Influence of Fusobacterium nucleatum on Tumor Necrosis Factor Alpha Therapy in Ulcerative Colitis.

Inflammatory bowel disease (IBD), including ulcerative colitis (UC), involves chronic gastrointestinal inflammation, with tumor necrosis factor alpha (TNF-α) playing a key role. Anti-TNF therapy is widely used, but not all UC patients respond, suggesting additional contributing factors. Gut microbiota alterations, particularly dysbiosis, may influence treatment outcomes. This study examines the relationship between Fusobacterium nucleatum (F. nucleatum) density and TNF-α expression in UC patients receiving anti-TNF therapy. Biopsy samples from responders (n = 10), nonresponders (n = 10), and healthy controls (n = 10) were analyzed using real-time PCR. Fusobacterium nucleatum density was significantly higher in nonresponders than in responders (3.2-fold, p  < 0.05) and controls (fivefold, p  < 0.05). TNF-α expression was elevated in both UC groups. These findings suggest F. nucleatum may contribute to anti-TNF therapy resistance by modulating intestinal inflammation, highlighting its potential as a biomarker for treatment prediction.