AccScience Publishing / MI / Online First / DOI: 10.36922/MI025230051
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ORIGINAL RESEARCH ARTICLE

Impact of dietary emulsifiers on the presence of adherent-invasive Escherichia coli in Crohn’s disease

Yu Lin1,2 ,  Xiangqian Dong3,4 ,  Hein Min Tun2,5 ,  Wenli Huang1,2 ,  Yinglei Miao3,4 ,  Juan Luo3,4 ,  Fengrui Zhang3,4 ,  Caroline Chevarin6 ,  Anthony Buisson6,7 ,  Nicolas Barnich6 ,  Jean-Frédéric Colombel8 ,  Francis Ka Leung Chan2,9 ,  Yang Sun3,4* ,  Zhilu Xu1,2* ,  Siew Chien Ng1,2*
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1 Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
2 Microbiota I-Center (MagIC), Hong Kong SAR, China
3 Department of Gastroenterology, The First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
4 Yunnan Province Clinical Research Center for Digestive Diseases, Kunming, Yunnan, China
5 The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
6 Université Clermont Auvergne, Inserm U1071, INRAE USC 1382, Microbes, Intestin, Inflammation et Susceptibilité de l’Hôte (M2iSH), Clermont-Ferrand, France
7 Université Clermont Auvergne, Inserm, 3iHP, CHU Clermont-Ferrand, Service d’Hépato-Gastro Entérologie, Clermont-Ferrand, France
8 Department of Medicine, Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, United States of America
9 Center for Gut Microbiota Research, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
MI, 025230051 https://doi.org/10.36922/MI025230051
Received: 6 June 2025 | Revised: 18 July 2025 | Accepted: 1 August 2025 | Published online: 21 August 2025
© 2025 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Adherent-invasive Escherichia coli (AIEC) has been implicated in Crohn’s disease (CD) pathogenesis. We aimed to evaluate the impact of dietary factors on the presence of AIEC in patients with CD and to identify AIEC-associated mucosa microbial signatures in regions with different urbanization levels. A total of 112 CD patients and healthy controls were recruited from a rural area in China (Yunnan). Clinical demographics, food additive questionnaires, and ileal biopsies were collected from subjects in rural China. AIEC was isolated from biopsy samples by an antibiotic protection assay. Correlation between AIEC presence and food additives was evaluated using multivariate logistic regression. In addition, a secondary dataset of an urban CD cohort (Hong Kong) was included for microbiome analysis. AIEC was detected in the ileal mucosa in 20.83% of patients with CD in rural China. Multivariate analysis showed that living in an urban area was associated with the presence of AIEC in CD patients. Carrageenan consumption was positively correlated with AIEC presence in CD. AIEC-positive CD patients with primary education consumed more carrageenan than AIEC-negative CD patients (p=0.008). AIEC presence in CD patients was associated with 23 microbial genera in both urban and rural areas. AIEC-positive CD patients showed a decrease in anti-inflammatory pathways. AIEC colonizes the gut mucosa of CD patients in a rural area of China, with its presence significantly associated with higher carrageenan consumption. These findings suggest a potential link between dietary emulsifiers, microbial dysbiosis, and AIEC-related CD pathogenesis.

Graphical abstract
Keywords
Adherent-invasive Escherichia coli
Crohn’s disease
Dietary emulsifiers
Funding
The study was funded by The French National Research Agency (ANR)/Research Grants Council (RGC) Joint Research Scheme (A-CUHK402/17); National Natural Science Foundation of China (82060107, 82160113); “Xingdian Talents” Support Project of Yunnan Province, China; and Applied Basic Research Projects of Yunnan Province, China (202201AW070019, 2019FE001(-039)). Authors affiliated with MagIC are partially supported by InnoHK, the Government of Hong Kong, Special Administrative Region of the People’s Republic of China.
Conflict of interest
Francis Ka Leung Chan is a Board Member of CUHK Medical Centre. He is a co-founder, non-executive Board Chairman, non-executive scientific advisor, and shareholder of GenieBiome Ltd. He receives patent royalties through his affiliated institutions. He has received fees as an advisor and honoraria as a speaker for Eisai Co. Ltd., AstraZeneca, Pfizer Inc., Takeda Pharmaceutical Co., and Takeda (China) Holdings Co. Ltd. Siew Chien Ng has served as an advisory board member for Pfizer, Ferring, Janssen, and Abbvie and received honoraria as a speaker for Ferring, Tillotts, Menarini, Janssen, Abbvie, and Takeda. Siew Chien Ng has received research grants through her affiliated institutions from Olympus, Ferring, and AbbVie. Siew Chien Ng is a founder member, non-executive director, non-executive scientific advisor, and shareholder of GenieBiome Ltd. Siew Chien Ng receives patent royalties through her affiliated institutions. RIL is a Medical Affairs Manager of GenieBiome Ltd. Francis Ka Leung Chan, Siew Chien Ng, Zhilu Xu, and RIL are named inventors of patent applications held by the CUHK and MagIC that cover the therapeutic and diagnostic use of microbiome and receive patent royalties through their affiliated institutions.
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Microbes & Immunity, Electronic ISSN: 3029-2883 Print ISSN: 3041-0886, Published by AccScience Publishing
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