Division of Gastroenterology, Shenzhen Children's Hospital, Shenzhen, Guangdong, China.
Co-Innovation Center for Sustainable Forestry in Southern China & Key Laboratory of National Forestry and Grassland Administration on Subtropical Forest Biodiversity Conservation, College of Biology and the Environment, Nanjing Forestry University, Nanjing, China.
Front Cell Infect Microbiol. 2023 Jul 18;13:1202007. doi: 10.3389/fcimb.2023.1202007. eCollection 2023.
Split-dose polyethylene glycol (PEG) is routinely used for bowel preparation before colonoscopy. This study aimed to investigate the composition of gut microbiota and its functions in pediatric patients undergoing split-dose PEG bowel preparation for colonoscopy to understand the stability and resilience of gut microbiota.
From September to December 2021, 19 pediatric patients were enrolled at Shenzhen Children's Hospital and 76 samples (4 time points) were analyzed using metagenomics. Time points included Time_1 (one day before bowel preparation), Time_2 (one day after colonoscopy), Time_3 (two weeks after bowel preparation), and Time_4 (four weeks after bowel preparation).
Alpha diversity comparison at both the species and gene levels showed a decrease in community richness after colonoscopy, with little statistical significance. However, the Shannon diversity index significantly decreased (<0.05) and gradually returned to pre-preparation levels at two weeks after bowel preparation. The genus level analysis showed six genera (, , , , , and ) significantly different across the four time periods. Additionally, at the species level, the abundance of , , and significantly increased at one day after colonoscopy before gradually decreasing at two weeks after bowel preparation. In contrast, the abundance of decreased at one day after colonoscopy but then recovered at two weeks after bowel preparation, reaching the preoperative level at four weeks after bowel preparation. Furthermore, five functional pathways (base excision repair, biosynthesis of ansamycins, biosynthesis of siderophore group nonribosomal peptide, flavonoid biosynthesis, and biosynthesis of type II polyketide products) were significantly different across the four time periods, with recovery at two weeks after bowel preparation and reaching preoperative levels at four weeks after bowel preparation.
Gut microbiota at the genus level, species level, and functional pathways are impacted in pediatric patients undergoing split-dose PEG bowel preparation and colonoscopy, with recovery two weeks following bowel preparation. However, the phylum level was not impacted. Modifications in gut microbiota composition and function may be investigated in future studies of bowel preparation. This study highlights the stability and resilience of gut microbiota among pediatric patients during bowel preparation.
聚乙二醇（PEG）分剂量法是结肠镜检查前常规使用的肠道准备方法。本研究旨在探讨行分剂量 PEG 肠道准备的儿童患者肠道微生物群的组成及其功能，以了解肠道微生物群的稳定性和弹性。
2021 年 9 月至 12 月，在深圳市儿童医院招募了 19 名儿科患者，共分析了 76 个样本（4 个时间点），采用宏基因组学方法。时间点包括时间点 1（肠道准备前 1 天）、时间点 2（结肠镜检查后 1 天）、时间点 3（肠道准备后 2 周）和时间点 4（肠道准备后 4 周）。
在种和基因水平上进行的 alpha 多样性比较显示，结肠镜检查后群落丰富度降低，但无统计学意义。然而，Shannon 多样性指数显著下降（<0.05），并在肠道准备后 2 周逐渐恢复到准备前水平。属水平分析显示，四个时间点有 6 个属（、、、、和）有显著差异。此外，在种水平上，在结肠镜检查后 1 天，、和的丰度显著增加，然后在肠道准备后 2 周逐渐减少。相比之下，在结肠镜检查后 1 天，的丰度下降，但在肠道准备后 2 周恢复，在肠道准备后 4 周达到术前水平。此外，有 5 个功能途径（碱基切除修复、ansamycins 生物合成、铁载体非核糖体肽生物合成、黄酮类生物合成和 II 型聚酮产物生物合成）在四个时间点有显著差异，在肠道准备后 2 周恢复，并在肠道准备后 4 周达到术前水平。
在接受分剂量 PEG 肠道准备和结肠镜检查的儿科患者中，肠道微生物群在属水平、种水平和功能途径上受到影响，在肠道准备后 2 周恢复。然而，门水平不受影响。在未来的肠道准备研究中可能会进一步研究肠道微生物群组成和功能的改变。本研究强调了肠道准备期间儿科患者肠道微生物群的稳定性和弹性。
