Tursi Antonio, Mastromarino Paola, Capobianco Daniela, Elisei Walter, Miccheli Alfredo, Capuani Giorgio, Tomassini Alberta, Campagna Giuseppe, Picchio Marcello, Giorgetti GianMarco, Fabiocchi Federica, Brandimarte Giovanni
*Gastroenterology Service, ASL BAT, Andria (BT) Departments of †Public Health and Infectious Diseases, Section of Microbiology §Chemistry ∥Experimental Medicine, Sapienza University ‡Division of Gastroenterology, ASL RMH, Albano Laziale ¶Division of Surgery, "P. Colombo" Hospital, ASL RMH, Velletri #Digestive Endoscopy and Nutrition Unit, "S. Eugenio" Hospital **Division of Gastroenterology, "Cristo Re" Hospital, GIOMI Group, Rome, Italy.
J Clin Gastroenterol. 2016 Oct;50 Suppl 1:S9-S12. doi: 10.1097/MCG.0000000000000626.
The aim of this study was to assess fecal microbiota and metabolome in a population with symptomatic uncomplicated diverticular disease (SUDD).
Whether intestinal microbiota and metabolic profiling may be altered in patients with SUDD is unknown.
Stool samples from 44 consecutive women [15 patients with SUDD, 13 with asymptomatic diverticulosis (AD), and 16 healthy controls (HCs)] were analyzed. Real-time polymerase chain reaction was used to quantify targeted microorganisms. High-resolution proton nuclear magnetic resonance spectroscopy associated with multivariate analysis with partial least-square discriminant analysis (PLS-DA) was applied on the metabolite data set.
The overall bacterial quantity did not differ among the 3 groups (P=0.449), with no difference in Bacteroides/Prevotella, Clostridium coccoides, Bifidobacterium, Lactobacillus, and Escherichia coli subgroups. The amount of Akkermansia muciniphila species was significantly different between HC, AD, and SUDD subjects (P=0.017). PLS-DA analysis of nuclear magnetic resonance -based metabolomics associated with microbiological data showed significant discrimination between HCs and AD patients (R=0.733; Q=0.383; P<0.05, LV=2). PLS analysis showed lower N-acetyl compound and isovalerate levels in AD, associated with higher levels of A. municiphila, as compared with the HC group. PLS-DA applied on AD and SUDD samples showed a good discrimination between these 2 groups (R=0.69; Q=0.35; LV=2). SUDD patients were characterized by low levels of valerate, butyrate, and choline and by high levels of N-acetyl derivatives and U1.
SUDD and AD do not show colonic bacterial overgrowth, but a significant difference in the levels of fecal A. muciniphila was observed. Moreover, increasing expression of some metabolites as expression of different AD and SUDD metabolic activity was found.
本研究旨在评估有症状的非复杂性憩室病（SUDD）人群的粪便微生物群和代谢组。
SUDD患者的肠道微生物群和代谢谱是否会发生改变尚不清楚。
分析了44名连续女性的粪便样本[15例SUDD患者、13例无症状憩室病（AD）患者和16名健康对照者（HC）]。采用实时聚合酶链反应定量靶向微生物。将高分辨率质子核磁共振波谱与偏最小二乘判别分析（PLS-DA）的多变量分析相结合，应用于代谢物数据集。
三组之间的总细菌数量无差异（P=0.449），拟杆菌属/普雷沃菌属、球状梭菌、双歧杆菌、乳酸杆菌和大肠杆菌亚组也无差异。嗜黏蛋白阿克曼氏菌的数量在HC、AD和SUDD受试者之间存在显著差异（P=0.017）。基于核磁共振的代谢组学与微生物学数据的PLS-DA分析显示，HC和AD患者之间存在显著差异（R=0.733；Q=0.383；P<0.05，LV=2）。PLS分析显示，与HC组相比，AD组中N-乙酰化合物和异戊酸水平较低，而嗜黏蛋白阿克曼氏菌水平较高。对AD和SUDD样本进行的PLS-DA显示这两组之间有良好的区分度（R=0.69；Q=0.35；LV=2）。SUDD患者的特征是戊酸、丁酸和胆碱水平较低，N-乙酰衍生物和U1水平较高。
SUDD和AD未显示结肠细菌过度生长，但观察到粪便中嗜黏蛋白阿克曼氏菌水平存在显著差异。此外，还发现了一些代谢物表达增加，作为不同AD和SUDD代谢活性的表达。
