Department of Veterinary Biosciences, Microbiology, University of Helsinki, Helsinki, Finland.
Immune Biology Research Program, Department of Bacteriology and Immunology, University of Helsinki, Helsinki, Finland.
Gut. 2015 Oct;64(10):1562-8. doi: 10.1136/gutjnl-2014-307240. Epub 2014 Dec 19.
An adequate bowel cleansing is essential for a successful colonoscopy. Although purgative consumption is safe for the patient, there is little consensus on how the intestinal microbiota is affected by the procedure, especially regarding the potential long-term consequences.
23 healthy subjects were randomised into two study groups consuming a bowel preparation (Moviprep), either in two separate doses of 1 L or as a single 2-L dose. Participants donated faecal samples at the baseline, after bowel cleansing, 14 and 28 days after the treatment. The intestinal microbiota composition was determined with phylogenetic microarray as well as quantitative PCR analysis and correlated with the previously quantified faecal serine proteases.
The lavage introduced an instant and substantial change to the intestinal microbiota. The total microbial load was decreased by 31-fold and 22% of the participants lost the subject-specificity of their microbiota. While the bacterial levels and community composition were essentially restored within 14 days, the rate of recovery was dose dependent: consumption of the purgative in a single dose had a more severe effect on the microbiota composition than that of a double dose, and notably increased the levels of Proteobacteria, Fusobacteria and bacteria related to Dorea formicigenerans. The abundance of the latter also correlated with the amount of faecal serine proteases that were increased after purging.
Our results suggest that the bowel cleansing using two separate dosages introduces fewer alterations to the intestinal microbiota than a single dose and hence may be preferred in clinical practice.
充分的肠道清洁对于成功进行结肠镜检查至关重要。虽然泻药的使用对患者是安全的，但对于肠道微生物群如何受到该过程的影响，尤其是关于潜在的长期后果，目前尚未达成共识。
23 名健康受试者被随机分为两组，分别服用两种不同剂量的肠道准备药物（ Moviprep），即 1 升剂量分两次服用或 2 升剂量一次性服用。参与者在基线、肠道清洁后、治疗后 14 天和 28 天捐赠粪便样本。使用系统发生微阵列以及定量 PCR 分析来确定肠道微生物群落组成，并与先前定量的粪便丝氨酸蛋白酶进行相关性分析。
冲洗即刻且大量改变了肠道微生物群。总微生物负荷降低了 31 倍，有 22%的参与者失去了其肠道微生物群的个体特异性。虽然细菌水平和群落组成在 14 天内基本恢复，但恢复速度取决于剂量：单次服用泻药对微生物群落组成的影响比两次服用更大，并且显著增加了变形菌门、梭杆菌门和与 Dorea formicigenerans 相关的细菌的水平。后者的丰度也与粪便丝氨酸蛋白酶的含量相关，该蛋白酶在冲洗后增加。
我们的结果表明，与单次剂量相比，使用两剂肠道准备药物进行肠道清洁对肠道微生物群的干扰较小，因此在临床实践中可能更受欢迎。
