■探讨与胆总管结石(CDL)的形成和复发相关的胆道和十二指肠菌群特征。
■我们前瞻性招募了原发性(P-CDL,n=29)和复发性CDL(R-CDL,n=27)用于内镜逆行胰胆管造影术(ERCP)。十二指肠粘膜(DM),收集P-和R-CDL患者的胆汁和胆管结石(BDS)样本。还在8个健康对照(HC)中收集DM样品。用16SrRNA基因测序进行微生物区系谱分析。
■ERCP前的短期抗生素应用对CDL中胆道和十二指肠菌群的α和β多样性没有显着影响。CDL中的α多样性显示DM和胆汁样品之间没有差异。P-和R-CDL的十二指肠微生物丰富度和多样性均低于HC。胆道微生物组成显示P-和R-CDL之间的高度相似性。DM中梭杆菌和肠球菌的丰度较高,胆汁,R-CDL的BDS样本比P-CDL,以及胆汁中R-CDL的大肠杆菌和克雷伯菌。CDL中丰富的十二指肠和胆道细菌与胆囊切除术密切相关,炎症和肝功能障碍。R-CDL的胆汁相关微生物群表达D-葡糖醛酸和D-葡糖醛酸的降解能力增强,暗示胆汁中富集的大肠杆菌和克雷伯氏菌可能产生的β-葡萄糖醛酸苷酶水平升高。
■十二指肠菌群CDL失衡。十二指肠菌群可能是胆道菌群的主要来源,与CDL的形成和复发密切相关。肠球菌,梭杆菌,大肠埃希菌和克雷伯菌可能导致CDL复发。
■该研究已在中国临床试验注册中心注册(https://www.chictr.org.cn/index。html,ChiCTR2000033940)。
■在线版本包含补充材料,可在10.1007/s13755-023-00267-2获得。
UNASSIGNED: To explore the biliary and duodenal microbiota features associated with the formation and recurrence of choledocholithiasis (CDL).
UNASSIGNED: We prospectively recruited patients with primary (P-CDL, n = 29) and recurrent CDL (R-CDL, n = 27) for endoscopic retrograde cholangiopancreatography (ERCP). Duodenal mucosa (DM), bile and bile duct stones (BDS) samples were collected in P- and R-CDL patients. DM samples were also collected in 8 healthy controls (HC). The microbiota profile analysis was performed with 16S rRNA gene sequencing.
UNASSIGNED: Short-course antibiotic application before ERCP showed no significant effects in alpha and beta diversities of the biliary and duodenal microbiota in CDL. Alpha diversity showed no difference between DM and bile samples in CDL. The duodenal microbial richness and diversity was lower in both P- and R-CDL than HC. The biliary microbiota composition showed a high similarity between P- and R-CDL. Fusobacterium and Enterococcus were higher abundant in DM, bile, and BDS samples of R-CDL than P-CDL, as well as Escherichia and Klebsiella in bile samples of R-CDL. The enriched duodenal and biliary bacteria in CDL were closely associated with cholecystectomy, inflammation and liver dysfunction. The bile-associated microbiota of R-CDL expressed enhanced capacity of D-glucuronide and D-glucuronate degradation, implicating an elevated level of β-glucuronidase probably produced by enriched Escherichia and Klebsiella in bile.
UNASSIGNED: The duodenal microbiota was in an imbalance in CDL. The duodenal microbiota was probably the main source of the biliary microbiota and was closely related to CDL formation and recurrence. Enterococcus, Fusobacterium, Escherichia and Klebsiella might contribute to CDL recurrence.
UNASSIGNED: The study was registered at the Chinese Clinical Trial Registry (https://www.chictr.org.cn/index.html, ChiCTR2000033940).
UNASSIGNED: The online version contains supplementary material available at 10.1007/s13755-023-00267-2.