1
|
Xu YS, Wang YH, Liu Y, Sun X, Xu JS, Song Y, Jiang X, Xiong ZF, Tian ZB, Zhang CP. Alteration of the faecal microbiota composition in patients with constipation: evidence of American Gut Project. Benef Microbes 2022; 13:427-436. [PMID: 36377576 DOI: 10.3920/bm2022.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
There is limited information is known about the composition difference of the gut microbiota in patients with constipation and healthy controls. Here, the faecal 16S rRNA fastq sequence data of microbiota from the publicly available American Gut Project (AGP) were analysed. The tendency score matching (PSM) method was used to match in a 1:1 manner to control for confounding factors age, gender, body mass index (BMI), and country. A total of 524 participants including 262 patients with constipation and 262 healthy controls were included in this analysis. The richness and evenness of the gut microbiota in the constipation group were significantly lower than those in the control group. The dominant genera in the constipation group include Escherichia_Shigella, Pseudomonas, and Citrobacter. The dominant genera in the control group include Faecalibacterium, Prevotella, Roseburia, Clostridium_XlVa, and Blautia. The abundance of three butyrate production-related pathways were significantly higher in the constipation group than in the control groups. There was no significant difference in the diversity and gut microbiota composition in patients with constipation at different ages. In conclusion, patients with constipation showed gut microbiota and butyrate metabolism dysbiosis. This dysbiosis might provide a reference for the diagnosis and clinical therapy of diseases.
Collapse
Affiliation(s)
- Y S Xu
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, China P.R
| | - Y H Wang
- School of Mathematics, Shandong University, Jinan, China P.R
| | - Y Liu
- Department of Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China P.R
| | - X Sun
- Department of Gastroenterology, Qilu Hospital of Shandong University (Qingdao), Qingdao, China P.R
| | - J S Xu
- Division of Nephrology, Jiaozhou Hospital of Tongji University DongFang Hospital, Jiaozhou, China P.R
| | - Y Song
- Division of Gastroenterology, Jiaozhou Hospital of Tongji University DongFang Hospital, Jiaozhou, China P.R
| | - X Jiang
- Division of Gastroenterology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, 400400 Wuhan, China P.R
| | - Z F Xiong
- Division of Gastroenterology, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, 400400 Wuhan, China P.R
| | - Z B Tian
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, China P.R
| | - C P Zhang
- Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao, China P.R
| |
Collapse
|
2
|
DINNING PG, WIKLENDT L, MASLEN L, GIBBINS I, PATTON V, ARKWRIGHT JW, LUBOWSKI DZ, O'GRADY G, BAMPTON PA, BROOKES SJ, COSTA M. Quantification of in vivo colonic motor patterns in healthy humans before and after a meal revealed by high-resolution fiber-optic manometry. Neurogastroenterol Motil 2014; 26:1443-57. [PMID: 25131177 PMCID: PMC4438670 DOI: 10.1111/nmo.12408] [Citation(s) in RCA: 135] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 07/04/2014] [Indexed: 02/06/2023]
Abstract
BACKGROUND Until recently, investigations of the normal patterns of motility of the healthy human colon have been limited by the resolution of in vivo recording techniques. METHODS We have used a new, high-resolution fiber-optic manometry system (72 sensors at 1-cm intervals) to record motor activity from colon in 10 healthy human subjects. KEY RESULTS In the fasted colon, on the basis of rate and extent of propagation, four types of propagating motor pattern could be identified: (i) cyclic motor patterns (at 2-6/min); (ii) short single motor patterns; (iii) long single motor patterns; and (iv) occasional retrograde, slow motor patterns. For the most part, the cyclic and short single motor patterns propagated in a retrograde direction. Following a 700 kCal meal, a fifth motor pattern appeared; high-amplitude propagating sequences (HAPS) and there was large increase in retrograde cyclic motor patterns (5.6 ± 5.4/2 h vs 34.7 + 19.8/2 h; p < 0.001). The duration and amplitude of individual pressure events were significantly correlated. Discriminant and multivariate analysis of duration, gradient, and amplitude of the pressure events that made up propagating motor patterns distinguished clearly two types of pressure events: those belonging to HAPS and those belonging to all other propagating motor patterns. CONCLUSIONS & INFERENCES This work provides the first comprehensive description of colonic motor patterns recorded by high-resolution manometry and demonstrates an abundance of retrograde propagating motor patterns. The propagating motor patterns appear to be generated by two independent sources, potentially indicating their neurogenic or myogenic origin.
