Fecal microbiome and bile acid metabolome in adult short bowel syndrome

被引:17
作者
Boutte, Harold J., Jr. [1 ]
Chen, Jacqueline [1 ]
Wylie, Todd N. [2 ,3 ]
Wylie, Kristine M. [2 ,3 ]
Xie, Yan [1 ]
Geisman, Mackenzie [1 ]
Prabu, Anirudh [1 ]
Gazit, Vered [1 ]
Tarr, Phillip, I [2 ,4 ]
Levin, Marc S. [1 ,7 ]
Warner, Brad W. [5 ]
Davidson, Nicholas O. [1 ,6 ]
Rubin, Deborah C. [1 ,6 ]
机构
[1] Washington Univ, Sch Med, Dept Med, Div Gastroenterol, St Louis, MO 63110 USA
[2] Washington Univ, Sch Med, Dept Pediat, St Louis, MO 63110 USA
[3] Washington Univ, Sch Med, McDonnell Genome Inst, St Louis, MO USA
[4] Washington Univ, Sch Med, Dept Mol Microbiol, St Louis, MO 63110 USA
[5] Washington Univ, Sch Med, Dept Surg, Div Pediat Surg, St Louis, MO 63110 USA
[6] Washington Univ, Sch Med, Dept Dev Biol, St Louis, MO 63110 USA
[7] Vet Adm St Louis Hlth Care Syst, St Louis, MO USA
来源
AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY | 2022年 / 322卷 / 01期
关键词
enterohepatic bile acid cycling; FGF19; intestinal adaptation; short gut syndrome; AKKERMANSIA-MUCINIPHILA; GUT; SIGNATURES; RESPONSES;
D O I
10.1152/ajpgi.00091.2021
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Loss of functional small bowel surface area causes short bowel syndrome (SBS), intestinal failure, and parenteral nutrition (PN) dependence. The gut adaptive response following resection may be difficult to predict, and it may take up to 2 yr to determine which patients will wean from PN. Here, we examined features of gut microbiota and bile acid (BA) metabolism in determining adaptation and ability to wean from PN. Stool and sera were collected from healthy controls and from patients with SBS (n = 52) with ileostomy, jejunostomy, ileocolonic, and jejunocolonic anastomoses fed with PN plus enteral nutrition or who were exclusively enterally fed. We undertook 16S rRNA gene sequencing, BA profiling, and 7a-hydroxy-4-cholesten-3-one (C4) quantitation with LC-MS/MS and serum amino acid analyses. Patients with SBS exhibited altered gut microbiota with reduced gut microbial diversity compared with healthy controls. We observed differences in the microbiomes of patients with SBS with ileostomy versus jejunostomy, jejunocolonic versus ileocolonic anastomoses, and PN dependence compared with those who weaned from PN. Stool and serum BA composition and C4 concentrations were also altered in patients with SBS, reflecting adaptive changes in enterohepatic BA cycling. Stools from patients who were weaned from PN were enriched in secondary BAs including deoxycholic acid and lithocholic aicd. Shifts in gut microbiota and BA metabolites may generate a favorable luminal environment in select patients with SBS, promoting the ability to wean from PN. Proadaptive microbial species and select BA may provide novel targets for patient-specific therapies for SBS. NEW & NOTEWORTHY Loss of intestinal surface area causes short bowel syndrome, intestinal failure, and parenteral nutrition dependence. We analyzed the gut microbiota and bile acid metabolome of a large cohort of short bowel syndrome adult patients with different postsurgical anatomies. We report a novel analysis of the microbiome of patients with ileostomy and jejunostomy. Enrichment of specific microbial and bile acid species may be associated with the ability to wean from parenteral nutrition.
引用
收藏
页码:G154 / G168
页数:15
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