Kvasnovsky Charlotte L, Leong Lex E X, Choo Jocelyn M, Abell Guy C J, Papagrigoriadis Savvas, Bruce Kenneth D, Rogers Geraint B
Department of Surgery, University of Maryland Medical Center, Baltimore, Maryland, USA.
Department of Colorectal Surgery, King's College Hospital.
Eur J Gastroenterol Hepatol. 2018 Jan;30(1):107-112. doi: 10.1097/MEG.0000000000000995.
There is growing consensus that symptomatic uncomplicated diverticular disease is a chronic inflammatory condition, and that alterations in the fecal microbiota may contribute to its pathogenesis.
The aim of this study was to relate the fecal microbiota composition in symptomatic uncomplicated diverticular disease to measures of inflammation, symptoms, and history of previous acute diverticulitis.
Fecal microbiota composition in 28 individuals with symptomatic uncomplicated diverticular disease was characterized by 16S RNA gene amplicon sequencing. Microbiota composition was related to clinical history, symptom and inflammation measures, and demographic variables.
Previous acute diverticulitis was associated with higher relative abundance of Pseudobutyrivibrio, Bifidobacterium, Christensenellaceae family, and Mollicutes RF9 order (P=0.004, 0.006, 0.010, and 0.019, respectively), but not microbiota alpha or beta diversity. A higher bloating severity score was significantly correlated with a higher relative abundance of Ruminococcus (P=0.032), and significantly inversely correlated with the relative abundance of the Roseburia (P=0.002). Fecal calprotectin levels were positively correlated with alpha diversity (Shannon index, P=0.005) and the relative abundance of Lactobacillus (P=0.004). Pain score was positively correlated with the relative abundance of Cyanobacterium (adjusted P=0.032).
Patient symptoms in symptomatic diverticular disease are significantly correlated with features of the fecal microbiota. Our findings suggest the potential utility of therapies that target intestinal microbiology, such as dietary prebiotic supplements.
越来越多的人达成共识，即有症状的非复杂性憩室病是一种慢性炎症性疾病，并且粪便微生物群的改变可能有助于其发病机制。
本研究的目的是将有症状的非复杂性憩室病患者的粪便微生物群组成与炎症指标、症状以及既往急性憩室炎病史相关联。
通过16S RNA基因扩增子测序对28例有症状的非复杂性憩室病患者的粪便微生物群组成进行了表征。微生物群组成与临床病史、症状和炎症指标以及人口统计学变量相关。
既往急性憩室炎与假丁酸弧菌属、双歧杆菌属、克里斯滕森菌科和柔膜菌纲RF9目的相对丰度较高相关（分别为P = 0.004、0.006、0.010和0.019），但与微生物群的α或β多样性无关。腹胀严重程度评分较高与瘤胃球菌属的相对丰度较高显著相关（P = 0.032），与罗氏菌属的相对丰度显著负相关（P = 0.002）。粪便钙卫蛋白水平与α多样性（香农指数，P = 0.005）和乳酸杆菌属的相对丰度呈正相关（P = 0.004）。疼痛评分与蓝细菌属的相对丰度呈正相关（校正P = 0.032）。
有症状的憩室病患者的症状与粪便微生物群的特征显著相关。我们的研究结果表明，针对肠道微生物群的疗法（如膳食益生元补充剂）具有潜在的效用。