Collapse
Affiliation(s)
- P. G. DINNING
- Departments of Gastroenterology and Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia, Disciplines of Human Physiology, Flinders University, Bedford Park, South Australia, Australia, St. George Hospital Clinical School, Faculty of Medicine, University of New South Wales, Kogarah, New South Wales, Australia
| | - L. WIKLENDT
- Disciplines of Human Physiology, Flinders University, Bedford Park, South Australia, Australia
| | - L. MASLEN
- Departments of Gastroenterology and Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - I. GIBBINS
- Anatomy and Histology, Flinders University, Bedford Park, South Australia, Australia
| | - V. PATTON
- St. George Hospital Clinical School, Faculty of Medicine, University of New South Wales, Kogarah, New South Wales, Australia, Department of Anorectal Physiology, St George Hospital, Kogarah, New South Wales, Australia
| | - J. W. ARKWRIGHT
- Computer Science, Engineering and Mathematics, Flinders University, Bedford Park, South Australia, Australia
| | - D. Z. LUBOWSKI
- Disciplines of Human Physiology, Flinders University, Bedford Park, South Australia, Australia
| | - G. O'GRADY
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - P. A. BAMPTON
- Departments of Gastroenterology and Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia
| | - S. J. BROOKES
- Disciplines of Human Physiology, Flinders University, Bedford Park, South Australia, Australia
| | - M. COSTA
- Disciplines of Human Physiology, Flinders University, Bedford Park, South Australia, Australia
| |
Collapse
|
3
|
Dinning PG, Wiklendt L, Gibbins I, Patton V, Bampton P, Lubowski DZ, Cook IJ, Arkwright JW. Low-resolution colonic manometry leads to a gross misinterpretation of the frequency and polarity of propagating sequences: Initial results from fiber-optic high-resolution manometry studies. Neurogastroenterol Motil 2013; 25:e640-9. [PMID: 23773787 DOI: 10.1111/nmo.12170] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2013] [Accepted: 05/16/2013] [Indexed: 01/30/2023]
Abstract
BACKGROUND High-resolution manometry catheters are now being used to record colonic motility. The aim of this study was to determine the influence of pressure sensor spacing on our ability to identify colonic propagating sequences (PS). METHODS Fiber-optic catheters containing 72-90 sensors spaced at 1 cm intervals were placed colonoscopically to the cecum in 11 patients with proven slow transit constipation, 11 patients with neurogenic fecal incontinence and nine healthy subjects. A 2 h section of trace from each subject was analyzed. Using the 1 cm spaced data as the gold standard, each data set was then sub-sampled, by dropping channels from the data set to simulate sensor spacing of 10, 7, 5, 3, and 2 cm. In blinded fashion, antegrade and retrograde PS were quantified at each test sensor spacing. The data were compared to the PSs identified in the corresponding gold standard data set. KEY RESULTS In all subject groups as sensor spacing increased; (i) the frequency of identified antegrade and retrograde PSs decreased (P < 0.0001); (ii) the ratio of antegrade to retrograde PSs increased (P < 0.0001); and (iii) the number of incorrectly labeled PSs increased (P < 0.003). CONCLUSIONS & INFERENCES Doubling the sensor spacing from 1 to 2 cm nearly halves the number of PSs detected. Tripling the sensor spacing from 1 to 3 cm resulted in a 30% chance of incorrectly labeling PSs. Closely spaced pressure recording sites (<2 cm) are mandatory to avoid gross misrepresentation of the frequency, morphology, and directionality of colonic propagating sequences.
Collapse
Affiliation(s)
- P G Dinning
- Departments of Gastroenterology & Surgery, Flinders Medical Centre, Flinders University, South Australia, Australia; School of Medicine, University of New South Wales, New South Wales, Australia
| | | | | | | | | | | | | | | |
Collapse
|
4
|
Dinning PG, Benninga MA, Southwell BR, Scott SM. Paediatric and adult colonic manometry: A tool to help unravel the pathophysiology of constipation. World J Gastroenterol 2010; 16:5162-72. [PMID: 21049550 PMCID: PMC2975087 DOI: 10.3748/wjg.v16.i41.5162] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Colonic motility subserves large bowel functions, including absorption, storage, propulsion and defaecation. Colonic motor dysfunction remains the leading hypothesis to explain symptom generation in chronic constipation, a heterogeneous condition which is extremely prevalent in the general population, and has huge socioeconomic impact and individual suffering. Physiological testing plays a crucial role in patient management, as it is now accepted that symptom-based assessment, although important, is unsatisfactory as the sole means of directing therapy. Colonic manometry provides a direct method for studying motor activities of the large bowel, and this review provides a contemporary understanding of how this technique has enhanced our knowledge of normal colonic motor physiology, as well as helping to elucidate pathophysiological mechanisms underlying constipation. Methodological approaches, including available catheter types, placement technique and recording protocols, are covered, along with a detailed description of recorded colonic motor activities. This review also critically examines the role of colonic manometry in current clinical practice, and how manometric assessment may aid diagnosis, classification and guide therapeutic intervention in the constipated individual. Most importantly, this review considers both adult and paediatric patients. Limitations of the procedure and a look to the future are also addressed.
