Altered Fecal Microflora and Increased Fecal Calprotectin in Infants with Colic
Altered Fecal Microflora and Increased Fecal Calprotectin in Infants with Colic
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DOI：
10.1016/j.jpeds.2009.05.012
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发表时间：
2009-12-01
影响因子：
5.1
通讯作者：
Ferris, Michael J.
中科院分区：
文献类型：
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作者：
Rhoads, J. Marc;Fatheree, Nicole Y.;Ferris, Michael J.
目的探讨肠道炎症、结肠发酵和/或结肠菌群改变是否可能提供肠绞痛的病理生理机制。研究人群包括36名年龄从14天到81天的足月婴儿。用ELISA法测定粪便钙保护蛋白（中性粒细胞浸润的标志物）；粪便微生物变性梯度凝胶电泳、克隆和测序；用气相色谱法测定氢气浓度。结果在24小时内，与对照组婴儿（n = 17, 103 +/- 17分钟）相比，绞痛婴儿（n = 19）哭泣和大惊小怪的平均时间为314 +/- 36 （SEM）分钟。肠绞痛婴儿的粪便钙保护蛋白水平比对照组婴儿高2倍（413 +/- 71 vs 197 +/- 46 μ g/g, P = 0.042）。在变性梯度凝胶电泳中，肠绞痛婴儿的粪便可识别的条带较少。绞痛患者中检出克雷伯氏菌种类多于对照组（8比1，P = 0.02），而肠杆菌/Pantoea仅在对照组中检出。这些差异不能归因于配方奶粉与母乳喂养的差异、食用元素配方奶粉或接触抗生素。结论：婴儿绞痛，以前被认为是一种非器质性的疾病，有证据表明肠道嗜中性粒细胞浸润和粪便微生物群落的多样性较少。
Objective We explored whether gut inflammation, colonic fermentation, and/or an altered colonic flora could provide a pathophysiological mechanism for colic.Study design The study population consisted of 36 term infants ranging in age from 14 to 81 days. We measured fecal calprotectin (a marker of neutrophil infiltration) by ELISA; stool microorganisms by denaturing gradient gel electrophoresis, cloning, and sequencing; and breath hydrogen levels using gas chromatography.Results During 24 hours, infants with colic (n = 19) cried and fussed for a mean of 314 +/- 36 (SEM) minutes, compared with control infants (n = 17, 103 +/- 17 minutes). Fecal calprotectin levels were 2-fold higher in infants with colic than in control infants (413 +/- 71 vs 197 +/- 46 mu g/g, P = .042). Stools of infants with colic had fewer identifiable bands on denaturing gradient gel electrophoresis. Klebsiella species were detected in more colic patients than in control patients (8 vs 1, P = .02), whereas Enterobacter/Pantoea species were detected only in the control patients. These differences could not be attributed to differences in formula versus breast milk feeding, consumption of elemental formula, or exposure to antibiotics.Conclusions Infants with colic, a condition previously believed to be nonorganic in nature, have evidence of intestinal neutrophilic infiltration and a less diverse fecal microflora.