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Gut microbial profile in biliary atresia: a case-control study.

Junfeng Wang1, Tian Qian2, Jingying Jiang1

  • 1Department of Pediatric Surgery, Children's Hospital of Fudan University and Shanghai Key Laboratory of Birth Defect, Shanghai, China.

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Summary

Gut microbial dysbiosis is linked to biliary atresia (BA), with decreased bile acids potentially causing this imbalance. This gut microbiome alteration shows diagnostic potential for BA.

Keywords:
16S ribosome RNA gene sequencingBile acidBiliary atresiaDiagnostic markerIntestinal microbiomeMetagenomic sequencing

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Area of Science:

  • Gastroenterology
  • Microbiology
  • Pediatric Surgery

Background:

  • Biliary atresia (BA) is a progressive, fibro-inflammatory cholangiopathy of unknown cause.
  • Altered gut microbiome is observed in various liver disorders, but its role in BA is unexplored.

Purpose of the Study:

  • To investigate the gut microbiota composition in patients with biliary atresia.
  • To explore the relationship between gut microbiota, bile acids, and liver function in BA.
  • To assess the diagnostic potential of gut microbiome alterations in BA.

Main Methods:

  • Case-control study comparing 34 BA patients and 34 healthy controls.
  • 16S rRNA gene sequencing and metagenomic sequencing for gut microbiome analysis.
  • Ultra-high performance liquid chromatography for fecal bile acid determination.
  • Analysis of microbiome shifts post-Kasai procedure in 16 BA patients.

Main Results:

  • BA patients exhibited lower microbial diversity and significant structural segregation compared to controls.
  • Increased Proteobacteria and decreased Bacteroidetes were observed in BA.
  • Pathogenic bacteria like Streptococcus and Klebsiella increased, while beneficial Bifidobacterium and butyrate-producers decreased.
  • Microbiome alterations correlated with liver function, and the Streptococcus/Bacteroides ratio showed diagnostic promise for BA.
  • Fecal bile acids were significantly decreased in BA patients.

Conclusions:

  • Gut microbial dysbiosis, potentially driven by decreased bile acids, is associated with liver dysfunction in BA.
  • The gut microbiome in BA possesses diagnostic potential.
  • Further research into gut microbiota may offer therapeutic benefits for BA.