Analysis of the relationship between bile duct and duodenal microbiota reveals that potential dysbacteriosis is the main cause of primary common bile duct stones

Abstract

Bacteria play an important role in the formation of primary Common Bile Duct (CBD) stones. However, the composition and function of the microbiota of bile duct in patients with primary CBD stones remained to be explored. We utilized the 16S rRNA gene high-throughput sequencing technology to analyze the microbial diversity and community composition of biliary and duodenal microbiota in 15 patients with primary CBD stones and 4 patients without biliary tract diseases. Alpha diversity analysis showed that the microbiota richness was similar in bile and intestinal fluid; Beta diversity analysis showed that there were differences in the composition between biliary microbiota and the duodenal microbiota, but the abundance of the main groups showed similarities. The composition of the biliary microbiota from gallstone patients was more complex, as was the duodenal microbiota. Proteobacteria and Firmicutes were the dominant bacteria at phylum level, accounting for at least 75% of the total reads in each subgroup. Pseudomonas and Escherichia−Shigella were the major genus among subgroups, but Escherichia-Shigella had increased abundance in duodenal microbiota with primary choledocholithiasis, which may play an important role in stone formation. It is noteworthy that Clostridium sensu_stricto, Lachnospiraceae _UCG-008, Butyrivibrio and Roseburia which could produce short chain fatty acids (SCFAs), were significantly decreased in biliary microbiota with primary CBD stones (p < 0.05). Our study provided new insights into the compositional of normal biliary microbiota. The micro-ecology of biliary and duodenal in patients with stones is complex and closely related, and there is a potential for dysbacteriosis. The decrease in abundance of certain major acid-producing bacteria affects the health of the biliary tract and thus leads to the formation of stones.

The Role of the Bile Microbiome in Common Bile Duct Stone Development

“…Consequently, Enterococcus produces acetate and formate. This suggests that the significant increases in acetate and formate in the CBD stones group found in our study were statistically strongly correlated with the increased Enterococcus in CBD stones [ 21 , 23 ]. Acetate plays a crucial role in the regulation of host metabolism and immunity, and reports have linked it to inflammation [ 24 , 25 ].…”

Effect of the extrahepatic bile duct anatomy on choledocholithiasis and its clinical significance

“…This suggests decreased choledocholithiasis risk with an increasing choledochal angle, both in primary and recurrent cases. Furthermore, the biliary tract is not a sterile environment[ 21 , 22 ], and a smaller common bile duct angle may lead to shape distortion, causing a twisted common bile duct. This increases the risk of bile stagnation, bacterial infection, and stone formation.…”

ABO-Incompatible Liver Transplantation under the Desensitization Protocol with Rituximab: Effect on Biliary Microbiota and Metabolites

“…However, due to the fact of ethical issues, there are currently a small number of studies on biliary microbiota in healthy people. This aspect of research is mainly conducted by replacing the biliary tract of healthy people with the biliary tract of LT donors and patients with pancreatic disease without hepatobiliary disease [36][37][38][39]. Therefore, it is difficult to compare biliary microbiota after transplantation with those in healthy people.…”