawal (8 weeks, end-of-study). Colonic biopsies were obtained at baseline and Week 4. Clinical assessments, and serum and stool samples (metagenomics, metatranscriptomics, and metabolomics) were collected at Weeks 0, 2, 4, and 8. The primary efficacy outcome measure was the induction of clinical remission.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Oral vancomycin resulted in clinical remission in 12\/15 patients and significant reductions in fecal calprotectin. Oral vancomycin was associated with reduced abundances of Lachnospiraceae, genera Blautia and Bacteroides; and enrichment of Enterobacteriaceae, and genera Veillonella, Akkermansia, and Escherichia. Oral vancomycin treatment was associated with the downregulation of multiple metatranscriptomic pathways (including short-chain fatty acid [SCFA] metabolism and bile acid [BA] biotransformation), along with host genes and multiple pathways involved in inflammatory responses and antimicrobial defence; and an upregulation of genes associated with extracellular matrix repair. Oral vancomycin use resulted in the loss of specific fecal SCFAs and secondary BAs, including lithocholic acid derivatives. Colitis activity relapsed following OV withdrawal, with host mucosal and microbial changes trending toward baseline.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Four weeks of OV induces remission in PSC-IBD activity, associated with a reduction in gut bacterial diversity and compositional changes relating to BA and SCFA homeostasis.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ecco-jcc\/jjae189","type":"journal-article","created":{"date-parts":[[2024,12,14]],"date-time":"2024-12-14T20:52:05Z","timestamp":1734209525000},"source":"Crossref","is-referenced-by-count":40,"title":["Open Label Vancomycin in Primary Sclerosing Cholangitis-Inflammatory Bowel Disease: Improved Colonic Disease Activity and Associations With Changes in Host\u2013Microbiome\u2013Metabolomic Signatures"],"prefix":"10.1093","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2338-8397","authenticated-orcid":false,"given":"Mohammed Nabil","family":"Quraishi","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, University Hospitals Birmingham , Birmingham ,","place":["UK"]},{"name":"Institute of Cancer and Genomic Sciences, University of Birmingham , Birmingham ,","place":["UK"]},{"name":"University of Birmingham Microbiome Treatment Centre, University of Birmingham , Birmingham ,","place":["UK"]},{"name":"Liver Unit, University Hospitals Birmingham , Birmingham ,","place":["UK"]},{"name":"National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham , Birmingham ,","place":["UK"]},{"name":"Department of Gastroenterology, Inflammatory Bowel Disease Center, Sheikh Shakhbout Medical City , Abu Dhabi ,","place":["UAE"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Cheesbrough","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospitals Birmingham , Birmingham ,","place":["UK"]},{"name":"National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham , Birmingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Rimmer","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospitals Birmingham , Birmingham ,","place":["UK"]},{"name":"National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, Centre for Liver and Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham , Birmingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6300-3100","authenticated-orcid":false,"given":"Benjamin H","family":"Mullish","sequence":"additional","affiliation":[{"name":"Division of Digestive Diseases, Department of Metabolism, Digestion and Reproduction, Faculty of Medicine, Imperial College London , London ,","place":["UK"]},{"name":"Department of Gastroenterology, St Mary\u2019s Hospital, Imperial College Healthcare NHS Trust , London ,","place":["UK"]},{"name":"Department of Hepatology, St Mary\u2019s Hospital, Imperial College Healthcare NHS Trust , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naveen","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, University Hospitals Birmingham , Birmingham ,","place":["UK"]},{"name":"Institute of Cancer and Genomic Sciences, University of Birmingham , Birmingham ,","place":["UK"]},{"name":"University of Birmingham Microbiome Treatment Centre, University of Birmingham , Birmingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Efstathiou","sequence":"additional","affiliation":[{"name":"Institute of Cancer and Genomic Sciences, University of Birmingham , Birmingham ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2735-7010","authenticated-orcid":false,"given":"Animesh","family":"Acharjee","sequence":"additional","affiliation":[{"name":"Institute of Translational Medicine, University Hospitals Birmingham , Birmingham ,","place":["UK"]},{"name":"MRC Health Data Research UK (HDR UK), Birmingham, UK\u00a0"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios","family":"Gkoutus","sequence":"additional","affiliation":[{"name":"Institute of Translational Medicine, University Hospitals Birmingham , Birmingham 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