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Trajectory of gut microbiota before and after pediatric cardiopulmonary bypass surgery
Xi Yin1, Minhua Xiao2, Jing Sun2
1Clinical Physiology Laboratory, Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou, China.
Insights
Congenital heart disease (CHD) causes gut microbiota dysbiosis, which persists after surgery but improves within a year. Gut microbial communities in VSD and TOF patients show similar recovery patterns post-cardiopulmonary bypass (CPB).
Area of Science:
- Microbiology
- Pediatric Cardiology
- Gastroenterology
Background:
- Congenital heart disease (CHD) can lead to gut dysbiosis due to reduced blood flow and oxygen.
- Cardiopulmonary bypass (CPB) may further disrupt the gut microbiota in infants with CHD.
- The long-term effects of CPB on gut microbiota in different types of CHD remain unclear.
Purpose of the Study:
- To investigate the gut microbiota trajectory in infants with ventricular septal defect (VSD) and tetralogy of Fallot (TOF) from pre- to post-cardiopulmonary bypass (CPB).
- To compare the gut microbial changes between VSD and TOF patients during the perioperative and long-term postoperative periods.
- To assess the recovery of gut microbiota towards normal levels one year after CPB.
Main Methods:
- Fecal samples were collected from infants with VSD (n=13) and TOF (n=11) pre- and early post-CPB.
- Healthy control groups were included for comparison at both infant and one-year post-operative stages.
- 16S rRNA sequencing was used to analyze the gut microbial composition and diversity.
Main Results:
- Pre-CPB, both VSD and TOF groups exhibited increased Enterobacteriaceae and Shigella, and decreased Bifidobacterium compared to controls.
- Gut microbial diversity showed no significant changes between pre- and early post-CPB periods.
- One-year post-CPB, there was a significant increase in short-chain fatty acid-producing microbes, with communities approaching those of controls.
Conclusions:
- Gut microbiota dysbiosis is present in infants with VSD or TOF before surgery and is not significantly altered by CPB.
- Gut microbial communities in VSD and TOF patients demonstrate similar recovery patterns, normalizing within one year after CPB.
- The study highlights the resilience of the gut microbiota, showing significant improvement one year post-surgery.
Background:
Varied congenital heart disease (CHD) may induce gut microbiota dysbiosis due to intestinal hypoperfusion or/and hypoxemia. Microbiota dysbiosis has been found in preoperative infants and cardiopulmonary bypass (CPB) exacerbated it further. However, the trajectory of gut microbiota from pre- to early post-CPB and one-year later remains unexplored. We examined this trajectory in the two most common CHDs, i.e., left-to-right shunt (ventricular septal defect, VSD) vs. right-to-left shunt (tetralogy of Fallot, TOF).
Methods:
We enrolled 13 infants with VSD and 11 with TOF, and collected fecal samples at pre- and early post-CPB. 10 and 12 age- and gender-matched healthy control infants were enrolled respectively. We also enrolled 13 and 9 gender- and CHD diagnosis- and operation-matched one-year post-CPB patients, and 8 age- and gender-matched healthy control children. 16S rRNA sequencing of fecal samples were performed.
Results:
Compared to the control groups, both VSD and TOF pre-CPB groups had significantly increased Enterobacteriaceae and Shigella, and decreased Bifidobacterium (Ps ≤ 0.049). No significant change in microbial community diversity was observed between pre- and early post-CPB periods (Ps≥0.227). Compared with early post-CPB, one-year post-CPB groups had significantly increased short-chain fatty acids-producing microbes (Ps ≤ 0.025), and their microbial communities were close to that of the control group (Ps≥0.102). There was no significant difference in microbial communities between VSD and TOF groups in any of 3 periods (Ps≥0.055).
Conclusion:
In children with VSD or TOF, gut microbiota dysbiosis existed preoperatively and were not significantly altered by CPB. One-year post-CPB, microbiota significantly improved towards normal. Similar microbial communities were found between children with VSD and TOF throughout the perioperative and long-term postoperative periods.
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