Modulation of cytokine patterns and microbiome during pregnancy in IBD

Janine van der Giessen, Dana Binyamin, Anna Belogolovski, Sigal Frishman, Kinneret Tenenbaum-Gavish, Eran Hadar, Yoram Louzoun, Maikel Petrus Peppelenbosch, Christien Janneke van der Woude, Omry Koren, Gwenny Manel Fuhler

Research output: Contribution to journalArticlepeer-review

58 Scopus citations


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.

Original languageEnglish
Pages (from-to)473-486
StatePublished - 5 Jun 2019

Bibliographical note

Publisher Copyright:
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY. Published by BMJ.


  • crohn's disease
  • cytokines
  • inflammatory bowel disease
  • intestinal microbiology
  • ulcerative colitis


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