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The Gut Microbiome in Patients With Chronic Pancreatitis Is Characterized by Significant Dysbiosis and Overgrowth by Opportunistic Pathogens

Exocrine pancreatic function is a critical host factor in determining the intestinal microbiota composition. Diseases affecting the exocrine pancreas could therefore influence the gut microbiome. We investigated the changes in gut microbiota of patients with chronic pancreatitis (CP). METHODS: Patie...

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Autores principales: Frost, Fabian, Weiss, Frank U., Sendler, Matthias, Kacprowski, Tim, Rühlemann, Malte, Bang, Corinna, Franke, Andre, Völker, Uwe, Völzke, Henry, Lamprecht, Georg, Mayerle, Julia, Aghdassi, Ali A., Homuth, Georg, Lerch, Markus M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7494146/
https://www.ncbi.nlm.nih.gov/pubmed/33094959
http://dx.doi.org/10.14309/ctg.0000000000000232
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author Frost, Fabian
Weiss, Frank U.
Sendler, Matthias
Kacprowski, Tim
Rühlemann, Malte
Bang, Corinna
Franke, Andre
Völker, Uwe
Völzke, Henry
Lamprecht, Georg
Mayerle, Julia
Aghdassi, Ali A.
Homuth, Georg
Lerch, Markus M.
author_facet Frost, Fabian
Weiss, Frank U.
Sendler, Matthias
Kacprowski, Tim
Rühlemann, Malte
Bang, Corinna
Franke, Andre
Völker, Uwe
Völzke, Henry
Lamprecht, Georg
Mayerle, Julia
Aghdassi, Ali A.
Homuth, Georg
Lerch, Markus M.
author_sort Frost, Fabian
collection PubMed
description Exocrine pancreatic function is a critical host factor in determining the intestinal microbiota composition. Diseases affecting the exocrine pancreas could therefore influence the gut microbiome. We investigated the changes in gut microbiota of patients with chronic pancreatitis (CP). METHODS: Patients with clinical and imaging evidence of CP (n = 51) were prospectively recruited and compared with twice the number of nonpancreatic disease controls matched for distribution in age, sex, body mass index, smoking, diabetes mellitus, and exocrine pancreatic function (stool elastase). From stool samples of these 153 subjects, DNA was extracted, and intestinal microbiota composition was determined by bacterial 16S ribosomal RNA gene sequencing. RESULTS: Patients with CP exhibited severely reduced microbial diversity (Shannon diversity index and Simpson diversity number, P < 0.001) with an increased abundance of facultative pathogenic organisms (P < 0.001) such as Enterococcus (q < 0.001), Streptococcus (q < 0.001), and Escherichia.Shigella (q = 0.002). The CP-associated changes were independent of exocrine pancreatic insufficiency. Short-chain fatty acid producers, considered protective for epithelia such as Faecalibacterium (q < 0.001), showed reduced abundance in patients with CP. Of 4 additional patients with CP previously treated with antibiotics (ceftriaxone and metronidazole), 3 patients were characterized by distinct Enterococcus overgrowth. DISCUSSION: CP is associated with marked gut microbiota dysbiosis, greatly reduced diversity, and increased abundance of opportunistic pathogens, specifically those previously isolated from infected pancreatic necrosis. Taxa with a potentially beneficial role in intestinal barrier function are depleted. These changes can increase the probability of complications from pancreatitis such as infected fluid collections or small intestinal bacterial overgrowth (see Graphical Abstract, Supplementary Digital Content 1, http://links.lww.com/CTG/A383).
