Duodenal and rectal mucosal microbiota related to small intestinal bacterial overgrowth in diarrhea-predominant irritable bowel syndrome
Duodenal and rectal mucosal microbiota related to small intestinal bacterial overgrowth in diarrhea-predominant irritable bowel syndrome
复制标题
十二指肠和直肠粘膜微生物群与腹泻为主的 IBS 中小肠细菌过度生长有关。
DOI：
10.1111/jgh.14910
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发表时间：
2019-11-05
影响因子：
4.1
通讯作者：
Hou, Xiaohua
中科院分区：
文献类型：
--
作者：
Yang, Min;Zhang, Lei;Hou, Xiaohua
背景和目的小肠细菌过度生长（SIBO）被认为是肠易激综合征，特别是以大肠杆菌为主的亚型（IBS-D）的一个致病因素。我们的目的是确定潜在的肠道微生物模式在IBS-D患者SIBO。方法选择符合罗马III标准的腹泻型肠易激综合征患者，随机分为探索性队列（57例）和验证性队列（20例）。根据标准葡萄糖氢呼气试验确定SIBO。对于16 S rRNA基因测序，收集并进行十二指肠粘膜、十二指肠液、直肠粘膜和新鲜粪便样品。评估了SIBO+和SIBO-IBS-D受试者中的α和β多样性以及微生物组成和功能的差异。结果SIBO+和SIBO- IBS-D组十二指肠和直肠粘膜微生物多样性和组成有明显差异，而十二指肠液和新鲜粪便中微生物多样性和组成无明显差异。对于直肠粘膜微生物群，其显示出显著减少的需氧菌和革兰氏阴性菌和增加的兼性厌氧菌和革兰氏阳性菌，此外，改变了SIBO+ IBS-D中微生物代谢的功能。在SIBO+ IBS-D中观察到显著更高的直肠粘膜相关微生物生态失调指数，并且在-0.37处的截止值具有56.55%的灵敏度和90.91%的特异性以识别IBS-D受试者中的SIBO。结论SIBO+ IBS-D患者的粘液菌群比非SIBO患者的肠道菌群更明显。直肠粘膜相关微生物群可能是IBS-D患者SIBO的潜在预测因子。
Background and Aim Small intestinal bacterial overgrowth (SIBO) has been proposed as an etiologic factor in irritable bowel syndrome, particularly the diarrhea-predominant subtype (IBS-D). We aimed to identify potential intestinal microbial pattern in IBS-D patients with SIBO. Methods Diarrhea-predominant irritable bowel syndrome patients fulfilling Rome III criteria were recruited and randomly divided into an exploratory cohort (57 cases) and a validation cohort (20 cases). SIBO was identified according to standard glucose hydrogen breath test. For 16S rRNA gene sequencing, samples of duodenal mucosa, duodenal fluid, rectal mucosa, and fresh feces were collected and performed. The alpha and beta diversity, as well as differences in microbial composition and function, in SIBO+ and SIBO- IBS-D subjects were evaluated. Results The microbial diversity and composition obviously differed between SIBO+ and SIBO- IBS-D in duodenal and rectal mucosa but not in duodenal fluid and fresh feces. For rectal mucosal microbiota, it displayed markedly reduced aerobe and Gram-negative bacteria and increased facultative anaerobe and Gram-positive bacteria, moreover, altered functions of microbial metabolism in SIBO+ IBS-D. Significantly higher rectal mucosa-related microbial dysbiosis index was observed in SIBO+ IBS-D, and a cut-off value at -0.37 had a sensitivity of 56.55% and specificity of 90.91% to identify the SIBO in IBS-D subjects. Conclusions Mucosal microbiota, rather than luminal bacteria, has a more apparent dysbiosis in SIBO+ IBS-D patients relative to those without SIBO. Rectal mucosa-associated microbiota may act as a potential predictor of SIBO in IBS-D patients.