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©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
Characteristics of fecal microbial communities in patients with non-anastomotic biliary strictures after liver transplantation
Jing Zhang, Feng-Gang Ren, Peng Liu, Hong-Ke Zhang, Hao-Yang Zhu, Zhe Feng, Xu-Feng Zhang, Bo Wang, Xue-Ming Liu, Xiao-Gang Zhang, Rong-Qian Wu, Yi Lv
Jing Zhang, Feng-Gang Ren, Peng Liu, Hong-Ke Zhang, Hao-Yang Zhu, Zhe Feng, Xu-Feng Zhang, Bo Wang, Xue-Ming Liu, Xiao-Gang Zhang, Yi Lv, Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Jing Zhang, Feng-Gang Ren, Peng Liu, Hong-Ke Zhang, Hao-Yang Zhu, Zhe Feng, Xu-Feng Zhang, Bo Wang, Xue-Ming Liu, Xiao-Gang Zhang, Rong-Qian Wu, Yi Lv, Institute of Advanced Surgical Technology and Engineering, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Jing Zhang, Feng-Gang Ren, Peng Liu, Hong-Ke Zhang, Hao-Yang Zhu, Zhe Feng, Xu-Feng Zhang, Bo Wang, Xue-Ming Liu, Xiao-Gang Zhang, Rong-Qian Wu, Yi Lv, Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, Shaanxi Province, China
Author contributions: Zhang J, Lv Y, Wu RQ, Wang B, Liu XM and Zhang XG designed the study; Zhang J and Feng Z collected the samples; Zhang J, Liu P and Feng Z performed the DNA extraction; Zhang J, Ren FG, Zhu HY, Zhang XF and Lv Y performed the data analysis and interpretation; Zhang J, Ren FG, Liu P and Zhu HY drafted the manuscript; Lv Y and Wu RQ revised the manuscript critically; the funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
Supported by the National Natural Science Foundation of China, No. 81470896.
Institutional review board statement: The study was reviewed and approved by The First Affiliated Hospital of Xi’an Jiaotong University Institutional Review Board.
Informed consent statement: All participants were totally informed of the related matters prior to entering in and signed the informed consent form.
Conflict-of-interest statement: The authors declare no competing financial interests.
Data sharing statement: No additional unpublished data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yi Lv, MD, PhD, Professor, Department of Hepatobiliary Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an 710061, Shaanxi Province, China. luyi169@126.com
Telephone: +86-13991200581 Fax: +86-29-82653903
Received: August 2, 2017
Peer-review started: August 5, 2017
First decision: August 30, 2017
Revised: September 13, 2017
Accepted: November 7, 2017
Article in press: November 7, 2017
Published online: December 14, 2017
ARTICLE HIGHLIGHTS
Research background
Non-anastomotic biliary stricture (NAS) is a lethal disorder after liver transplantation (LT), but the mechanisms are still obscure. Gut microbiota has been shown to participate in the pathogenesis of some post-LT complications, while the characteristics of microbial communities in patients with NAS have never been investigated.
Research motivation
The purpose of this study was to explore the possible relationship between fecal microbial communities and NAS after OLT.
Research objectives
To perform possible mechanism research about NAS after LT to shed some light on its prevention in future.
Research methods
A total of 30 subjects including 10 patients with NAS, 10 patients with no complications after LT, and 10 non-LT healthy individuals were enrolled. Fecal microbial communities were assessed by the 16S rRNA gene sequencing technology. Diversity indexes and the species accumulation curve were calculated by QIIME. PCA plots of the bacterial communities were created using pcaMethods. Other data analysis was finished by Chi-square or Fisher’s exact test or ANOVA test using SPSS software.
Research results
Different from the uncomplicated and healthy groups, unbalanced fecal bacterium ratio existed in patients with non-anastomotic biliary strictures after liver transplantation. The results showed that NAS patients were associated with a decrease of Firmicutes and Bacteroidetes and an increase of Proteobacteria at the phylum level, with the proportion-ratio imbalance between potentially pathogenic families including Enterococcaceae, Streptococcaceae, Enterobacteriaceae, and Pseudomonadaceae and dominant families including Bacteroidaceae.
Research conclusions
The compositional shifts of the increase of potential pathogenic bacterium as well as the decrease of dominant bacterium might contribute to the incidence of NAS. Gut microbiota may participate in the pathological process of NAS. Factors including poor liver graft, ABO-incompatibility, cytomegalovirus (CMV) infection contribute to the development of NAS.
Dysbacteriosis may be another inducer contributing to the development of NAS. The shifts of fecal microbial communities may participate in or exacerbate the process of bile duct injury. Unbalanced ratio of pathogenic bacteria to dominant bacteria really existed in patients with NAS after liver transplantation. What are the implications of this? Bacterial intervention may be a new therapy for preventing the occurence of NAS.
Research perspectives
According to our study, shifts of fecal microbial communities may participate in or exacerbate the process of bile duct inflammation. This might be helpful for NAS prevention. While the definite relationship was obscure, more mechanism research about how microbiota affects the pathological process should be carried out in the future. To learn more interaction relationship between microbiota and biliary inflammatory injury, technology based on functional genomics may be used for future research.
