Impact of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy on gut microbiota: a metagenomic comparative analysis
Impact of laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy on gut microbiota: a metagenomic comparative analysis
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DOI：
10.1016/j.soard.2020.03.014
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发表时间：
2020-07-01
影响因子：
3.1
通讯作者：
Ehrlich, S. Dusko
中科院分区：
文献类型：
--
作者：
Farin, William;Onate, Florian Plaza;Ehrlich, S. Dusko
背景：减肥手术是治疗病态肥胖患者的有效方法。两种最常见的干预措施是袖状胃切除术（SG）和腹腔镜Roux-en-Y胃旁路术（LRYGB）。目的：本研究的目的是比较肥胖患者SG和LRYGB手术后的微生物组长期微生物组。设置：法国大学医院;美国大学医院;瑞士大学医院。方法：分别招募了89名和108名接受SG和LRYGB的患者。术前和术后6个月收集粪便。用鸟枪法宏基因组测序（SOLiD 5500 xl Wildfire）分析微生物DNA。MSPminer是一种新的创新工具，用于表征新的计算机生物实体，用于识别715个宏基因组物种泛基因组。148个功能模块进行了分析，使用GOmixer和KEGG database.Results：两种干预措施导致了类似的增加Shannon的多样性指数和基因丰富度的肠道微生物群，在平行的体重减轻，但微生物组成的变化是不同的。LRYGB导致更高的相对丰度的耐气细菌，如大肠杆菌和口腔物种，如链球菌和韦荣氏球菌属。相比之下，厌氧菌，如梭菌，更丰富的SG后，这表明更好地保护肠道中的厌氧条件。两次手术后还观察到嗜粘蛋白阿克曼氏菌的富集。功能水平的变化包括更高的潜力，细菌使用的补充剂，如维生素B12，B1，铁LRYGB.Conclusion：减肥手术后的微生物群的变化取决于干预的性质。LRYGB比SG在肠道微生物群中诱导更大的分类和功能变化。这些变化可能对健康产生的长期影响仍有待确定。(C)2020年美国肥胖外科学会。爱思唯尔公司出版
Background: Bariatric surgery is an effective therapeutic procedure for morbidly obese patients. The 2 most common interventions are sleeve gastrectomy (SG) and laparoscopic Roux-en-Y gastric bypass (LRYGB).Objectives: The aim of this study was to compare microbiome long-term microbiome after SG and LRYGB surgery in obese patients.Setting: University Hospital, France; University Hospital, United States; and University Hospital, Switzerland.Methods: Eighty-nine and 108 patients who underwent SG and LRYGB, respectively, were recruited. Stools were collected before and 6 months after surgery. Microbial DNA was analyzed with shotgun metagenomic sequencing (SOLiD 5500 xl Wildfire). MSPminer, a novel innovative tool to characterize new in silico biological entities, was used to identify 715 Metagenomic Species Pan-genome. One hundred forty-eight functional modules were analyzed using GOmixer and KEGG database.Results: Both interventions resulted in a similar increase of Shannon's diversity index and gene richness of gut microbiota, in parallel with weight loss, but the changes of microbial composition were different. LRYGB led to higher relative abundance of aero-tolerant bacteria, such as Escherichia coli and buccal species, such as Streptococcus and Veillonella spp. In contrast, anaerobes, such as Clostridium, were more abundant after SG, suggesting better conservation of anaerobic conditions in the gut. Enrichment of Akkermansia muciniphila was also observed after both surgeries. Function-level changes included higher potential for bacterial use of supplements, such as vitamin B12, B1, and iron upon LRYGB.Conclusion: Microbiota changes after bariatric surgery depend on the nature of the intervention. LRYGB induces greater taxonomic and functional changes in gut microbiota than SG. Possible long-term health consequences of these alterations remain to be established. (C) 2020 American Society for Bariatric Surgery. Published by Elsevier Inc.