Abdel-Raoof Fouda Mohamed, Abdel-Wahhab Mohamed, Abdelkader Ahmed Esmail, Ibrahim Mohsen El-Sayd, Elsheikh Taher Abozeid, Aldeweik Hisham Mohammad, Elfeky Nora
Microbiology, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
General Surgery, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
BMC Infect Dis. 2025 Jan 30;25(1):140. doi: 10.1186/s12879-025-10466-9.
Liver transplantation (LT) is a critical intervention for individuals with end-stage liver disease; yet, post-transplant problems, especially infections, graft rejection, and chronic liver disease, are often linked to systemic inflammation. Cytokines, small signaling molecules, significantly influence immune responses during and post-liver transplantation. Nonetheless, the intricate relationships among cytokines, immune responses, and the gut microbiota, especially gut dysbiosis, are still inadequately comprehended. Thus, this study aims to identify the gut microbiota (GM) and determine their relationship to cytokines (IL-17 and IL-10) in LT patients, due to their importance in enhancing the recovery rate.
The research included 31 liver transplant (LT) patients from the Gastroenterology Surgical Center at Mansoura University, resulting in the collection of 174 stool and blood samples from all participants. Fourteen bacterial species have been identified in samples collected at three intervals: one week before, one week post, and two weeks post LT. A change in gut microbiota composition was noted, characterized by a rise in potentially pathogenic bacteria such as Enterococci and Enterobacteriaceae (including Escherichia coli and Klebsiella) and a reduction in beneficial bacteria such as Bacteroidetes and Firmicutes. The examination of patient demographic and clinical data revealed no significant correlations between sex, age, or diagnostic categories and gut microbiota composition. The findings of the Multivariate Analysis of Variance (MANOVA) indicated a substantial effect of gut microbiota composition on cytokine levels (IL-10 and IL-17), with all tests producing p-values of 0.001. The assessment of cytokine levels indicated fluctuating variations at several time points following surgery. IL-10 levels in the GM groups exhibited a statistically significant elevation during the second week post-surgery (p = 0.036), suggesting a potential recovery-related anti-inflammatory response. In contrast, IL-17 levels rose in the NI group over time, indicating a transition to a pro-inflammatory condition.
This study emphasizes the pivotal role of the gut microbiota in regulating immune responses following transplantation.
肝移植（LT）是终末期肝病患者的关键治疗手段；然而，移植后问题，尤其是感染、移植物排斥和慢性肝病，往往与全身炎症有关。细胞因子作为小信号分子，在肝移植期间及移植后对免疫反应有显著影响。尽管如此，细胞因子、免疫反应和肠道微生物群（尤其是肠道菌群失调）之间的复杂关系仍未得到充分理解。因此，本研究旨在确定肝移植患者的肠道微生物群（GM），并确定它们与细胞因子（IL-17和IL-10）的关系，因为它们对提高恢复率很重要。
该研究纳入了曼苏拉大学胃肠外科中心的31例肝移植（LT）患者，共收集了所有参与者的174份粪便和血液样本。在肝移植前一周、移植后一周和移植后两周这三个时间点采集的样本中，共鉴定出14种细菌。观察到肠道微生物群组成发生了变化，其特征是潜在致病菌如肠球菌和肠杆菌科（包括大肠杆菌和克雷伯菌）增加，而有益菌如拟杆菌门和厚壁菌门减少。对患者人口统计学和临床数据的检查显示，性别、年龄或诊断类别与肠道微生物群组成之间无显著相关性。多变量方差分析（MANOVA）结果表明，肠道微生物群组成对细胞因子水平（IL-10和IL-17）有显著影响，所有测试的p值均为0.001。细胞因子水平评估表明，术后几个时间点存在波动变化。GM组的IL-10水平在术后第二周出现统计学显著升高（p = 0.036），表明可能存在与恢复相关的抗炎反应。相比之下，NI组的IL-17水平随时间升高，表明向促炎状态转变。
本研究强调了肠道微生物群在调节移植后免疫反应中的关键作用。
