Vladimir V Kiselev¹*, Alexey V Kurenkov¹, Sergey S Petrikov¹, Petr A Yartsev¹, Vera E Odintsova², Stanislav I Koshechkin², Alexander V Tyakht² and Mariya S Zhigalova¹

¹Sklifosovsky Research Institute of Emergency Care of the Moscow Healthcare Department, Moscow, Russia
²Atlas Biomed Group - Knomics LLC, Atlas LLC, London, United Kingdom
³Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Institute of Gene Biology, Russian Academy of Sciences, Moscow, Russia

*Corresponding Author: Vladimir V Kiselev, Sklifosovsky Research Institute of Emergency Care of the Moscow Healthcare Department, Moscow, Russia.

Received: July 09, 2021; Published: July 26, 2021

Citation: Vladimir V Kiselev., et al. “Microbial Community of Small Intestine in Acute Severe Pancreatitis Patients: A Pilot Study". Acta Scientific Gastrointestinal Disorders 4.8 (2021): 58-65.

Abstract

Purpose of the Study: To describe the composition of the microbiota of the initial sections of the small intestine in patients with severe necrotizing acute pancreatitis.

Objectives of the Study:

1. Determine the composition of the microbiota of the initial sections of the small intestine upon admission to the ICU;
2. Determine the differences in the composition of the microbiota of the initial sections of the small intestine, depending on the timing of the onset of the disease.

Introduction: Disturbance of intestinal homeostasis is a leading factor in the pathogenesis and progression of systemic inflammation in patients with severe acute pancreatitis. The development of systemic complications occurs due to both mesenteric hypoperfusion and dysregulation of intestinal motility, and the destruction of the intestinal barrier, with the translocation of bacterial bodies and their substrates. Which increases the risk of developing POI and increasing mortality. With the advent of methods for high-throughput sequencing of microbiome samples - for example, in the 16S rRNA format - the possibilities for studying the structure of microbial communities have significantly expanded. In this regard, there is more and more evidence of the relationship between the state of human health and microflora inhabiting various parts of the body.

Materials and Methods: The study included 7 patients with a diagnosis of severe necrotizing acute pancreatitis (6 men, 1 woman), the mean age was 54.1 ± 14.4 years. The patients were divided into two groups. Group 1 (n = 4) included patients admitted 2 - 4 days after the onset of a pain attack. Group 2 (n = 3) - patients admitted no later than 24 hours from the onset of the disease. The bacterial composition of jejunal wash samples was studied using 16S RNA sequencing. The severity of the condition was assessed using the integral scales APACHE II, SOFA, SAPS II. In patients of the main group, APACHE II was 22 ± 2.83 points (18; 24), SOFA - 6.8 ± 0.5 points (6; 7), SAPSII - 32.9 ± 6.4 points (24.7; 40), in patients of the comparison group, APACHE II is 18.0 ± 3.7 points (12; 22), SOFA - 4.0 ± 2.6 points (2; 7), SAPSII - 24.4 ± 5.0 points (20.9; 30.1).

Material was collected at the time of installation of a sterile multifunctional intestinal catheter for Treitz's ligament, no later than 12 hours from the moment of admission to the ICU. At the time of sampling, patients were not receiving antibiotic therapy.

Results: A more severe course was associated with a reduced representation in the microbiome of the species Neisseria mucosa and Parvimonas micra inhabiting the mucosal layer, as well as Megasphaera micronuciformis. The share of Streptococcus genera (S. rubneri/parasanguinis/australis species) and Actinomyces and a number of genera from the Enterobacteriaceae family in such patients, on the contrary, was higher.

Keywords: Intestinal Lavage; Microbiome; Severe Necrotizing Acute Pancreatitis; Saline Solution; Intestinal Barrier

