Association between postoperative changes in the gut microbiota and pseudopsia after cardiac surgery: prospective observational study

Maekawa, Magojiro; Yoshitani, Kenji; Yahagi, Musashi; Asahara, Takashi; Shishido, Yoshihiro; Fukushima, Satsuki; Tadokoro, Naoki; Fujita, Tomoyuki; Ohnishi, Yoshihiko

doi:10.1186/s12893-020-00907-4

Cited by 11 publications

(15 citation statements)

References 43 publications

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“…The anti-inflammatory mechanism entails direct interaction with immune cells to block histone deacetylases, resulting in more transcriptionally active chromatin and down-regulated inflammatory cytokines, such as TNF-a and IL-12 35. In addition, SCFAs were reported to be directly associated with memory function recovery and an increase in gene expression involved associative learning 31…”

Section: Discussionmentioning

confidence: 99%

“…35 In addition, SCFAs were reported to be directly associated with memory function recovery and an increase in gene expression involved associative learning. 31 By applying elevations of plasma TJ protein and endotoxin as markers of gut barrier dysfunction, researchers observed increased intestinal permeability after surgery. 36 In our study, plasma LPS, claudin-1, and occludin were higher in pAD patients prior to surgery, particularly in SCD patients, which may suggest preexisting high intestinal permeability in pAD patients.…”

Section: Discussionmentioning

confidence: 99%

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Orthopedic Surgery Causes Gut Microbiome Dysbiosis and Intestinal Barrier Dysfunction in Prodromal Alzheimer Disease Patients

Liu

Duan

et al. 2022

Annals of Surgery

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Objective: To investigate gut microbiota and intestinal barrier function changes after orthopedic surgery in elderly patients with either normal cognition (NC) or a prodromal Alzheimer disease phenotype (pAD) comprising either subjective cognitive decline (SCD) or amnestic mild cognitive impairment (aMCI). Background: Homeostatic disturbances induced by surgical trauma and/or stress can potentially alter the gut microbiota and intestinal barrier function in elderly patients before and after orthopedic surgery. Methods: In this prospective cohort study, 135 patients were subject to preoperative neuropsychological assessment and then classified into: NC (n=40), SCD (n=58), or aMCI (n=37). Their gut microbiota, bacterial endotoxin (lipopolysaccharide), tight junction (TJ) protein, and inflammatory cytokines in blood were measured before surgery and on postsurgical day 1, 3, and 7 (or before discharge). Results: The short-chain fatty acid (SCFA)-producing bacteria were lower while the gram-negative bacteria, lipopolysaccharide and TJ were higher preoperatively in both the SCD and aMCI (pAD) groups compared with the NC group. After surgery, a decrease in SCFA-producing bacteria, and an increase in both gram-negative bacteria and plasma claudin were significant in the pAD groups relative to the NC group. SCFA-producing bacteria were negatively correlated with TJ and cytokines in pAD patients on postsurgical day 7. Furthermore, surgery-induced perioperative metabolic stress and inflammatory responses were associated with gut microbiota alterations. Conclusions: Surgery exacerbates both preexisting microbiota dysbiosis and intestinal barrier dysfunction in pAD patients, all of which may be associated with systemic inflammation and, in turn, may lead to further cognitive deterioration.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Orthopedic Surgery Causes Gut Microbiome Dysbiosis and Intestinal Barrier Dysfunction in Prodromal Alzheimer Disease Patients

Liu

Duan

et al. 2022

Annals of Surgery

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“…In a clinical study of the relationship between the gut microbiota and pseudopsia after cardiac surgery, Maekawa et al ( 22 ) reported that surgery lowered the total bacterial counts and species numbers. Staphylococcus and Pseudomonas counts were significantly higher postoperatively, and may be associated with the pathogenesis of pseudopsia.…”

Section: Discussionmentioning

confidence: 99%

“…In a previous study of POD, Zhang et al ( 21 ) detected an association between an abnormal composition of the gut microbiota and delirium-like behaviors after abdominal surgery in mice. Additionally, Maekawa et al ( 22 ) observed a clinical association between pseudopsia and the gut microbiota among patients who underwent cardiac surgery. However, the relationship between POD and the gut microbiota in various surgery types and the relationship with aging has not been widely examined.…”

Section: Introductionmentioning

confidence: 99%

Preoperative Status of Gut Microbiota Predicts Postoperative Delirium in Patients With Gastric Cancer

