Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Centre for Chronic Intestinal Failure, IRCCS AOUBO, Bologna, Italy.
Microbiomics Unit, Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Clin Nutr. 2024 Jun;43(6):1331-1342. doi: 10.1016/j.clnu.2024.04.018. Epub 2024 Apr 18.
Fecal microbiota was investigated in adult patients with chronic intestinal failure (CIF) due to short bowel syndrome (SBS) with jejunocolonic anastomosis (SBS-2). Few or no data are available on SBS with jejunostomy (SBS-1) and CIF due to intestinal dysmotility (DYS) or mucosal disease (MD). We profiled the fecal microbiota of various pathophysiological mechanisms of CIF.
Cross-sectional study on 61 adults with CIF (SBS-1 30, SBS-2 17, DYS 8, MD 6). Fecal samples were collected and profiled by 16S rRNA amplicon sequencing. Healthy controls (HC) were selected from pre-existing cohorts, matched with patients by sex and age.
Compared to HC, SBS-1, SBS-2 and MD patients showed lower alpha diversity; no difference was found for DYS. In beta diversity analysis, SBS-1, SBS-2 and DYS groups segregated from HC and from each other. Taxonomically, the CIF groups differed from HC even at the phylum level. In particular, CIF patients' microbiota was dominated by Lactobacillaceae and Enterobacteriaceae, while depleted in typical health-associated taxa belonging to Lachnospiraceae and Ruminococcaceae. Notably, compositional peculiarities of the CIF groups emerged. Furthermore, in the SBS groups, the microbiota profile differed according to the amount of parenteral nutrition required and the duration of CIF.
CIF patients showed marked intestinal dysbiosis with microbial signatures specific to the pathophysiological mechanism of CIF as well as to the severity and duration of SBS.
研究患有短肠综合征（SBS）合并空肠结肠吻合术（SBS-2）的慢性肠衰竭（CIF）成年患者的粪便微生物群。关于空肠造口术（SBS-1）和因肠动力障碍（DYS）或黏膜疾病（MD）导致的 CIF 的 SBS 数据很少或没有。我们对 CIF 的各种病理生理机制的粪便微生物群进行了分析。
对 61 名 CIF 成人（SBS-1 30 例，SBS-2 17 例，DYS 8 例，MD 6 例）进行横断面研究。采集粪便样本，通过 16S rRNA 扩增子测序进行分析。健康对照（HC）从现有的队列中选择，按性别和年龄与患者匹配。
与 HC 相比，SBS-1、SBS-2 和 MD 患者的 alpha 多样性较低；DYS 患者无差异。在 beta 多样性分析中，SBS-1、SBS-2 和 DYS 组与 HC 组以及彼此之间均有分离。在分类学上，即使在门水平上，CIF 组与 HC 也存在差异。特别是，CIF 患者的微生物群以乳杆菌科和肠杆菌科为主，而与厚壁菌门和瘤胃球菌科等与健康相关的典型属类减少。值得注意的是，CIF 组出现了组成上的特殊性。此外，在 SBS 组中，根据所需的肠外营养量和 CIF 的持续时间，微生物群谱也有所不同。
CIF 患者表现出明显的肠道菌群失调，其微生物特征与 CIF 的病理生理机制以及 SBS 的严重程度和持续时间有关。
