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The difference of gut microbiome in different biliary diseases in infant before operation and the changes after
Xinhe Sun1, Yaoyao Cai1, Wenwen Dai2
1Department of Pediatric Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China.
Insights
Infants with biliary atresia (BA) show distinct gut microbiome differences compared to non-biliary atretic cholestasis (CD). Specific bacteria like Enterococcus and Ralstonia may aid in early diagnosis of these cholestatic liver diseases.
Area of Science:
- Gastroenterology
- Microbiology
- Pediatric Hepatology
Background:
- Cholestatic liver diseases are associated with altered gut microbiome composition.
- Differentiating biliary atresia (BA) from non-biliary atretic cholestasis (CD) presents a significant clinical challenge.
- Understanding gut microbiome variations in infant cholestasis is crucial for diagnosis and management.
Purpose of the Study:
- To compare gut microbiome composition between infants with BA and CD.
- To identify potential microbial biomarkers for early diagnosis of BA and CD.
- To investigate the impact of bile presence/absence on infant cholestatic gut microbiome.
Main Methods:
- 16S rDNA gene sequencing was employed to analyze the intestinal flora of infants.
- Comparative analysis of gut microbiota diversity and taxonomic composition between BA and CD groups.
- Functional analysis of microbial communities to understand metabolic pathway differences.
Main Results:
- Significant structural separation in gut microbiota observed between BA and CD groups, both pre- and post-surgery.
- Increased abundance of Proteobacteria and Firmicutes, with elevated pathogens (e.g., Shigella, Streptococcus) and decreased probiotics (e.g., Bifidobacteria, Lactobacillus) in both groups pre-surgery.
- Differential enrichment of Enterococcus and Ralstonia in BA, while Veillonella and Clostridium were enriched in CD. BA group focused on energy release, CD group on amino acid biosynthesis.
Conclusions:
- Gut microbiome composition significantly differs between infants with biliary atresia and non-biliary atretic cholestasis.
- Enterococcus and Ralstonia show potential as diagnostic biomarkers for differentiating BA from CD.
- Microbiome analysis offers a promising avenue for early identification of these pediatric cholestatic conditions.
Background:
Evidence supports an association between cholestatic liver disease and changes in microbiome composition. Nevertheless, the identification of this special type of biliary atresia from non-biliary atresia cholestasis is still a major clinical difficulty. The purpose of this study is to compare the differences in the composition of gut microbiome between infants with biliary atresia and infant with non-biliary atrestic cholestasis, to find new ways to identify and diagnose these two diseases early, to understand the influence of the presence or absence of bile on the composition of the gut microbiome in infants with cholestasis.
Methods:
Using 16S rDNA gene sequencing technology to analyze the intestinal flora of the participants.
Results:
In terms of diversity, there is an obvious structural separation in the intestinal microbiota of the BA group and the CD group, and this structural separation also exists in the comparison between the two groups before surgery. Taxonomic analysis demonstrated that the two groups showed an increase in Proteobacteria and Firmicutes before surgery, and the relative abundance of potential pathogens such as Shigella, Streptococcus, Klebsiella, etc. increased, potential probiotics such as Bifidobacteria and Lactobacillus decreased, but the relative abundance of each genus was different between groups. It was found that Enterococcus, Ralstonia, Nitriliruptoraceae, etc. were differentially enriched in the BA group, the CD group are mainly enriched in Veillonella, Clostridium_sensu_stricto_1 and Lactobacillus. Functional analysis of the groups showed that the BA group mainly focused on the processes of energy release processes, and the CD group mainly focused on the biosynthesis of amino-acids to consume energy.
Conclusions:
The composition of intestinal flora is different between biliary atresia and non-biliary atretic cholestasis. Enterococcus, Ralstonia, etc. may become biomarkers for the identification and diagnosis of both.
