胆囊切除术后患者肠道微生物组的改变：与胆囊切除术后腹泻的潜在关系——前后研究。

Alteration of the fecal microbiome in patients with cholecystectomy: potential relationship with postcholecystectomy diarrhea - before and after study.

机构信息

Department of Gastroenterology.

Department of Surgery, Ajou University School of Medicine, Suwon, Republic of Korea.

出版信息

Int J Surg. 2023 Sep 1;109(9):2585-2597. doi: 10.1097/JS9.0000000000000518.

DOI:10.1097/JS9.0000000000000518

PMID:37288587

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10498850/

Abstract

BACKGROUND

Bile acid (BA) is a crucial determinant of the gut microbiome, and cholecystectomy can alter the physiology of BA. Physiological changes in BA resulting from cholecystectomy can also influence the gut microbiome. We aimed to identify the specific taxa associated with perioperative symptoms, including postcholecystectomy diarrhea (PCD), and to evaluate the effect of cholecystectomy on the microbiome by investigating the fecal microbiome of patients with gallstones.

METHODS

We analyzed the fecal samples of 39 patients with gallstones (GS group) and 26 healthy controls (HC group) to evaluate their gut microbiome. We also collected fecal samples from GS group 3 months postcholecystectomy. Symptoms of patients were evaluated before and after cholecystectomy. Further, 16S ribosomal RNA amplification and sequencing were performed to determine the metagenomic profile of fecal samples.

RESULTS

The microbiome composition of GS differed from that of HC; however, the alpha diversity was not different. No significant microbiome alterations were observed before and after cholecystectomy. Moreover, GS group showed a significantly lower Firmicutes to Bacteroidetes ratio before and after cholecystectomy than the HC group (6.2, P< 0.05). The inter-microbiome relationship was lower in GS than in HC and tended to recover 3 months after surgery. Furthermore, ~28.1% ( n =9) of patients developed PCD after surgery. The most prominent species among PCD (+) patients was Phocaeicola vulgatus. Compared with the preoperative state, Sutterellaceae , Phocaeicola , and Bacteroidals were the most dominant taxa among PCD (+) patients.

CONCLUSION

GS group showed a different microbiome from that of HC; however, their microbiomes were not different 3 months after cholecystectomy. Our data revealed taxa-associated PCD, highlighting the possibility of symptom relief by restoring the gut microbiome.

摘要

背景

胆汁酸（BA）是肠道微生物组的重要决定因素，胆囊切除术可以改变 BA 的生理学。胆囊切除术后 BA 的生理变化也会影响肠道微生物组。我们旨在确定与围手术期症状相关的特定分类群，包括胆囊切除术后腹泻（PCD），并通过研究胆结石患者的粪便微生物组来评估胆囊切除术对微生物组的影响。

方法

我们分析了 39 名胆结石患者（GS 组）和 26 名健康对照者（HC 组）的粪便样本，以评估他们的肠道微生物组。我们还在胆囊切除术后 3 个月收集了 GS 组的粪便样本。在胆囊切除术前和术后评估患者的症状。此外，进行 16S 核糖体 RNA 扩增和测序以确定粪便样本的宏基因组谱。

结果

GS 的微生物组组成与 HC 不同；然而，α多样性没有差异。胆囊切除术前和术后均未观察到明显的微生物组改变。此外，GS 组在胆囊切除术前和术后的厚壁菌门与拟杆菌门比值明显低于 HC 组（6.2，P<0.05）。GS 组的肠道微生物组之间的关系低于 HC 组，并在手术后 3 个月趋于恢复。此外，约 28.1%（n=9）的患者在手术后出现 PCD。PCD（+）患者中最突出的物种是 Phocaeicola vulgatus。与术前状态相比，PCD（+）患者中 Sutterellaceae、Phocaeicola 和 Bacteroidals 是最主要的分类群。