Gut microbiota profiles and fecal beta‐glucuronidase activity in kidney transplant recipients with and without post‐transplant diarrhea
| Autor: | Michelle Lubetzky, Lisa T. Zhang, Brittany Botticelli, Shady Albakry, Lars F. Westblade, Matthew Magruder, Michael R. Taylor, Amy Robertson, Michael J. Satlin, John R. Lee, Emmanuel Edusei, Fatima Iqbal, Tricia Alston, Alice Chung, Darshana Dadhania, Simon A. Hirota, Steven C. Greenway |
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| Rok vydání: | 2021 |
| Předmět: |
Diarrhea
medicine.medical_specialty 030230 surgery Gut flora Gastroenterology 03 medical and health sciences 0302 clinical medicine RNA Ribosomal 16S Internal medicine medicine Humans Feces Kidney transplantation Glucuronidase Transplantation biology business.industry Beta-glucuronidase activity biology.organism_classification medicine.disease Kidney Transplantation Gastrointestinal Microbiome Toxicity Biomarker (medicine) 030211 gastroenterology & hepatology medicine.symptom Complication business |
| Zdroj: | Clinical Transplantation. 35 |
| ISSN: | 1399-0012 0902-0063 |
| DOI: | 10.1111/ctr.14260 |
| Popis: | Post-transplant diarrhea is a common complication after solid organ transplantation and is frequently attributed to the widely prescribed immunosuppressant mycophenolate mofetil (MMF). Given recent work identifying the relationship between MMF toxicity and gut bacterial β-glucuronidase activity, we evaluated the relationship between gut microbiota composition, fecal β-glucuronidase activity, and post-transplant diarrhea. We recruited 97 kidney transplant recipients and profiled the gut microbiota in 273 fecal specimens using 16S rRNA gene sequencing. We further characterized fecal β-glucuronidase activity in a subset of this cohort. Kidney transplant recipients with post-transplant diarrhea had decreased gut microbial diversity and decreased relative gut abundances of 12 genera when compared to those without post-transplant diarrhea (adjusted p value < .15, Wilcoxon rank sum test). Among the kidney transplant recipients with post-transplant diarrhea, those with higher fecal β-glucuronidase activity had a more prolonged course of diarrhea (≥7 days) compared to patients with lower fecal β-glucuronidase activity (91% vs 40%, p = .02, Fisher's exact test). Our data reveal post-transplant diarrhea as a complex phenomenon with decreased gut microbial diversity and commensal gut organisms. This study further links commensal bacterial metabolism with an important clinical outcome measure, suggesting fecal β-glucuronidase activity could be a novel biomarker for gastrointestinal-related MMF toxicity. |
| Databáze: | OpenAIRE |
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