Yin Xi, Xiao Minhua, Sun Jing, Feng Jinqing, Xia Shuliang, Li Fengxiang, Liu Xihong, Li Jia
Clinical Physiology Laboratory, Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou, China.
Department of Nutrition, Guangzhou Women and Children's Medical Center, Guangzhou, China.
Front Cell Infect Microbiol. 2025 Feb 13;14:1470925. doi: 10.3389/fcimb.2024.1470925. eCollection 2024.
Varied congenital heart disease (CHD) may induce gut microbiota dysbiosis due to intestinal hypoperfusion or/and hypoxemia. Microbiota dysbiosis has been found in preoperative infants and cardiopulmonary bypass (CPB) exacerbated it further. However, the trajectory of gut microbiota from pre- to early post-CPB and one-year later remains unexplored. We examined this trajectory in the two most common CHDs, i.e., left-to-right shunt (ventricular septal defect, VSD) vs. right-to-left shunt (tetralogy of Fallot, TOF).
We enrolled 13 infants with VSD and 11 with TOF, and collected fecal samples at pre- and early post-CPB. 10 and 12 age- and gender-matched healthy control infants were enrolled respectively. We also enrolled 13 and 9 gender- and CHD diagnosis- and operation-matched one-year post-CPB patients, and 8 age- and gender-matched healthy control children. 16S rRNA sequencing of fecal samples were performed.
Compared to the control groups, both VSD and TOF pre-CPB groups had significantly increased Enterobacteriaceae and , and decreased ( 0.049). No significant change in microbial community diversity was observed between pre- and early post-CPB periods (≥0.227). Compared with early post-CPB, one-year post-CPB groups had significantly increased short-chain fatty acids-producing microbes ( ≤ 0.025), and their microbial communities were close to that of the control group (≥0.102). There was no significant difference in microbial communities between VSD and TOF groups in any of 3 periods (≥0.055).
In children with VSD or TOF, gut microbiota dysbiosis existed preoperatively and were not significantly altered by CPB. One-year post-CPB, microbiota significantly improved towards normal. Similar microbial communities were found between children with VSD and TOF throughout the perioperative and long-term postoperative periods.
多种先天性心脏病（CHD）可能由于肠道灌注不足或/和低氧血症而导致肠道微生物群失调。术前婴儿中已发现微生物群失调，而体外循环（CPB）会使其进一步加剧。然而，从CPB前到CPB后早期以及一年后的肠道微生物群变化轨迹仍未得到探索。我们在两种最常见的先天性心脏病中研究了这一轨迹，即左向右分流（室间隔缺损，VSD）与右向左分流（法洛四联症，TOF）。
我们纳入了13例VSD婴儿和11例TOF婴儿，并在CPB前和CPB后早期采集粪便样本。分别纳入了10例和12例年龄和性别匹配的健康对照婴儿。我们还纳入了13例和9例CPB后一年的性别、CHD诊断和手术匹配的患者，以及8例年龄和性别匹配的健康对照儿童。对粪便样本进行16S rRNA测序。
与对照组相比，VSD和TOF的CPB前组肠杆菌科均显著增加，而双歧杆菌属减少（P<0.049）。CPB前和CPB后早期之间未观察到微生物群落多样性的显著变化（P≥0.227）。与CPB后早期相比，CPB后一年组中产生短链脂肪酸的微生物显著增加（P≤0.025），其微生物群落接近对照组（P≥0.102）。在三个时期中的任何一个时期，VSD和TOF组之间的微生物群落均无显著差异（P≥0.055）。
在VSD或TOF患儿中，术前存在肠道微生物群失调，且未因CPB而发生显著改变。CPB后一年，微生物群显著向正常改善。在围手术期和术后长期，VSD和TOF患儿之间发现了相似的微生物群落。
