Page 83 - MI-2-4

Microbes & Immunity Dietary emulsifiers affect the presence of AIEC

been reported that chondroitin sulfate could reduce IBD Natalie Chen for their guidance during the experimental
relapse in a prospective follow-up study. Altogether, these phase of this project.
43
microbiome alterations may reflect a more dysbiotic gut
environment in AIEC-positive individuals. Funding
Given the observed associations among carrageenan The study was funded by The French National Research
intake, AIEC presence, and increased CD risk, our Agency (ANR)/Research Grants Council (RGC) Joint
findings suggest that a potential dietary modification Research Scheme (A-CUHK402/17); National Natural
strategy, particularly those aimed at reducing the intake of Science Foundation of China (82060107, 82160113);
emulsifiers such as carrageenan, may help lower the risk of “Xingdian Talents” Support Project of Yunnan Province,
AIEC colonization and mitigate gut dysbiosis. Promoting China; and Applied Basic Research Projects of Yunnan
nutritional education and reducing the consumption Province, China (202201AW070019, 2019FE001(-039)).
of processed foods, especially among individuals with Authors affiliated with MagIC are partially supported
lower education levels, could be valuable in reducing the by InnoHK, the Government of Hong Kong, Special
risk of CD. Although our study cannot establish causal Administrative Region of the People’s Republic of China.
relationships, these strategies may serve as practical Conflict of interest
interventions to support the management of high-risk
populations. Future interventional studies are warranted to Francis Ka Leung Chan is a Board Member of CUHK
evaluate the effectiveness of these approaches in reducing Medical Centre. He is a co-founder, non-executive
AIEC colonization and improving clinical outcomes. Board Chairman, non-executive scientific advisor, and
shareholder of GenieBiome Ltd. He receives patent
This study had several limitations. First of all, dietary
and environmental data were only available for the rural royalties through his affiliated institutions. He has received
fees as an advisor and honoraria as a speaker for Eisai Co.
subjects. Second, since this is an observational study, Ltd., AstraZeneca, Pfizer Inc., Takeda Pharmaceutical
the association between carrageenan intake with AIEC Co., and Takeda (China) Holdings Co. Ltd. Siew Chien
presence and the gut microbiome is descriptive, and Ng has served as an advisory board member for Pfizer,
the causal relationship could not be proven. Further Ferring, Janssen, and Abbvie and received honoraria as a
studies using prospective, well-characterized cohorts and speaker for Ferring, Tillotts, Menarini, Janssen, Abbvie,
mechanistic animal studies or in vitro experiments are and Takeda. Siew Chien Ng has received research grants
needed to confirm the findings and make causal inferences. through her affiliated institutions from Olympus, Ferring,
5. Conclusion and AbbVie. Siew Chien Ng is a founder member, non-
executive director, non-executive scientific advisor, and
Our findings suggest that reducing dietary emulsifiers, shareholder of GenieBiome Ltd. Siew Chien Ng receives
particularly carrageenan, might mitigate AIEC colonization patent royalties through her affiliated institutions. RIL is
risk—especially among high-risk groups such as less- a Medical Affairs Manager of GenieBiome Ltd. Francis
educated populations who may consume more processed Ka Leung Chan, Siew Chien Ng, Zhilu Xu, and RIL are
foods in rural areas. This hypothesis is supported by a named inventors of patent applications held by the CUHK
clinical trial demonstrating that carrageenan exposure and MagIC that cover the therapeutic and diagnostic use
increased relapse risk and IL-6 levels in ulcerative colitis of microbiome and receive patent royalties through their
patients. Together with our observation of urban-rural affiliated institutions.
44
differences in AIEC prevalence, these results highlight
how both dietary factors and urbanization may shape gut Author contributions
microbiome composition and CD risk. Most importantly, Conceptualization: Siew Chien Ng, Zhilu Xu, Nicolas
we provide population-based evidence that AIEC should Barnich, Caroline Chevarin, Anthony Buisson
be considered a global risk factor for CD pathogenesis. Data curation: Xiangqian Dong, Yang Sun, Yinglei Miao,
Future intervention studies should evaluate whether Juan Luo, Fengrui Zhang
emulsifier-restricted diets can reduce AIEC colonization Formal analysis: Yu Lin
and improve clinical outcomes in CD patients. Investigation: Yu Lin, Zhilu Xu, Wenli Huang

Acknowledgments Methodology: Yu Lin, Zhilu Xu
Supervision: Siew Chien Ng, Yang Sun, Zhilu Xu, Francis
We thank Winnie Lin for her assistance in processing the Ka Leung Chan
food questionnaire data to estimate food additive content. Writing–original draft: Yu Lin
We would also like to extend our thanks to Alan Chu and Writing–review & editing: Siew Chien Ng, Zhilu Xu, Hein

Volume 2 Issue 4 (2025) 75 doi: 10.36922/MI025230051