P074 HUMAN-DERIVED CLOSTRIDIUM VE202 STRAINS REDUCE ENTEROBACTERIACEAE AND FUSOBACTERIA AND REVERSE EXPERIMENTAL COLITIS INDUCED BY HUMAN GUT MICROBIOTA
Authors: Oka Akihiko , Mishima Yoshiyuki , Bongers Gerold , Baltus Andrew , Liu Bo , Herzog Jeremy , Ohkusa Toshifumi , Atarashi Koji , Honda Kenya , San Mateo Lani , Plevy Scott , Sartor R Balfour 
Published: January 2020

Abstract

Background
17 human-derived Clostridium strains (VE202), belonging to a bacterial cluster under-represented in active IBD, induce colonic IL-10-producing FOXP3+ regulatory T cells and prevent colitis in murine IBD models (Nature 2013). The VE202 consortium is a promising live biotherapeutic product for clinical application. However, its 1) therapeutic benefit on established colitis and 2) effect on intestinal microbiota composition remain unclear.

Methods
Models: We established colitis in ex-germ-free (exGF) Rag2−/− mice with naïve T cell transfer (Hu-nT) and Il10−/− (Hu-Il10−/−) mice colonized with healthy human fecal microbiota, using stool with low abundance of Clostridiales. In Hu-Il10−/−, we tested two other healthy donor stools (one with low Clostridiales and another with Fusobacteria, which is a potential pathobiont in IBD). For a selected bacteria-colonized model, we selected three aggressive Enterobacteriaceae strains cultured from the human donor stool used for the previous studies, based on colonic Th1 response and colitis in monoassociated exGF-Il10−/−. We then established an aggressive Klebsiella (K), Enterobacter (E) and E. coli (E) strain -colonized exGF Il10−/− colitis model (KEE-colitis). In addition, we established a human IBD-derived E.coli and Fusobacterium varium consortium-colonized Il10−/− (EF-colitis) model. In vitro, we anaerobically co-cultured human stools with VE202 and analyzed bacterial composition. Therapy: We treated mice by oral administration of VE202 or vehicle twice weekly for 2–4 weeks. Evaluation: Colitis severity was assessed by blinded histological score, fecal lipocalin-2, stool consistency score and colonic IFNγ +CD4+ T cells. Bacteria profiles in cecal contents were analyzed by metagenomics or qPCR.

Results
Hu-nT and Hu-Il10−/− (Fig.1A, B): VE202 significantly reversed histological colitis and other inflammatory endpoints compared to vehicle. Consistently VE202 attenuated colitis induced by three different donor stools. Bacteria profiling revealed that VE202 attenuated the colitis-associated bloom of Enterobacteriaceae and Fusobacteria. In KEE-colitis (Fig.1C) VE202 reversed colitis with reduction of all Enterobacteriaceae strains. In EF-colitis (Fig.1D) VE202 reversed colitis with reduction of E. coli and F. varium. Co-culture (Fig.1E): VE202 reduced abundance of Enterobacteriaceae in a dose dependent manner.

Conclusion
Our findings suggest a novel IL-10-independent protective mechanism for human Clostridium VE202 strains, i.e. correction of dysbiosis with reduction of levels of Enterobacteriaceae and Fusobacteria. In addition, VE202 treatment is consistently effective for different human donor microbiota in vivo and in vitro. These results provide a rationale and target for therapeutic use of rationally selected resident protective bacterial cocktails in IBD patients.