Collapse
|
5
|
Abstract
Colonic sensorimotor dysfunction is recognized as the principal pathophysiological mechanism underpinning chronic constipation. This review addresses current understanding derived from both human and animal studies, with particular reference made to methods of investigation.
Collapse
Affiliation(s)
- P. G. Dinning
- Department of Medicine, University of New South Wales, St George Hospital, Sydney, Australia
| | - T. K. Smith
- Department of Physiology and Cell Biology, University of Nevada School of Medicine, Reno, NV, USA
| | - S. M. Scott
- Queen Mary University London, Barts and the London School of Medicine & Dentistry, London, UK
| |
Collapse
|
6
|
Sarna SK. Molecular, functional, and pharmacological targets for the development of gut promotility drugs. Am J Physiol Gastrointest Liver Physiol 2006; 291:G545-55. [PMID: 16565417 DOI: 10.1152/ajpgi.00122.2006] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The science of gastrointestinal motility has made phenomenal advances during the last fifty years. Yet, there is a paucity of effective promotility drugs to treat functional bowel disorders that affect 10-29% of the U.S. population. A part of the reason for the lack of effective drugs is our limited understanding of the etiology of these diseases. In the absence of this information, mostly an ad hoc approach has been used to develop the currently available drugs, which are modestly effective or effective in only a subset of the patients with functional bowel disorders. This review discusses a grounds-up approach for development of the next generation of promotility drugs. The approach is based on our current understanding of 1) the different types of contractions that produce overall motility function of mixing and orderly net distal propulsion in major gut organs, 2) the regulatory mechanisms of these contractions, 3) which receptors and intracellular signaling molecules could be targeted to stimulate specific types of contractions to accelerate or retard transit, and 4) the strengths and limitations of animal models and experimental approaches that could screen potential promotility drugs for their efficacy in human gut propulsion in functional bowel disorders.
Collapse
Affiliation(s)
- Sushil K Sarna
- Division of Gastroenterology, Dept. of Internal Medicine, University of Texas Medical Branch at Galveston, 9.138 Medical Research Bldg., Galveston, TX 77555-1064, USA.
| |
Collapse
|
7
|
Harder H, Serra J, Azpiroz F, Malagelada JR. Reflex control of intestinal gas dynamics and tolerance in humans. Am J Physiol Gastrointest Liver Physiol 2004; 286:G89-94. [PMID: 12946941 DOI: 10.1152/ajpgi.00174.2003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Intestinal transit of gas is normally adapted to the luminal gas load, but in some patients impaired transit may lead to gas retention and symptoms. We hypothesized that intestinal gas transit is regulated by reflex mechanisms released by segmental distension at various gut levels. In 24 healthy subjects, we measured gas evacuation and perception of jejunal gas infusion (12 ml/min) during simultaneous infusion of duodenal lipids mimicking the postprandial caloric load (Intralipid, 1 kcal/min). We evaluated the effects of proximal (duodenal) distension (n = 8), distal (rectal) distension (n = 8), and sham distension, as control (n = 8). Duodenal lipid infusion produced gas retention (366 +/- 106 ml) with low abdominal perception (1.5 +/- 0.8 score). Distension of either the duodenum or rectum during lipid infusion expedited gas transit and prevented retention (-120 +/- 164 and -124 +/- 162 ml retention, respectively; P < 0.05 vs. control). However, the tolerance to the intestinal gas load differed markedly, depending on the site of distension; perception remained low during rectal distension (2.6 +/- 0.7 score; not significant vs. control) but increased during duodenal distension (4.4 +/- 0.7 score; P < 0.05 vs. control). We conclude that focal gut distension, either at proximal or distal sites, accelerates gas transit, but the symptomatic response depends on the site of stimulation.
Collapse
Affiliation(s)
- Hermann Harder
- Digestive System Research Unit, Hospital General Vall d'Hebron, Autonomous University of Barcelona, 08035 Barcelona, Spain
| | | | | | | |
Collapse
|