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The composition of the gut microbiota is altered in biliary atresia with cholangitis
Lulu Zheng1, Yibo Wu1, Zhenhua Gong1
1Department of General Surgery, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Insights
The gut microbiota composition differs in infants with biliary atresia (BA) who develop cholangitis after Kasai surgery compared to those who do not. This finding highlights potential microbial targets for managing BA complications.
Area of Science:
- Gastroenterology
- Microbiology
- Pediatric Surgery
Background:
- Biliary atresia (BA) is a serious neonatal liver disease requiring surgical intervention (Kasai procedure).
- The gut microbiota plays a crucial role in host health and disease, but its role in BA post-surgery is not fully understood.
Purpose of the Study:
- To investigate the gut microbiota composition in infants with biliary atresia following the Kasai operation.
- To compare the gut microbiota between patients who develop cholangitis and those who do not after surgery.
Main Methods:
- Fecal samples were collected from infants within six months post-Kasai surgery.
- Gut microbiota composition was analyzed using 16S rRNA sequencing.
- Patients were categorized into BAcho (with cholangitis) and BAnoncho (without cholangitis) groups based on follow-up data.
Main Results:
- The BAcho group exhibited significantly increased AST, ALT, and GGT levels compared to the BAnoncho group.
- Microbiota diversity, indicated by the Chao index, was significantly higher in the BAnoncho group.
- Key bacterial genera differed, with *Klebsiella* dominant in the BAcho group and *Bifidobacterium* in the BAnoncho group. *Bacteroides* was significantly decreased in the BAcho group.
Conclusions:
- Gut microbiota composition significantly differs between biliary atresia patients who experience cholangitis post-Kasai surgery and those who do not.
- These microbial differences may influence the development of cholangitis and associated liver enzyme elevations in BA patients.
Aim:
To detect the composition of the gut microbiota in biliary atresia after Kasai surgery.
Methods:
Infants within six months after the Kasai operation who were diagnosed by cholangiography at Shanghai Children's Hospital were enrolled in the study. Fecal samples were collected from diapers, placed into sterile tubes in the inpatient department or outpatient department and frozen at -80°C within half an hour. The gut microbiota was detected by 16S rRNA sequences. Then, the patients that were followed up to one year after the Kasai operation who suffered from cholangitis at least one time were grouped into the BAcho group, and the others were grouped into the BAnoncho group.
Results:
Nine of 18 BA patients were grouped into the BAcho group, and the others were grouped into the BAnoncho group. In the BAcho group, AST, ALT and GGT were significantly increased compared to the BAnoncho group. The number of total OTUs (operational taxonomic units) in feces was more elevated in the BAnoncho group than in the BAcho group. In the BAnoncho group, the Chao index at the OTU level was significantly increased compared to that in the BAcho group (66.37 ± 21.5 vs. 45.64 ± 11.25, p = 0.02 < 0.05). Bifidobacterium was the most abundant genus in the BAnoncho group, accounting for 22.14%, and Klebsiella accounted for 22.74% in the BAcho group. Compared with the BAnoncho group, Bacteroides was significantly decreased in the BAcho group (p = 0.037).
Conclusion:
The composition of the gut microbiota was different between BA with cholangitis and BA without cholangitis.
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