Nakai Yoko, Akagawa Shohei, Fujishiro Sadayuki, Akagawa Yuko, Yamagishi Mitsuru, Yamanouchi Sohsaku, Kimata Takahisa, Ohashi Atsushi, Hashiyada Masaki, Akane Atsushi, Tsuji Shoji, Kaneko Kazunari
Department of Pediatrics, Kansai Medical University, Hirakata, Osaka, Japan.
Department of Legal Medicine, Kansai Medical University, Hirakata, Osaka, Japan.
JPEN J Parenter Enteral Nutr. 2023 Jan;47(1):67-76. doi: 10.1002/jpen.2435. Epub 2022 Aug 29.
Children with severe motor and intellectual disabilities (SMIDs) frequently and continuously receive enteral nutrition and medications and lack adequate exercise, which may lead to dysbiosis, an imbalance in the composition of the gut microbiota. However, studies on the composition of gut microbiota in children with SMIDs are limited. Therefore, we aimed to examine the characteristics of the gut microbiota in children with SMIDs.
16S rRNA gene sequencing was performed using fecal samples of 10 children with SMIDs, who received enteral nutrition through a gastric fistula or gastric tube (SMID group: median age, 10.0 years), and 19 healthy children (healthy control [HC] group: median age, 9.0 years). Microbial diversity, microbial composition, and abundance of butyric acid-producing bacteria were compared between the groups. Daily dietary fiber intake in the SMID group was evaluated using questionnaires.
The Shannon and Simpson indices (alpha diversity indices) were significantly lower in the SMID group than those in the HC group. Beta diversity analysis identified different clusters. Compared with the HC group, Clostridiales and butyric acid-producing bacteria were less abundant and Bacteroidales were more abundant in the SMID group. Dietary fiber intake in the SMID group was approximately two-thirds of the estimated average requirement for healthy Japanese children.
Children with SMIDs showed dysbiosis with alteration in the microbial diversity, which could partly be attributed to their low dietary fiber intake. Further studies, with the intervention of prebiotics, probiotics, and synbiotics, are warranted to improve dysbiosis in children with SMIDs.
患有严重运动和智力残疾（SMIDs）的儿童经常持续接受肠内营养和药物治疗，且缺乏足够的运动，这可能导致肠道菌群失调，即肠道微生物群组成失衡。然而，关于SMIDs儿童肠道微生物群组成的研究有限。因此，我们旨在研究SMIDs儿童肠道微生物群的特征。
对10名通过胃瘘或胃管接受肠内营养的SMIDs儿童（SMID组：中位年龄10.0岁）和19名健康儿童（健康对照组[HC]：中位年龄9.0岁）的粪便样本进行16S rRNA基因测序。比较两组之间的微生物多样性、微生物组成和产丁酸细菌的丰度。通过问卷调查评估SMID组的每日膳食纤维摄入量。
SMID组的香农指数和辛普森指数（α多样性指数）显著低于HC组。β多样性分析确定了不同的聚类。与HC组相比，SMID组中梭菌目和产丁酸细菌的丰度较低，拟杆菌目的丰度较高。SMID组的膳食纤维摄入量约为健康日本儿童估计平均需求量的三分之二。
SMIDs儿童表现出微生物多样性改变的肠道菌群失调，这可能部分归因于他们膳食纤维摄入量低。有必要进一步开展研究，采用益生元、益生菌和合生元进行干预，以改善SMIDs儿童的肠道菌群失调。
