Publication: Estudio de la microbiota intestinal en el síndrome de intestino corto
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2018-04-16
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Universidad Complutense de Madrid
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Abstract
La microbiota intestinal ha demostrado influir en la producción de sustancias como los ácidos grasos de cadena corta u hormonas intestinales, que juegan un papel importante en el proceso de adaptación tras la resección intestinal en el Síndrome de Intestino Corto (SIC), por lo que podría suponer un nuevo factor pronóstico en el desarrollo de Fallo Intestinal (FI). Objetivos: Estudiar la microbiota en los pacientes con SIC. Caracterizar las disbiosis que la presencia o ausencia de colon, así como de FI puede inducir en estos sujetos, teniendo en cuenta la ingesta dietética y el estado nutricional. Materiales y métodos: Estudio multicéntrico transversal observacional en pacientes > 18 años, con 4 grupos de SIC (con y sin FI, con y sin colon) y 1 grupo control. Se estudió microbiota mediante tec-nología de secuenciación basadas en 16 S ARN ribosómico. Se tuvo en cuenta la ingesta dietética, el soporte nutricional, parámetros del estado nutricional (antropométricos, gasto energético, bioquímicos: hematológicos y orina). Resultados: Se incluyeron 20 pacientes con SIC y 20 controles de ambos sexos. Los pacientes con SIC presentaron una mayor abundancia relativa de Verrucomicrobia y Fusobacteria, y un descenso de Bacteriodetes, en comparación con sujetos sanos. La ausencia de colon dis-minuyó la presencia de Verrucomicrobia, Enterobacteriaceae y Veillonela. La presencia de FI produjo disminución de la diversidad bacteriana en pacientes con colon. La ingesta deficitaria de proteínas aumentó los Bacteroidetes, mientras que una ingesta insufi-ciente de fibra disminuyó Actinobacteria en pacientes con SIC. Conclusiones: La microbiota de los pacientes con SIC difiere de la de los sujetos sanos. Además, las disbiosis que se producen dependen de la presencia o no de colon en continuidad, así como del desarrollo o no de FI.
Gut's microbiota has shown to influence the production of substances such as short chain fatty acids or gut´s hormones, which play an important role in the intestinal adap-tation following resection in Short Bowel Syndrome (SBS). Because of this, it could be a new prognostic factor in the development of Intestinal Failure (IF). Aims: Study gut´s microbiota in patients with SBS. Characterize the dysbiosis induced by the presence or absence of colon, as well as IF, taking into account their dietary intake and nutritional status. Materials and methods: Multicenter observational cross-sectional study in patients over eighteen years, with four SIC groups (with and without IF, with and without colon) and one control group. Microbiota was studied by sequencing technology based on 16 S ribosomal RNA. Dietary intake, nutritional support, nutritional status parameters (anthropometric, energy ex-penditure, biochemical, hematological and urine) were studied as well. Results: Twenty patients with SIC and twenty controls of both sexes were included. The patients with SIC had a greater relative abundance of Verrucomicrobia and Fusobacteria, and a decrease of Bacteroidetes, compared to healthy subjects. The absence of colon de-creased the presence of Verrucomicrobia, Enterobacteriaceae and Veillonella. The pres-ence of IF resulted in decreased bacterial diversity in patients with colon. Inadequate protein intake increased Bacteroidetes, whereas an insufficient intake of fiber decreased Actinobacteria in patients with SIC. Conclusions: The microbiota of patients with SBS is different compared to healthy subjects. In addi-tion, the dysbioses produced depend on the presence or absence of colon in continuity, as well as the development or not of IF.
Gut's microbiota has shown to influence the production of substances such as short chain fatty acids or gut´s hormones, which play an important role in the intestinal adap-tation following resection in Short Bowel Syndrome (SBS). Because of this, it could be a new prognostic factor in the development of Intestinal Failure (IF). Aims: Study gut´s microbiota in patients with SBS. Characterize the dysbiosis induced by the presence or absence of colon, as well as IF, taking into account their dietary intake and nutritional status. Materials and methods: Multicenter observational cross-sectional study in patients over eighteen years, with four SIC groups (with and without IF, with and without colon) and one control group. Microbiota was studied by sequencing technology based on 16 S ribosomal RNA. Dietary intake, nutritional support, nutritional status parameters (anthropometric, energy ex-penditure, biochemical, hematological and urine) were studied as well. Results: Twenty patients with SIC and twenty controls of both sexes were included. The patients with SIC had a greater relative abundance of Verrucomicrobia and Fusobacteria, and a decrease of Bacteroidetes, compared to healthy subjects. The absence of colon de-creased the presence of Verrucomicrobia, Enterobacteriaceae and Veillonella. The pres-ence of IF resulted in decreased bacterial diversity in patients with colon. Inadequate protein intake increased Bacteroidetes, whereas an insufficient intake of fiber decreased Actinobacteria in patients with SIC. Conclusions: The microbiota of patients with SBS is different compared to healthy subjects. In addi-tion, the dysbioses produced depend on the presence or absence of colon in continuity, as well as the development or not of IF.
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Medicina, leída el 21/06/2017