Song Wei, Sun Li-Ying, Zhu Zhi-Jun
Liver Transplantation Center, National Clinical Research Center for Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, Beijing, China.
Clinical Center for Pediatric Liver Transplantation, Capital Medical University, Beijing, China.
Front Med (Lausanne). 2021 Sep 27;8:704328. doi: 10.3389/fmed.2021.704328. eCollection 2021.
Biliary atresia (BA) is the most common cholestatic liver disease in neonates. Although the Kasai procedure can improve temporary biliary drainage in some cases, complications and liver fibrosis still develop. Liver transplantation is the ultimate treatment. The current study aimed to investigate the effect of previous Kasai surgery on gut microbiota and bile acid in BA with end-stage liver disease. Patients with BA with end-stage liver disease were divided into two groups according to whether they had previously undergone Kasai surgery (non-Kasai: = 8, post-Kasai: = 8). Metagenomic sequencing and ultraperformance liquid chromatography/tandem mass spectrometry were performed to identify the gut microbiota and bile acid. Previous Kasai surgery had some effects on gut microbiota and bile acid in BA with end-stage liver disease. In the gut microbiome, the differential species were mainly distributed at the species level. had a significant increase in the non-Kasai group ( < 0.05). spp., spp., spp., spp., spp., spp. and spp. were increased in the post-Kasai group ( < 0.05). Concerning functional profiles, methionine biosynthesis was enriched in the non-Kasai group, while pyridoxal biosynthesis and riboflavin biosynthesis were enriched in the post-Kasai group (linear discriminant analysis > 2, < 0.05). In stools, 17 bile acids were distinctly elevated in the post-Kasai group, such as cholic acid, chenodeoxycholic acid, β-muricholic acid and tauro α-muricholate ( < 0.05). Spearman correlation test showed that had an enormously positive correlation with liver enzymes. and were associated with derivatives of the alternative pathway of bile acid metabolism. Previous Kasai surgery can improve the gut microbiota and bile acid in patients with BA with end-stage liver disease. This improvement contributes to maintaining the intestinal barrier.
胆道闭锁（BA）是新生儿中最常见的胆汁淤积性肝病。尽管在某些情况下，葛西手术可以改善临时胆汁引流，但并发症和肝纤维化仍会发展。肝移植是最终的治疗方法。本研究旨在探讨既往葛西手术对终末期肝病BA患儿肠道微生物群和胆汁酸的影响。将终末期肝病BA患儿根据是否曾接受葛西手术分为两组（未接受葛西手术组：n = 8，接受葛西手术组：n = 8）。采用宏基因组测序和超高效液相色谱/串联质谱法鉴定肠道微生物群和胆汁酸。既往葛西手术对终末期肝病BA患儿的肠道微生物群和胆汁酸有一定影响。在肠道微生物组中，差异物种主要分布在物种水平。未接受葛西手术组中某物种显著增加（P < 0.05）。接受葛西手术组中某几个物种增加（P < 0.05）。关于功能谱，蛋氨酸生物合成在未接受葛西手术组中富集，而吡哆醛生物合成和核黄素生物合成在接受葛西手术组中富集（线性判别分析>2，P < 0.05）。在粪便中，接受葛西手术组有17种胆汁酸明显升高，如胆酸、鹅去氧胆酸、β-鼠胆酸和牛磺α-鼠胆酸盐（P < 0.05）。Spearman相关性检验显示某物质与肝酶呈极显著正相关。某两种物质与胆汁酸代谢替代途径的衍生物有关。既往葛西手术可改善终末期肝病BA患儿的肠道微生物群和胆汁酸。这种改善有助于维持肠道屏障。
