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克罗恩病患儿的健康兄弟姐妹在对完全肠内营养的反应中,其微生物组组成的变化更快。

Healthy Siblings of Children With Crohn's Disease Exhibit More Rapid Changes in Microbiota Composition as a Response to Exclusive Enteral Nutrition.

机构信息

Children's Hospital Zagreb, Zagreb, Croatia.

University Hospital for Infectious Diseases, Zagreb, Croatia.

出版信息

JPEN J Parenter Enteral Nutr. 2021 Aug;45(6):1352-1363. doi: 10.1002/jpen.1981. Epub 2020 Aug 26.

DOI:10.1002/jpen.1981
PMID:32740959
Abstract

BACKGROUND

The aim of this study was to determine the impact of exclusive enteral nutrition (EEN) on the microbiota composition of the newly diagnosed Crohn's disease (CD) patients and to determine the effect of EEN received for 2 days in siblings of patients with CD.

METHODS

Newly diagnosed pediatric CD patients (n = 17) and unaffected healthy siblings (n = 10) participated in the study. In CD patients, stool samples were collected at 3 time points: prior to therapy introduction, the second day of EEN therapy, and the last day of EEN therapy. In healthy siblings, stool samples were collected before the introduction of EEN and the second day of EEN. Molecular approach targeting 16S ribosomal RNA was used for analyzing the gut microbiota of participants' stool samples.

RESULTS

There was no significant difference in microbial diversity between children with CD and healthy siblings before EEN (P = .127 for HhaI digestion; P = .604 for MspI digestion) as opposed to the second day of EEN (P = .006 HhaI digestion; P = .023 MspI digestion). In healthy controls, significant changes in microbiota composition were apparent by the second day of EEN, contrary to children with CD, in whom similar changes in microbiota composition were apparent on the last day of EEN.

CONCLUSION

EEN leads to significant microbiota changes in both healthy children and children with CD. Changes in microbiota composition occur more rapidly in healthy children, whereas in children with CD, significant changes were detected at the end of EEN.

摘要

背景

本研究旨在确定肠内营养(EEN)对新诊断克罗恩病(CD)患者肠道微生物群组成的影响,并确定 CD 患者的健康兄弟姐妹接受 2 天 EEN 治疗的效果。

方法

17 名新诊断的儿科 CD 患者(n=17)和 10 名未受影响的健康兄弟姐妹(n=10)参加了这项研究。在 CD 患者中,在 3 个时间点采集粪便样本:开始治疗前、EEN 治疗的第二天和 EEN 治疗的最后一天。在健康的兄弟姐妹中,在开始 EEN 治疗之前和 EEN 的第二天采集粪便样本。使用靶向 16S 核糖体 RNA 的分子方法分析参与者粪便样本中的肠道微生物群。

结果

与 EEN 前(HhaI 消化 P=0.127;MspI 消化 P=0.604)相比,CD 患儿与健康兄弟姐妹在 EEN 前的微生物多样性无显著差异(HhaI 消化 P=0.006;MspI 消化 P=0.023)。在健康对照组中,EEN 后第二天肠道微生物群组成发生显著变化,而与 CD 患儿不同,CD 患儿 EEN 最后一天肠道微生物群组成发生相似变化。

结论

EEN 导致健康儿童和 CD 儿童的肠道微生物群发生显著变化。在健康儿童中,微生物群组成的变化发生得更快,而在 CD 儿童中,在 EEN 结束时才检测到显著变化。

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