肠道菌群影响结直肠癌术后的吻合口愈合
创作:aluba 审核:aluba 01月09日
  • 将结直肠癌术后发生AL或未发生AL的患者的术前粪菌移植给AL小鼠模型,移植AL患者粪菌的AL小鼠的吻合口愈合较差;
  • 在患者及小鼠中,吻合口愈合与Alistipes onderdonkii及Parabacteroides goldsteinii的相对丰度相关;
  • 口服补充Alistipes onderdonkii可增加小鼠的吻合口渗漏,而灌胃Parabacteroides goldsteinii可通过发挥抗炎作用以改善吻合口愈合;
  • AL患者及移植AL患者粪菌的AL小鼠的术前黏膜MIP-1α、MIP-2、MCP-1及IL-17A/F上调。
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aluba
吻合口瘘(AL)是导致结直肠癌死亡及复发的主要并发症。来自Gut上发表的一项最新研究结果,将结直肠癌术后发生AL的患者的术前粪菌移植给AL小鼠模型后,可导致吻合口愈合较差,并鉴定出了可调节吻合口愈合的特定肠道细菌。另外,AL患者术前的特定黏膜促炎因子表达上调。
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Gut [IF:31.793]

Gut microbiota influence anastomotic healing in colorectal cancer surgery through modulation of mucosal proinflammatory cytokines

肠道菌群通过调节黏膜促炎细胞因子,影响结直肠癌术后的吻合口愈合

10.1136/gutjnl-2022-328389

2022-12-30, Article

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Objective: Colorectal cancer (CRC) is the third most diagnosed cancer, and requires surgical resection and reconnection, or anastomosis, of the remaining bowel to re-establish intestinal continuity. Anastomotic leak (AL) is a major complication that increases mortality and cancer recurrence. Our objective is to assess the causal role of gut microbiota in anastomotic healing.
Design: The causal role of gut microbiota was assessed in a murine AL model receiving faecal microbiota transplantation (FMT) from patients with CRC collected before surgery and who later developed or not, AL. Anastomotic healing and gut barrier integrity were assessed after surgery. Bacterial candidates implicated in anastomotic healing were identified using 16S rRNA gene sequencing and were isolated from faecal samples to be tested both in vitro and in vivo.
Results: Mice receiving FMT from patients that developed AL displayed poor anastomotic healing. Profiling of gut microbiota of patients and mice after FMT revealed correlations between healing parameters and the relative abundance of Alistipes onderdonkii and Parabacteroides goldsteinii. Oral supplementation with A. onderdonkii resulted in a higher rate of leaks in mice, while gavage with P. goldsteinii improved healing by exerting an anti-inflammatory effect. Patients with AL and mice receiving FMT from AL patients presented upregulation of mucosal MIP-1α, MIP-2, MCP-1 and IL-17A/F before surgery. Retrospective analysis revealed that patients with AL present higher circulating neutrophil and monocyte counts before surgery.
Conclusion: Gut microbiota plays an important role in surgical colonic healing in patients with CRC. The impact of these findings may extend to a vast array of invasive gastrointestinal procedures.

First Authors:
Roy Hajjar

Correspondence Authors:
Manuela M Santos

All Authors:
Roy Hajjar,Emmanuel Gonzalez,Gabriela Fragoso,Manon Oliero,Ahmed Amine Alaoui,Annie Calvé,Hervé Vennin Rendos,Souad Djediai,Thibault Cuisiniere,Patrick Laplante,Claire Gerkins,Ayodeji Samuel Ajayi,Khoudia Diop,Nassima Taleb,Sophie Thérien,Frédéricke Schampaert,Hefzi Alratrout,François Dagbert,Rasmy Loungnarath,Herawaty Sebajang,Frank Schwenter,Ramses Wassef,Richard Ratelle,Eric Debroux,Jean-François Cailhier,Bertrand Routy,Borhane Annabi,Nicholas J B Brereton,Carole Richard,Manuela M Santos

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