Busing Jordan D, Fouladi Farnaz, Bulik-Sullivan Emily C, Carroll Ian M, Fodor Anthony A, Thomsen Kelly F, Gulati Ajay S, Nicholson Maribeth R
From the Department of Pediatric Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center, Nashville, TN.
Department of Bioinformatics and Genomics, University of North Carolina at Charlotte, Charlotte, NC.
JPGN Rep. 2023 Jun 9;4(3):e319. doi: 10.1097/PG9.0000000000000319. eCollection 2023 Aug.
D-lactic acidosis (D-LA) is an uncommon complication of short bowel syndrome characterized by elevated plasma D-lactate and encephalopathy. Treatments include rehydration, dietary carbohydrate restriction, and antibiotics to alter the gut microbiota. Fecal microbiota transplantation (FMT) has recently been used in children to successfully treat D-LA. We compared the clinical course and then utilized metagenomic shotgun sequencing to describe changes in the composition and function of the intestinal microbiome following FMT in 2 patients with recurrent D-LA. FMT altered the composition of the fecal microbiota in these 2 patients with recurrent D-LA, though not necessarily in a consistent manner. Importantly, microbial metabolic pathways were also impacted by FMT, which may be critical for achieving desired clinical outcomes. While sample size limits the generalizability of our results, these findings set the stage for further understanding of the role of microbes in the pathogenesis of recurrent D-LA.
D-乳酸酸中毒（D-LA）是短肠综合征的一种罕见并发症，其特征为血浆D-乳酸水平升高和脑病。治疗方法包括补液、限制饮食中的碳水化合物以及使用抗生素来改变肠道微生物群。粪便微生物群移植（FMT）最近已用于儿童，成功治疗了D-LA。我们比较了临床病程，然后利用宏基因组鸟枪法测序来描述2例复发性D-LA患者接受FMT后肠道微生物组的组成和功能变化。FMT改变了这2例复发性D-LA患者的粪便微生物群组成，尽管不一定是一致的方式。重要的是，微生物代谢途径也受到FMT的影响，这可能对实现预期的临床结果至关重要。虽然样本量限制了我们结果的普遍性，但这些发现为进一步了解微生物在复发性D-LA发病机制中的作用奠定了基础。
