Re-initiation of Oral Food Intake Following Enteral Nutrition Alters Oral and Gut Microbiota Communities
Re-initiation of Oral Food Intake Following Enteral Nutrition Alters Oral and Gut Microbiota Communities
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DOI：
10.3389/fcimb.2019.00434
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发表时间：
2019-12-20
影响因子：
5.7
通讯作者：
Iwata, Takanori
中科院分区：
文献类型：
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作者：
Katagiri, Sayaka;Shiba, Takahiko;Iwata, Takanori
中风与多种形式的残疾有关，包括吞咽困难。中风后吞咽困难增加了肺炎和死亡的风险，并经常导致口服喂养的停止。然而，适当的康复方法最终可以恢复口服食物的摄入。本研究试图阐明重新开始口服食物摄入可以改变吞咽困难患者的口腔/肠道微生物群落的组成。在78例亚急性期脑卒中患者中，11例未服用抗生素的完全管饲受试者入组并接受康复治疗以重新开始口服进食，8例受试者恢复完全口服进食。在相同营养条件下，使用唾液和粪便样本的16 S rRNA测序评估了从肠内营养恢复的患者在重新开始口服食物摄入之前和之后的口腔和肠道微生物群特征。医院的标准营养为1，840千卡，包括管饲和口服受试者的蛋白质= 75 g，脂肪= 45 g，碳水化合物= 280 g。口服食物摄入增加了口腔和肠道微生物组的多样性，并改变了微生物组的组成。口腔和肠道微生物组组成有很大的不同;然而，在重新开始口服食物摄入后，口腔和肠道微生物组中肉杆菌科和颗粒菌属的丰度都增加了。虽然口腔微生物群比肠道微生物群显示出更显著的变化，但宏基因组预测揭示了肠道中存在更多差异富集的途径。此外，与管饲期间相比，在经口喂养期间观察到口腔和肠道微生物组的更简单的共存网络，表明微生物组的生态失调得到改善。口服食物摄入影响肠内营养恢复患者的口腔和肠道微生物组。吞咽困难的康复可以通过增加多样性和改变口腔和肠道微生物群落的组成和共生网络结构来改善全身健康。
Stroke is associated with multiple forms of disability, including dysphagia. Post-stroke dysphagia increases the risks of pneumonia and mortality and often results in cessation of oral feeding. However, appropriate rehabilitation methods can eventually lead to resumption of oral food intake. This study tried to clarify that re-initiating oral food intake could modify the composition of oral/gut microbial communities in patients with dysphagia. From 78 patients with sub-acute stage of stroke, 11 complete tube feeding subjects without taking antibiotics were enrolled and received rehabilitation for re-initiation of oral food intake, and 8 subjects were brought back to complete oral feeding. Oral and gut microbiota community profiles were evaluated using 16S rRNA sequencing of the saliva and feces samples before and after re-initiation of oral food intake in patients recovering from enteral nutrition under the same nutrient condition. Standard nutrition in the hospital was 1,840 kcal, including protein = 75 g, fat = 45 g, and carbohydrates = 280 g both for tube and oral feeding subjects. Oral food intake increased oral and gut microbiome diversity and altered the composition of the microbiome. Oral and gut microbiome compositions were drastically different; however, the abundance of family Carnobacteriaceae and genus Granulicatella was increased in both the oral and gut microbiome after re-initiation of oral food intake. Although oral microbiota showed more significant changes than the gut microbiota, metagenome prediction revealed the presence of more differentially enriched pathways in the gut. In addition, simpler co-occurrence networks of oral and gut microbiomes, indicating improved dysbiosis of the microbiome, were observed during oral feeding as compared to that during tube feeding. Oral food intake affects oral and gut microbiomes in patients recovering from enteral nutrition. Rehabilitation for dysphagia can modify systemic health by increasing the diversity and altering the composition and co-occurrence network structure of oral and gut microbial communities.