背景：患有严重运动和智力障碍（SMID）的儿童经常和持续地接受肠内营养和药物治疗，并且缺乏足够的运动，这可能会导致生态失调，肠道微生物群组成的不平衡。然而,对SMID患儿肠道菌群组成的研究有限。因此,我们旨在研究SMID患儿的肠道菌群特征.
方法：使用10例SMID患儿的粪便样本进行16SrRNA基因测序，通过胃瘘或胃管接受肠内营养的患者(SMID组：中位年龄，10.0years),和19名健康儿童(健康控制[HC]组：中位年龄，9.0年）。微生物多样性,微生物组成，并比较了两组之间产生丁酸的细菌的丰度。使用问卷评估SMID组的每日膳食纤维摄入量。
结果：SMID组的Shannon和Simpson指数（α多样性指数）显着低于HC组。β多样性分析确定了不同的簇。与HC组相比，在SMID组中，梭菌和产生丁酸的细菌的丰度较低，而拟杆菌的丰度较高。SMID组的膳食纤维摄入量约为健康日本儿童估计平均需求的三分之二。
结论：患有SMID的儿童表现出生态失调，微生物多样性发生变化，这部分归因于他们的低膳食纤维摄入量。进一步研究,在益生元的干预下，益生菌，和合生元，有必要改善SMID儿童的菌群失调。
Children with severe motor and intellectual disabilities (SMIDs) frequently and continuously receive enteral nutrition and medications and lack adequate exercise, which may lead to dysbiosis, an imbalance in the composition of the gut microbiota. However, studies on the composition of gut microbiota in children with SMIDs are limited. Therefore, we aimed to examine the characteristics of the gut microbiota in children with SMIDs.
16S rRNA gene sequencing was performed using fecal samples of 10 children with SMIDs, who received enteral nutrition through a gastric fistula or gastric tube (SMID group: median age, 10.0 years), and 19 healthy children (healthy control [HC] group: median age, 9.0 years). Microbial diversity, microbial composition, and abundance of butyric acid-producing bacteria were compared between the groups. Daily dietary fiber intake in the SMID group was evaluated using questionnaires.
The Shannon and Simpson indices (alpha diversity indices) were significantly lower in the SMID group than those in the HC group. Beta diversity analysis identified different clusters. Compared with the HC group, Clostridiales and butyric acid-producing bacteria were less abundant and Bacteroidales were more abundant in the SMID group. Dietary fiber intake in the SMID group was approximately two-thirds of the estimated average requirement for healthy Japanese children.
Children with SMIDs showed dysbiosis with alteration in the microbial diversity, which could partly be attributed to their low dietary fiber intake. Further studies, with the intervention of prebiotics, probiotics, and synbiotics, are warranted to improve dysbiosis in children with SMIDs.
