Microbial and functional shifts between flare and remission in a single-center cohort of children with inflammatory bowel disease

doi:10.5409/wjcp.120066

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World Journal of Clinical Pediatrics

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2219-2808

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Clin Pediatr. Sep 9, 2026; 15(3): 120066
Published online Sep 9, 2026. doi: 10.5409/wjcp.120066

Microbial and functional shifts between flare and remission in a single-center cohort of children with inflammatory bowel disease

Delicia Shu-Qin Ooi, Yung-Seng Lee, Marion Margaret Aw, Carina Jing-Xuan Tay, James Guoxian Huang

James Guoxian Huang, Marion Margaret Aw, Yung-Seng Lee, Department of Paediatrics, Khoo Teck Puat - National University Children’s Medical Institute, National University Health System, Singapore 119228, Singapore

James Guoxian Huang, Carina Jing-Xuan Tay, Marion Margaret Aw, Yung-Seng Lee, Delicia Shu-Qin Ooi, Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore

Co-corresponding authors: James Guoxian Huang and Delicia Shu-Qin Ooi.

Author contributions: Huang JG, Tay CJX, and Ooi DSQ contributed to material preparation, data acquisition, and analysis; Huang JG, Aw MM, Lee YS, and Ooi DSQ contributed to conceptualization and design; Huang JG and Ooi DSQ contributed equally to this manuscript and are co-corresponding authors. All authors contributed to writing-draft manuscript and writing-revision and approved to submit the final version.

AI contribution statement: AI tools (specifically Claude) were used for linguistic refinement and formatting assistance in the manuscript and answering review. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.

Supported by the Exxon-Mobil National University Singapore Research Fellowship for Clinicians.

Institutional review board statement: This study was approved by the National Healthcare Group Domain Specific Review Board (Approval No. 2017/00298).

Clinical trial registration statement: The study was not a clinical trial and it was not registered. Although the study is a prospective study, it is an observational study involving stool sample collection during disease flare and remission, with no intervention. Hence it is not a clinical/interventional trial that requires registration.

Informed consent statement: Written informed consent was obtained from all study participants.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

Data sharing statement: Data is confidential and can be shared upon reasonable request.

Corresponding author: James Guoxian Huang, Assistant Professor, Department of Paediatrics, Khoo Teck Puat - National University Children’s Medical Institute, National University Health System, 1E Kent Ridge Road, National University Health System Tower Block, Level 12, Singapore 119228, Singapore. paehgj@nus.edu.sg

Received: February 14, 2026
Revised: March 10, 2026
Accepted: May 14, 2026
Published online: September 9, 2026
Processing time: 168 Days and 23.6 Hours

Core Tip

Core Tip: Using a longitudinal paired design, this paediatric inflammatory bowel disease metagenomic study shows that transition from active disease to remission is marked by a distinct gut microbiome with functional relevance. Remission was associated with enrichment of beneficial taxa (Anaerostipes hadrus, Bifidobacterium spp., Faecalibacterium prausnitzii, Lactobacillus gasseri) and metabolic pathways supporting short-chain fatty acid production, epithelial barrier repair, and immune modulation, whereas flare was dominated by Klebsiella pneumoniae. These findings highlight microbiome-derived functional pathways as promising targets for non-invasive biomarkers and microbiome-based therapeutic strategies to sustain remission in paediatric inflammatory bowel disease.