Liu

Gao

et al. 2022

Front. Psychiatry

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IntroductionPost-operative delirium (POD) is a serious complication which occurs after surgery, especially in the elderly undergoing abdominal surgery. Increasing evidence has revealed an association between the gut microbiota and psychological disorders involving the “brain-gut” axis. However, the association between the pathogenesis of POD after abdominal surgery in aging and composition of the gut microbiota remains unclear.MethodsForty patients (≥65 years old) who underwent abdominal surgery were included in the study. Twenty patients had POD, whereas 20 patients did not. POD was diagnosed and assessed using the confusion assessment method (CAM) during the postoperative period. Total DNA fractions were extracted from all fecal samples of patients. 16S rRNA sequencing was performed to determine the composition of the gut microbiota. The quality of the samples was determined by calculating the α- and β-diversities.ResultsThe α- and β-diversities indicated that the samples were eligible for detection and comparison. We observed multiple differentially abundant bacteria in patients with and without POD. Generally, Proteobacteria, Enterbacteriaceae, Escherichia shigella, Klebsiella, Ruminococcus, Roseburia, Blautia, Holdemanella, Anaerostipes, Burkholderiaceae, Peptococcus, Lactobacillus, and Dorea were abundant in the POD cohort, whereas Streptococcus equinus and Blautia hominis were abundant in the control cohort. The results of receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) of Escherichia shigella was 0.75. Phenotype prediction showed that the gut microbiota may influence POD by altering the tolerance to oxidative stress.ConclusionThere were significant associations between the pathogenesis of POD and composition of the gut microbiota. Escherichia shigella are promising diagnostic bacterial species for predicting POD onset after abdominal surgery in elderly people.Clinical Trial Registrationhttp://www.chictr.org.cn/index.aspx, Chinese Clinical Trial Registry ChiCTR200030131.

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“…Cardiovascular active drugs such as isoprotereno were used if HR < 50 bmp (anticholinergic drugs were avoided). Cefazolin was used 30–60 min before surgery to prevent infection ( Maekawa et al, 2020 ). Cefazolin was added every 3 h or when the bleeding volume was greater than 1,000 ml.…”

Section: Methodsmentioning

confidence: 99%

Mechanical Bowel Preparation Is a Risk Factor for Postoperative Delirium as It Alters the Gut Microbiota Composition: A Prospective Randomized Single-Center Study

Yang

Tong

Qian

et al. 2022

Front. Aging Neurosci.

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Background and ObjectivePostoperative delirium (POD) is a frequent complication in patients undergoing gastrectomy. Increasing evidence suggests that abnormal gut microbiota composition may contribute to its morbidity. However, it is unclear whether mechanical bowel preparation would cause postoperative delirium by altering the gut microbiota of patients. This study aimed to investigate the association between mechanical bowel preparation and postoperative delirium in patients undergoing gastrectomy.MethodsA prospective randomized single-center study was performed. A total of 81 patients with gastric cancer were enrolled and randomly assigned to two groups: preparation group and non-preparation group according to whether the patient received MBP before surgery. To diagnose postoperative delirium, we used the 3-Min Diagnostic Interview for Confusion Assessment Method-defined delirium for five successive days after surgery. 16s rRNA gene sequencing was used to investigate changes in the intestinal bacteria. The linear discriminant analysis and effect size (LefSe) analysis were also used to identify the different taxa of fecal microbiota between the postoperative delirium and non-postoperative delirium groups.ResultsWe found that there was a significant difference in β-diversity of the gut microbiota between the preparation group and non-preparation group (P = 0.048). Furthermore, patients in the preparation group had a much higher rate of postoperative delirium (13/40, 32.5%) compared with that in non-preparation groups (4/41, 9.8%). Multivariate regression analysis adjusted by other risk factors indicated that mechanical bowel preparation was associated with the occurrence of delirium (odds ratio = 4.792; 95% confidence interval: 1.274–18.028; P = 0.020). When comparing the gut microbiota of patients with and without POD, Bacteroides and Veillonella (genus), which were higher in the preparation group, were also higher in delirium patients (P < 0.05). Genus Olsenella was both relatively higher in the non-preparation group and non-POD group (P < 0.05).ConclusionMechanical bowel preparation not only altered the gut microbiota composition of patients with gastric cancer but also increased the incidence of postoperative delirium. Among all the gut microbiota altered by mechanical bowel preparation, Bacteroides and Veillonella genus might be a risk factor of POD. Genus Olsenella might be a beneficial bacteria to reduce the incidence of POD.

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Association between postoperative changes in the gut microbiota and pseudopsia after cardiac surgery: prospective observational study

Cited by 11 publications

References 43 publications

Orthopedic Surgery Causes Gut Microbiome Dysbiosis and Intestinal Barrier Dysfunction in Prodromal Alzheimer Disease Patients

Orthopedic Surgery Causes Gut Microbiome Dysbiosis and Intestinal Barrier Dysfunction in Prodromal Alzheimer Disease Patients

Preoperative Status of Gut Microbiota Predicts Postoperative Delirium in Patients With Gastric Cancer

Mechanical Bowel Preparation Is a Risk Factor for Postoperative Delirium as It Alters the Gut Microbiota Composition: A Prospective Randomized Single-Center Study

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