Bibliography

1. Dibirov MD., et al. “[Role of correction of the syndrome of intestinal failure and abdominal hypertension in the prevention of infection of pancreatic necrosis]”. Khirurgiia (2016): 67-72.
2. Khanna S and Tosh PK. “A Clinician’s Primer on the Role of the Microbiome in Human Health and Disease”. Mayo Clinic Proceedings 89 (2014): 107-114.
3. Rowland I., et al. “Gut microbiota functions: metabolism of nutrients and other food components”. European Journal of Nutrition 57 (2018): 1-24.
4. Yu LC-H. “Microbiota dysbiosis and barrier dysfunction in inflammatory bowel disease and colorectal cancers: exploring a common ground hypothesis”. Journal of Biomedical Science 25 (2018): 79.
5. Yu LC-H., et al. “Host-microbial interactions and regulation of intestinal epithelial barrier function: From physiology to pathology”. World Journal of Gastrointestinal Pathophysiology 3 (2012): 27-43.
6. Rooks MG and Garrett WS. “Gut microbiota, metabolites and host immunity”. Nature Reviews Immunology (2016): 341-352.
7. Koh A., et al. “From Dietary Fiber to Host Physiology: Short-Chain Fatty Acids as Key Bacterial Metabolites”. Cell 165 (2016): 1332-1345.
8. Grootjans J., et al. “Life and death at the mucosal-luminal interface: New perspectives on human intestinal ischemia-reperfusion”. World Journal of Gastroenterology 22 (2016): 2760-2770.
9. Ji Y., et al. “Endoplasmic reticulum stress-induced apoptosis in intestinal epithelial cells: a feed-back regulation by mechanistic target of rapamycin complex 1 (mTORC1)”. Journal of Animal Science and Biotechnology 9 (2018): 38.
10. Schellekens DH., et al. “Human small intestine is capable of restoring barrier function after short ischemic periods”. World Journal of Gastroenterology 23 (2017): 8452-8464.
11. Manohar M., et al. “Pathogenic mechanisms of pancreatitis”. World Journal of Gastrointestinal Pharmacology and Therapeutics 8 (2017): 10-25.
12. Lin R., et al. “Interleukin-10 attenuates impairment of the blood-brain barrier in a severe acute pancreatitis rat model”. Journal of Inflammation (2018).
13. Sertaridou E., et al. “Gut failure in critical care: old school versus new school”. Annals of Clinical Gastroenterology and Hepatology 28 (2015): 309-322.
14. Reintam Blaser A., et al. “Gastrointestinal function in intensive care patients: terminology, definitions and management. Recommendations of the ESICM Working Group on Abdominal Problems”. Intensive Care Medicine 38 (2012): 384-394.
15. Schmidt PN., et al. “Spectrum of microorganisms in infected walled-off pancreatic necrosis - Impact on organ failure and mortality”. Pancreatology (2014): 444-449.
16. Xiao H., et al. “Identification of potential diagnostic biomarkers of acute pancreatitis by serum metabolomic profiles”. Pancreatology 17 (2017): 543-549.
17. Yu S., et al. “Shotgun metagenomics reveals significant gut microbiome features in different grades of acute pancreatitis (2021).
18. Andrianova NV., et al. “Microbiome-Metabolome Signature of Acute Kidney Injury”. Metabolites (2020): 10.
19. Efimova D., et al. “Knomics-Biota - a system for exploratory analysis of human gut microbiota data”. BioData Mining 11 (2018): 25.
20. Callahan BJ., et al. “DADA2: High-resolution sample inference from Illumina amplicon data”. Nature Methods 13 (2016): 581-583.
21. Horton NJ and Kleinman K. “Using R and RStudio for Data Management, Statistical Analysis, and Graphics” (2015).
22. Aitchison J. “The Statistical Analysis of Compositional Data (1986).
23. Gloor GB., et al. “Microbiome Datasets Are Compositional: And This Is Not Optional”. Frontiers in Microbiology 8 (2017): 2224.
24. ZCompositions - R package for multivariate imputation of left-censored data under a compositional approach”. Chemometrics and Intelligent Laboratory Systems 143 (2015): 85-96.
25. Villmones HC., et al. “Species Level Description of the Human Ileal Bacterial Microbiota”. Scientific Reports 8 (2018): 4736.
26. Akshintala VS., et al. “The Gut Microbiome in Pancreatic Disease”. Clinical Gastroenterology and Hepatology 17 (2019): 290-295.
27. Yu J., et al. “Metagenomic analysis of faecal microbiome as a tool towards targeted non-invasive biomarkers for colorectal cancer”. Gut 66 (2017): 70-78.
28. Osman KL., et al. “Patients with Chronic Obstructive Pulmonary Disease harbour a variation of Haemophilus species”. Scientific Reports (2018).
29. Morton DJ., et al. “An invasive Haemophilus haemolyticus isolate”. Journal of Clinical Microbiology 50 (2012): 1502-1503.
30. Saulnier DM., et al. “Gastrointestinal microbiome signatures of pediatric patients with irritable bowel syndrome”. Gastroenterology 141 (2011): 1782-1791.
31. Dong Z., et al. “Detection of Microbial 16S rRNA Gene in the Serum of Patients With Gastric Cancer”. Frontiers in Oncology 9 (2019): 608.
32. Riegel P., et al. “Corynebacterium argentoratense sp. nov., from the human throat”. International Journal of Systematic and Evolutionary Microbiology 45 (1995): 533-537.
33. Fernández-Natal I., et al. “Phenotypic, molecular characterization, antimicrobial susceptibility and draft genome sequence of Corynebacterium argentoratense strains isolated from clinical samples”. New Microbes and New Infections 10 (2016): 116-121.
34. Chhatwal GS and Graham R. “Streptococcal Diseases”. International Encyclopedia of Public Health (2017): 87-97.
35. Fonkou MDM., et al. “Enterococcus timonensis” sp. nov., “Actinomyces marseillensis” sp. nov., “Leptotrichia massiliensis” sp. nov., “Actinomyces pacaensis” sp. nov., “Actinomyces oralis” sp. nov., “Actinomyces culturomici” sp. nov. and “Gemella massiliensis” sp. nov., new bacterial species isolated from the human respiratory microbiome”. New Microbes and New Infections (2018): 37-43.
36. Tønjum T. “Neisseria”. Bergey’s Manual of Systematics of Archaea and Bacteria (2015): 1-48.
37. Dai D., et al. “Role of oligosaccharides and glycoconjugates in intestinal host defense”. Journal of Pediatric Gastroenterology and Nutrition2 (2000): S23-33.
38. Gantuya B., et al. “Gastric microbiota in Helicobacter pylori-negative and-positive gastritis among high incidence of gastric cancer area”. Cancers4 (2019): 504.
39. Shetty SA., et al. “Comparative genome analysis of Megasphaera sp. reveals niche specialization and its potential role in the human gut”. PLoS One 8 (2013): e79353.
40. Marchandin H., et al. “Phylogenetic analysis of some Sporomusa sub-branch members isolated from human clinical specimens: description of Megasphaera micronuciformis sp. Nov”. International Journal of Systematic and Evolutionary Microbiology 53 (2003): 547-553.

Copyright: © Vladimir V Kiselev., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.