Objective Pregnancy may affect the disease course of IBD. Both pregnancy and IBD are associated with altered immunology and intestinal microbiology. However, to what extent immunological and microbial profiles are affected by pregnancy in patients with IBD remains unclear. Design Faecal and serum samples were collected from 46 IBD patients (31 Crohn’s disease (CD) and 15 UC) and 179 healthy controls during first, second and third trimester of pregnancy, and prepregnancy and postpartum for patients with IBD. Peripheral blood cytokine profiles were determined by ELISA, and microbiome analysis was performed by sequencing the V4 region of the bacterial 16S rRNA gene. Results Proinflammatory serum cytokine levels in patients with IBD decrease significantly on conception. Reduced interleukin (IL)-10 and IL-5 levels but increased IL-8 and interferon (IFN)γ levels compared with healthy controls were seen throughout pregnancy, but cytokine patterns remained stable during gestation. Microbial diversity in pregnant patients with IBD was reduced compared with that in healthy women, and significant differences existed between patients with UC and CD in early pregnancy. However, these microbial differences were no longer present during middle and late pregnancy. Dynamic modelling showed considerable interaction between cytokine and microbial composition. Conclusion Serum proinflammatory cytokine levels markedly improve on conception in pregnant patients with IBD, and intestinal microbiome diversity of patients with IBD normalises during middle and late pregnancy. We thus conclude that pregnancy is safe and even potentially beneficial for patients with IBD.

中文翻译：

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妊娠期 IBD 细胞因子模式和微生物组的调节

目的妊娠可能影响IBD的病程。怀孕和 IBD 都与免疫学和肠道微生物学的改变有关。然而，IBD 患者的免疫学和微生物特征在多大程度上受妊娠影响尚不清楚。设计的粪便和血清样本是从 46 名 IBD 患者（31 名克罗恩病 (CD) 和 15 名 UC）和 179 名健康对照者在怀孕的第一、第二和第三个三个月以及 IBD 患者的孕前和产后收集的。通过ELISA确定外周血细胞因子谱，并通过对细菌16S rRNA基因的V4区进行测序来进行微生物组分析。结果 IBD 患者的促炎血清细胞因子水平在受孕时显着降低。与健康对照相比，在整个妊娠期间，白细胞介素 (IL)-10 和 IL-5 水平降低，但 IL-8 和干扰素 (IFN)γ 水平增加，但细胞因子模式在妊娠期间保持稳定。与健康女性相比，妊娠期IBD患者的微生物多样性降低，妊娠早期UC和CD患者之间存在显着差异。然而，这些微生物差异在妊娠中期和晚期不再存在。动态建模显示细胞因子和微生物组成之间存在相当大的相互作用。结论 妊娠期IBD患者受孕时血清促炎细胞因子水平显着改善，IBD患者肠道菌群多样性在妊娠中后期恢复正常。