Laboratory Animal Center, Xi'an Jiaotong University Health Science Center, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
Research Institute of Atherosclerotic Disease and Laboratory Animal Center, School of Medicine, Xi'an Jiaotong University, Xi'an 710061, Shaanxi Province, China.
World J Gastroenterol. 2021 Feb 7;27(5):391-403. doi: 10.3748/wjg.v27.i5.391.
Post-cholecystectomy diarrhea (PCD) frequently occurs in patients following gallbladder removal. PCD is part of the post-cholecystectomy (PC) syndrome, and is difficult to treat. After cholecystectomy, bile enters the duodenum directly, independent of the timing of meals. The interaction between the bile acids and the intestinal microbes is changed. Therefore, the occurrence of PCD may be related to the change in microbiota. However, little is known about the relationship between the gut microbiota and PCD.
To better understand the role of the gut microbiota in PCD patients.
Fecal DNA was isolated. The diversity and profiles of the gut microbiota were analyzed by performing high-throughput 16S rRNA gene sequencing. The gut microbiota were characterized in a healthy control (HC) group and a PC group. Subsequently, the PC group was further divided into a PCD group and a post-cholecystectomy non-diarrhea group (PCND) according to the patients' clinical symptoms. The composition, diversity and richness of microbial communities were determined and compared.
In the PC and HC groups, 720 operational taxonomic units (OTUs) were identified. The PC group had fewer OTUs than the HC group. β-diversity was decreased in the PC group. This indicated decreased microbial diversity in the PC group. Fifteen taxa with differential abundance between the HC and PC groups were identified. In the PCD group compared to the PCND group, significant decreases in microbial diversity, Firmicutes/Bacteroidetes ratio, and richness of probiotic microbiota (Bifidobacterium and Lactococcus), and an increase in detrimental microbiota (Prevotella and Sutterella) were observed. Moreover, a negative correlation was found between Prevotella and Bifidobacterium. Using a Kyoto Encyclopedia of Genes and Genomes functional analysis, it was found that the abundances of gut microbiota involved in lipid metabolism pathways were markedly lower in the PCD group compared to the PCND group.
This study demonstrated that gut dysbiosis may play a critical role in PCD, which provides new insights into therapeutic options for PCD patients.
胆囊切除术后腹泻（PCD）经常发生在胆囊切除术后的患者中。PCD 是胆囊切除术后综合征（PC）的一部分，且难以治疗。胆囊切除术后，胆汁直接进入十二指肠，与进食时间无关。胆汁酸与肠道微生物的相互作用发生改变。因此，PCD 的发生可能与微生物群的改变有关。然而，关于肠道微生物群与 PCD 的关系知之甚少。
更好地了解肠道微生物群在 PCD 患者中的作用。
分离粪便 DNA。通过高通量 16S rRNA 基因测序分析肠道微生物群的多样性和特征。在健康对照组（HC）和 PC 组中对肠道微生物群进行了特征描述。随后，根据患者的临床症状，将 PC 组进一步分为 PCD 组和胆囊切除术后非腹泻组（PCND）。确定并比较了微生物群落的组成、多样性和丰富度。
在 PC 和 HC 组中，鉴定出 720 个操作分类单位（OTU）。PC 组的 OTU 少于 HC 组。PC 组的 β-多样性降低。这表明 PC 组的微生物多样性降低。鉴定出 15 个在 HC 和 PC 组之间丰度有差异的分类群。与 PCND 组相比，PCD 组的微生物多样性、厚壁菌门/拟杆菌门比值、益生菌菌群（双歧杆菌和乳球菌）的丰富度显著降低，而有害菌群（普雷沃氏菌和萨特氏菌）增加。此外，发现普雷沃氏菌与双歧杆菌呈负相关。使用京都基因与基因组百科全书功能分析发现，与 PCND 组相比，PCD 组肠道微生物群参与脂质代谢途径的丰度明显降低。
本研究表明，肠道菌群失调可能在 PCD 中起关键作用，为 PCD 患者的治疗选择提供了新的思路。
