肠内延伸型胆管支架置入前后实验猪胆道菌群多样性分析
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1.北京大学第三医院消化科;2.北京大学医学部实验动物科学部

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基金项目:

国家自然科学基金(82070653);北京市自然科学基金(7222207)


Analysis of biliary microbiota in experimental pigs before and after enteral extended biliary stents implantation
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Department of Gastroenterology, Peking University Third Hospital

Fund Project:

National Natural Science Foundation of China (82070653); Beijing Natural Science Foundation (7222207)

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    摘要:

    目的 通过动物实验对比肠内延伸型胆管支架(enteral extended biliary stent,EEBS)和传统塑料支架置入前后的胆道菌群变化,初步探索EEBS在预防支架堵塞中的可能机制。方法 12只健康巴马小型猪采用简单随机方法分为传统塑料支架组(n=6)和EEBS组(n=6),在支架置入前及置入后4周拔除支架时采集胆汁标本进行16S rRNA基因测序,分析比较不同支架置入前后胆汁菌群结构及多样性。结果 12只实验猪均未发生急性胆管炎、穿孔、出血、死亡等并发症,支架置入8 d后内镜复查两组支架均已脱落,于此时采集胆汁标本进行菌群分析。两组实验猪的胆道菌群在门水平主要是变形菌门、厚壁菌门和拟杆菌门。Alpha多样性分析显示传统塑料支架组支架置入后Shannon指数(P=0.004)和Simpson指数(P=0.008)较前显著减小;Beta多样性分析也提示传统塑料支架置入前后菌群结构发生显著变化(Anosim:R=0.514 8,P=0.011)。EEBS组支架置入前后Observed species指数(P=0.095)、Chao1指数(P=0.136)、Shannon指数(P=0.353)和Simpson指数(P=0.227)及Beta多样性(Anosim:R=0.059 3,P=0.187)差异均无统计学意义。差异菌LEfSe分析显示,传统塑料支架组支架置入后脆弱拟杆菌、变形菌门-γ变形菌纲-肠杆菌目-肠杆菌科-埃希_志贺菌属-大肠埃希菌丰度显著升高,EEBS组支架置入后脱硫菌门-脱硫菌纲-脱硫菌目-脱硫菌科-嗜胆菌属丰度显著升高。结论 EEBS短期置入后胆道菌群变化较小,可能通过延长反流路径达到了预防肠胆反流的效果。

    Abstract:

    Objective To compare the changes of biliary microbiota after enteral extended biliary stents (EEBS) implantation with that of conventional plastic stents in animal experiment, and to preliminarily investigate its possible mechanism in preventing stents occlusion. Methods A total of 12 healthy Bama minipigs were randomly assigned to the conventional plastic stent group (n=6) and the EEBS group (n=6) using simple random method. The bile samples of all pigs were collected before stents implantation and 4 weeks after stents placement. The biliary microbiota composition and diversity before and after different stents implantation were analyzed by 16S rRNA gene sequencing and compared. Results No complications including acute cholangitis, perforation, bleeding, or death occurred in 12 pigs. Eight days after stents implantation, stents were out of bile duct in all pigs under endoscopy, while the bile samples were collected again for analysis. The main composition of biliary microbiota at the phylum level were Proteobacteria, Firmicutes and Bacteroidota. Alpha-diversities revealed the Shannon (P=0.004) and Simpson index (P=0.008) significantly decreased in the conventional stent group after stents placement, and Bata diversity analysis also showed a significant difference in microbial composition (Anosim: R=0.514 8, P=0.011). There was no significant difference in Observed species index (P=0.095), Chao1 index (P=0.136), Shannon index (P=0.353), Simpson index (P=0.227) or Bata diversity (Anosim:R=0.059 3,P=0.187) in the EEBS group before and after stents placement. LEfSe algorithm indicated Bacteroides_fragilis and Proteobacteria⁃Gammaproteobacteria‑Enterobacterales‑Enterobacteriaceae‑scherichia_Shigella‑Escherichia_coli significantly increased in the conventional stent group, and Desulfobacterota⁃Desulfovibrionia⁃Desulfovibrionales⁃Desulfovibrionaceae‑Bilophila significantly increased in the EEBS group after stents placement. Conclusion The biliary microbiota change slightly after EEBS implantation in the short-term, and EEBS may prevent duodenobiliary reflux by prolonging the reflux path.

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徐晓芬,程卓,闫秀娥,等.肠内延伸型胆管支架置入前后实验猪胆道菌群多样性分析[J].中华消化内镜杂志,2023,40(6):472-477.

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  • 收稿日期:2022-04-02
  • 最后修改日期:2023-05-15
  • 录用日期:2022-04-14
  • 在线发布日期: 2023-05-17
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