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spelling pubmed-74941462020-09-24 The Gut Microbiome in Patients With Chronic Pancreatitis Is Characterized by Significant Dysbiosis and Overgrowth by Opportunistic Pathogens Frost, Fabian Weiss, Frank U. Sendler, Matthias Kacprowski, Tim Rühlemann, Malte Bang, Corinna Franke, Andre Völker, Uwe Völzke, Henry Lamprecht, Georg Mayerle, Julia Aghdassi, Ali A. Homuth, Georg Lerch, Markus M. Clin Transl Gastroenterol Article Exocrine pancreatic function is a critical host factor in determining the intestinal microbiota composition. Diseases affecting the exocrine pancreas could therefore influence the gut microbiome. We investigated the changes in gut microbiota of patients with chronic pancreatitis (CP). METHODS: Patients with clinical and imaging evidence of CP (n = 51) were prospectively recruited and compared with twice the number of nonpancreatic disease controls matched for distribution in age, sex, body mass index, smoking, diabetes mellitus, and exocrine pancreatic function (stool elastase). From stool samples of these 153 subjects, DNA was extracted, and intestinal microbiota composition was determined by bacterial 16S ribosomal RNA gene sequencing. RESULTS: Patients with CP exhibited severely reduced microbial diversity (Shannon diversity index and Simpson diversity number, P < 0.001) with an increased abundance of facultative pathogenic organisms (P < 0.001) such as Enterococcus (q < 0.001), Streptococcus (q < 0.001), and Escherichia.Shigella (q = 0.002). The CP-associated changes were independent of exocrine pancreatic insufficiency. Short-chain fatty acid producers, considered protective for epithelia such as Faecalibacterium (q < 0.001), showed reduced abundance in patients with CP. Of 4 additional patients with CP previously treated with antibiotics (ceftriaxone and metronidazole), 3 patients were characterized by distinct Enterococcus overgrowth. DISCUSSION: CP is associated with marked gut microbiota dysbiosis, greatly reduced diversity, and increased abundance of opportunistic pathogens, specifically those previously isolated from infected pancreatic necrosis. Taxa with a potentially beneficial role in intestinal barrier function are depleted. These changes can increase the probability of complications from pancreatitis such as infected fluid collections or small intestinal bacterial overgrowth (see Graphical Abstract, Supplementary Digital Content 1, http://links.lww.com/CTG/A383). Wolters Kluwer 2020-09-16 /pmc/articles/PMC7494146/ /pubmed/33094959 http://dx.doi.org/10.14309/ctg.0000000000000232 Text en © 2020 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of The American College of Gastroenterology This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work, provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.
spellingShingle Article
Frost, Fabian
Weiss, Frank U.
Sendler, Matthias
Kacprowski, Tim
Rühlemann, Malte
Bang, Corinna
Franke, Andre
Völker, Uwe
Völzke, Henry
Lamprecht, Georg
Mayerle, Julia
Aghdassi, Ali A.
Homuth, Georg
Lerch, Markus M.
The Gut Microbiome in Patients With Chronic Pancreatitis Is Characterized by Significant Dysbiosis and Overgrowth by Opportunistic Pathogens
title The Gut Microbiome in Patients With Chronic Pancreatitis Is Characterized by Significant Dysbiosis and Overgrowth by Opportunistic Pathogens
title_full The Gut Microbiome in Patients With Chronic Pancreatitis Is Characterized by Significant Dysbiosis and Overgrowth by Opportunistic Pathogens
title_fullStr The Gut Microbiome in Patients With Chronic Pancreatitis Is Characterized by Significant Dysbiosis and Overgrowth by Opportunistic Pathogens
title_full_unstemmed The Gut Microbiome in Patients With Chronic Pancreatitis Is Characterized by Significant Dysbiosis and Overgrowth by Opportunistic Pathogens
title_short The Gut Microbiome in Patients With Chronic Pancreatitis Is Characterized by Significant Dysbiosis and Overgrowth by Opportunistic Pathogens
title_sort gut microbiome in patients with chronic pancreatitis is characterized by significant dysbiosis and overgrowth by opportunistic pathogens
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7494146/
https://www.ncbi.nlm.nih.gov/pubmed/33094959
http://dx.doi.org/10.14309/ctg.0000000000000232
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