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JPEN J Parenter Enteral Nutr. 2017 Sep;41(7):1202-1212. doi: 10.1177/0148607116658762. Epub 2016 Jul 12.

Severe Gut Microbiota Dysbiosis Is Associated With Poor Growth in Patients With Short Bowel Syndrome.

Author information

1
1 Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
2
2 Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
3
3 Department of Immunology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
4
4 Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
5
5 Quantitative Biomedical Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
6
6 Center for Genetics of Host Defense, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
7
7 Harold C. Simmons Cancer Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
8
8 Department of Microbiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Abstract

BACKGROUND:

Children with short bowel syndrome (SBS) can vary significantly in their growth trajectory. Recent data have shown that children with SBS possess a unique gut microbiota signature compared with healthy controls. We hypothesized that children with SBS and poor growth would exhibit more severe gut microbiota dysbiosis compared with those with SBS who are growing adequately, despite similar intestinal anatomy.

MATERIALS AND METHODS:

Stool samples were collected from children with SBS (n = 8) and healthy controls (n = 3) over 3 months. Gut microbiota populations (16S ribosomal RNA sequencing and metagenomic shotgun sequencing) were compared, including a more in-depth analysis of SBS children exhibiting poor and good growth. Statistical analysis was performed using Mann-Whitney, Kruskal-Wallis, and χ2 tests as appropriate.

RESULTS:

Children with SBS had a significant deficiency of the commensal Firmicutes order Clostridiales ( P = .025, Kruskal-Wallis) compared with healthy children. Furthermore, children with SBS and poor growth were deficient in beneficial bacteria known to produce short-chain fatty acids and had expansion of proinflammatory Enterobacteriaceae ( P = .038, Kruskal-Wallis) compared with children with SBS who were growing adequately. Using metabolic function analyses, SBS/poor growth microbiomes were deficient in genes needed for gluconeogenesis but enriched in branched and aromatic amino acid synthesis and citrate cycle pathway genes.

CONCLUSIONS:

Patients with SBS, particularly those with suboptimal growth, have a marked gut dysbiosis characterized by a paucity of beneficial commensal anaerobes, resulting in a deficiency of key metabolic enzymes found in the gut microbiomes of healthy children.

KEYWORDS:

life cycle; microbiome; pediatrics; research and diseases; short bowel syndrome

PMID:
27406942
DOI:
10.1177/0148607116658762
[Indexed for MEDLINE]

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