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Updated: Jun 30, 2025
Murine Ileocolic Bowel Resection with Primary Anastomosis
Published on: October 29, 2014
Children with Hirschsprung disease exhibited alterations in host-microbial co-metabolism after pull-through operation
Kanokrat Thaiwatcharamas1, Watcharin Loilome2,3,4, Phuc N Ho2
1Department of Surgery, Division of Pediatric Surgery, Khon Kaen University, Khon Kaen, Thailand.
Insights
Fecal metabolome analysis in young children with Hirschsprung disease (HD) after surgery revealed significant differences in metabolites and amino acid metabolism pathways. These findings highlight the impact of HD on gut health and function.
Area of Science:
- Gastroenterology
- Metabolomics
- Pediatric Surgery
Background:
- Hirschsprung disease (HD) is a congenital condition affecting the large intestine.
- Post-pull-through surgery is a common treatment for HD in children.
- The fecal metabolome's role in post-surgical HD outcomes is not fully understood.
Purpose of the Study:
- To compare the fecal metabolome of children with HD (with and without HAEC) and healthy controls.
- To identify specific metabolites and metabolic pathways altered in young children post-pull-through HD surgery using NMR spectroscopy.
Main Methods:
- Collected fresh fecal samples from children under 5 years old: post-pull-through HD patients and healthy Thai children.
- Analyzed 20 fecal samples using Nuclear Magnetic Resonance (NMR) spectroscopy.
- Compared 34 identified metabolites between HD and healthy groups.
Main Results:
- HD samples showed significantly decreased levels of acetoin, phenylacetylglutamine, and N-acetylornithine compared to controls.
- Children with HD and HAEC had significantly lower succinate and xylose levels than those with HD without HAEC.
- Key metabolic pathways involved included glutamine/glutamate and alanine/aspartate/glutamate metabolism.
Conclusions:
- Significant differences in the type, quantity, and metabolism of proteins and other metabolites were observed in young children with HD after pull-through surgery.
- Altered metabolic pathways are primarily linked to amino acid metabolism, crucial for maintaining intestinal integrity and function.
- Fecal metabolomics can provide insights into the physiological impact of HD and its surgical management.
Purpose:
This study aims to compare the fecal metabolome in post pull-through HD with and without HAEC patients and healthy young children using nuclear magnetic resonance (NMR) spectroscopy.
Methods:
Fresh fecal samples were collected from children under 5 years of age in both post-pull-through HD patients and healthy Thai children. A total of 20 fecal samples were then analyzed using NMR spectroscopy.
Results:
Thirty-four metabolites identified among HD and healthy children younger than 5 years were compared. HD samples demonstrated a significant decrease in acetoin, phenylacetylglutamine, and N-acetylornithine (corrected p value = 0.01, 0.04, and 0.004, respectively). Succinate and xylose significantly decreased in HD with HAEC group compared to HD without HAEC group (corrected p value = 0.04 and 0.02, respectively). Moreover, glutamine and glutamate metabolism, and alanine, aspartate, and glutamate metabolism were the significant pathways involved, with pathway impact 0.42 and 0.50, respectively (corrected p value = 0.02 and 0.04, respectively).
Conclusion:
Differences in class, quantity, and metabolism of protein and other metabolites in young children with HD after pull-through operation were identified. Most of the associated metabolic pathways were correlated with the amino acids metabolism, which is required to maintain intestinal integrity and function.
