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Acute pancreatitis is associated with gut dysbiosis in children
Chinenye R Dike1, Nicholas J Ollberding2, Tyler Thompson3
1Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Nebraska Medical Center and Children's Hospital & Medical Center, Omaha, NE USA; Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, University of Alabama at Birmingham, Birmingham, AL USA.
Insights
Pediatric acute pancreatitis (AP) is linked to gut microbiome changes. Specific bacteria and metabolic pathways are altered in children with AP, correlating with disease severity.
Area of Science:
- Microbiome research
- Pediatric gastroenterology
- Metagenomics
Background:
- Pediatric acute pancreatitis (AP) causes significant illness.
- Understanding severe AP in children is crucial.
- Gut dysbiosis is known in adult AP, but pediatric data is limited.
Purpose of the Study:
- To analyze gut microbial and functional profiles in children with their first AP episode.
- To compare these profiles between AP patients and healthy controls (HC).
- To differentiate profiles between mild and severe AP cases.
Main Methods:
- Shotgun metagenomic sequencing of stool DNA.
- Recruitment of pediatric patients (under 21) with first AP attack (n=30) and healthy controls (n=34).
- Analysis of taxonomic and functional (MetaCyc pathways) microbial differences.
Main Results:
- Significant differences in gut microbial alpha and beta diversity between AP patients and HC.
- Enrichment of specific bacteria (e.g., R.gnavus, V.parvula, E.faecalis, C.innocuum) and metabolic pathways in AP patients.
- Distinct microbial beta diversity in severe AP compared to mild AP, with E.faecalis and C.citroniae enrichment.
Conclusions:
- Gut dysbiosis is present in pediatric AP and correlates with disease severity.
- Findings suggest the gut microbiome plays a role in pediatric AP.
- Further multicenter studies are needed to explore microbiome-targeted interventions for AP.
Background:
Pediatric acute pancreatitis (AP) is associated with significant morbidity. Therefore, improved understanding of children who will develop severe AP is critical. Adult studies have reported AP associated gut dysbiosis, but pediatric studies are lacking.
Aims:
Assess stool microbial taxonomic and functional profiles of children with first attack of AP compared to those of healthy controls (HC), and between mild and severe AP METHODS: Children under 21 years hospitalized at a tertiary center (n = 30) with first AP attack were recruited including HC (n = 34) from same region. Shotgun metagenomic sequencing was performed on extracted DNA.
Results:
Demographics were similar between AP and HC. Alpha diversity (-0.68 ± 0.13, p-value < 0.001), and beta-diversity (R2=0.13, p-value < 0.001) differed, in children with AP compared to HC. Species including R.gnavus, V.parvula, E.faecalis, C.innocuum were enriched in AP. MetaCyc pathways involved in amino acid metabolism and fatty acid beta-oxidation were enriched in AP. Beta-diversity (R2=0.06, p-value = 0.02) differed for severe AP compared to mild AP with enrichment in E.faecalis and C.citroniae.
Conclusions:
Gut dysbiosis occurs in pediatric AP and is associated with AP severity. A multicenter study confirming these findings could pave way for interventional trials manipulating the gut microbiome to mitigate AP severity.
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