Pini Prato Alessio, Bartow-McKenney Casey, Hudspeth Kelly, Mosconi Manuela, Rossi Valentina, Avanzini Stefano, Faticato Maria G, Ceccherini Isabella, Lantieri Francesca, Mattioli Girolamo, Larson Denise, Pavan William, De Filippo Carlotta, Di Paola Monica, Mavilio Domenico, Cavalieri Duccio
Division of Pediatric Surgery, AON SS Antonio e Biagio e Cesare Arrigo, Alessandria, Italy.
Division of Pediatric Surgery, Giannina Gaslini Institute, Genoa, Italy.
Front Pediatr. 2019 Aug 9;7:326. doi: 10.3389/fped.2019.00326. eCollection 2019.
Since 2010, several researches demonstrated that microbiota dynamics correlate and can even predispose to Hirschsprung (HSCR) associated enterocolitis (HAEC). This study aims at assessing the structure of the microbiota of HSCR patients in relation to extent of aganglionosis and HAEC status. All consecutive HSCR patients admitted to Gaslini Institute (Genova, Italy) between May 2012 and November 2014 were enrolled. Institutional review board (IRB) approval was obtained. Stools were sampled and 16S rDNA V3-V4 regions were sequenced using the Illumina-MiSeq. Taxonomy assignments were performed using QIIME RDP. Alpha diversity indexes were analyzed by Shannon and Simpson Indexes, and Phylogenetic Diversity. We enrolled 20 patients. Male to female ratio was 4:1. Six patients suffered from Total Colonic Aganglionosis (TCSA). Considering sample site (i.e., extent of aganglionosis), we confirmed the known relationship between sample site and both biodiversity and composition of intestinal microbiota. Patients with TCSA showed lower biodiversity and increased Proteobacteria/Bacteroidetes relative abundance ratio. When addressing biodiversity, composition and dynamics of TCSA patients we could not find any significant relationship with regard to HAEC occurrences. The composition of HAEC predisposing microbiota is specific to each patient. We could confirm that total colon resections can change the composition of intestinal microbiota and to dramatically reduce microbial diversity. The subsequent reduction of system robustness could expose TCSA patients to environmental microbes that might not be part of the normal microbiota. Future long-term studies should investigate both patients and their family environment, as well as their disease history.
自2010年以来，多项研究表明，微生物群动态变化与先天性巨结肠（HSCR）相关小肠结肠炎（HAEC）存在关联，甚至可能是其诱因。本研究旨在评估HSCR患者的微生物群结构与无神经节细胞症范围及HAEC状态之间的关系。纳入了2012年5月至2014年11月期间入住加斯林尼研究所（意大利热那亚）的所有连续性HSCR患者。获得了机构审查委员会（IRB）的批准。采集粪便样本，使用Illumina-MiSeq对16S rDNA V3-V4区域进行测序。使用QIIME RDP进行分类学赋值。通过香农指数、辛普森指数和系统发育多样性分析α多样性指数。我们纳入了20名患者。男女比例为4:1。6名患者患有全结肠无神经节细胞症（TCSA）。考虑样本部位（即无神经节细胞症范围），我们证实了样本部位与肠道微生物群的生物多样性和组成之间的已知关系。TCSA患者的生物多样性较低，变形菌门/拟杆菌门相对丰度比值增加。在研究TCSA患者的生物多样性、组成和动态变化时，我们未发现与HAEC发生之间存在任何显著关系。HAEC易感微生物群的组成因患者而异。我们可以证实，全结肠切除术会改变肠道微生物群的组成，并显著降低微生物多样性。随后系统稳健性的降低可能使TCSA患者暴露于可能不属于正常微生物群的环境微生物中。未来的长期研究应调查患者及其家庭环境以及他们的疾病史。
