Blood Loss Leads to Increase in Relative Abundance of Opportunistic Pathogens in the Gut Microbiome of Rabbits

Yang, Junjie; Zhang, Jiaming; Zhao, Chuanzhi; Gai, Zhongtao; Mu, Xiaojing; Wang, Ye; Zhang, Chunyu; Su, Zhenzhen; Gao, Lihe; Zhu, Dequan; Zuo, Zhuang; Heng, Xueyuan; Zhang, Lei

doi:10.1007/s00284-019-01825-2

Cited by 5 publications

(5 citation statements)

References 27 publications

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“…Yang et al 34 identified an initial surge in Bacteroidales, Clostridiales, and Ruminococcus growth in rabbits within 24 hours after hemorrhage that continued for 7 days postinjury. Our results did not replicate this robust response to trauma-hemorrhage alone, but rather this study identified an overabundance of taxa similar to those identified in their study but only after the addition of chronic stress over the course of 3 days, 7 days, or 14 days.…”

Section: Discussionmentioning

confidence: 99%

Stress-related changes in the gut microbiome after trauma

Kelly

Gharaibeh

Pons

et al. 2021

J Trauma Acute Care Surg

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BACKGROUND:The gut microbiome protects the host from infection by promoting epithelial integrity and providing basal immunologic stimulation. Disruption of this delicate ecosystem is linked to morbidity and mortality among critically ill patients, but the impact of traumatic injury on the gut microbiome is poorly understood. This study sought to identify alterations in gut microbiota following trauma and persistent stress in rodents without confounding antibiotics. METHODS:Male Sprague-Dawley rats aged 9 weeks to 11 weeks were randomized to naive, lung contusion with hemorrhagic shock (LCHS), and LCHS plus either 7 (LCHS/CS 7/7) or 14 days (LCHS/CS 14) of restraint cylinder stress for 2 hours daily. Stool was collected on Days 0, 3, 7, and 14 for bacterial whole genome DNA isolation. Alpha diversity, or the number and relative abundance of unique bacterial species within each cohort, was assessed using Chao1 indices. Beta diversity, or the measure of differences in biodiversity across cohorts, was assessed by principle coordinate analysis. False discovery rate correction was applied to all statistical analyses and corrected for cohousing effects. RESULTS:Rodent groups subject to restraint stress demonstrated a progressive increase in alpha diversity over time. These microbiota changes resolved after cessation of stress (LCHS/CS 7/7) but continued to increase among rats subjected to ongoing stress (LCHS/CS 14). The LCHS/CS 7/7 also demonstrated reductions in class Actinobacteria and increased abundance of the genus Bacteroides by Day 7, which resolved by Day 14. Increased abundance of Bacteroides was also noted in the LCHS/CS 14 cohort, suggesting the role of chronic stress in its destabilization. CONCLUSION: This study points to persistent stress as a potential source of the destabilization of microbial diversity seen after trauma. This lack of microbiota stability could be associated with worse long-term outcomes in critically ill trauma patients. Further studies are warranted to elucidate mechanistic pathways and potential therapeutic modalities.

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Section: Discussionmentioning

confidence: 99%

Stress-related changes in the gut microbiome after trauma

Kelly

Gharaibeh

Pons

et al. 2021

J Trauma Acute Care Surg

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“…While our diversity results differ from those of Kelly et al 16 who found that chronic daily stress resulted in a steady increase in α diversity and increased after lung contusion and hemorrhagic shock with chronic stress, their model was only of lung contusion and hemorrhagic shock and not profound multicompartmental injury. Yang et al 17 found an initial increase in α diversity initially after trauma, which began to decline up to 1 week afterward, although not below preinjury α diversity levels; however, their model was in rabbits subjected to hemorrhagic shock only. Nicholson et al 18 performed a study on PT but investigated acute changes after 2 hours, which demonstrated no significant changes in α diversity but did show differences in β diversity similar to our results.…”

Section: Discussionmentioning

confidence: 94%

“…14,15 Several preclinical studies have been performed on various levels of injury, including hemorrhagic shock and different organ injuries, which all demonstrate significant changes to the microbiome after trauma and a shift to the pathobiome. [16][17][18][19][20][21] However, few have studied severe and multicompartmental injuries; of these, only early changes in the microbiome, intestinal injury, and intestinal permeability have been investigated within 24 hours of injury. 18,[20][21][22] Human studies have begun to characterize microbial changes after acute injury, but most only evaluate patients with an Injury Severity Score (ISS) of 15 or higher.…”

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confidence: 99%

Multicompartmental traumatic injury and the microbiome: Shift to a pathobiome

Munley

Kelly

Pons

et al. 2022

J Trauma Acute Care Surg

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“…In this study, the correlation of various characteristics and POI was analysed by regression analysis. Multivariate analysis indicated that intraoperative blood loss≥200 ml (P=0.013) was significantly (39); third, through the alteration of the immune system, intraoperative blood loss can also increase the relative abundance of opportunistic pathogenic bacterial species in the intestinal tract (40). Given the relationship between intraoperative blood loss and POI, surgeons should take measures to reduce blood loss, such as identifying and managing patients at risk of high blood loss and improving techniques (carefully separating blood vessels, avoiding bleeding in a timely manner, hepatic portal occlusion et al) to control bleeding during surgery (41).…”

Section: Discussionmentioning

confidence: 99%

Impact of Postoperative Infectious Complications on Long-Term Outcomes for Patients Undergoing Simultaneous Resection for Colorectal Cancer Liver Metastases: A Propensity Score Matching Analysis

et al. 2022

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ObjectiveTo investigate the impact of postoperative infectious complications (POI) on the long-term outcomes of patients with colorectal cancer liver metastasis (CRLM) after simultaneous resection of colorectal cancer and liver metastases.MethodsFour hundred seventy-nine CRLM patients receiving simultaneous resection between February 2010 and February 2018 at our hospital were enrolled. A 1:3 propensity score matching analysis (PSM) analysis was performed to balance covariates and avoid selection bias. After PSM, 90 patients were distributed to the POI group, and 233 patients were distributed to the no POI group. A log-rank test was performed to compare the progression-free survival (PFS) and overall survival (OS) data. A multivariate Cox regression model was employed to identify prognostic factors influencing OS and PFS. A value of two-sided P<0.05 was considered statistically significant.ResultsCompared to patients in the no POI group, patients in the POI group were more likely to have hepatic portal occlusion (78.9% vs. 66.3%, P=0.021), operation time ≥325 min (61.1% vs. 48.1%, P=0.026), and intraoperative blood loss ≥200 ml (81.1% vs. 67.6%, P=0.012). In multivariate analysis, intraoperative blood loss ≥200 ml (OR = 2.057, 95% CI: 1.165-3.634, P=0.013) was identified as the only independent risk factor for POI. Patients with POI had a worse PFS (P<0.001, median PFS: 7.5 vs. 12.7 months) and a worse OS (P=0.010, median OS: 38.8 vs. 59.0 months) than those without POI. After 1:3 PSM analysis, no differences in clinicopathologic parameters were detected between the POI group and the no POI group. Patients with POI had a worse PFS (P=0.013, median PFS: 7.5 vs. 11.1 months) and a worse OS (P=0.020, median OS: 38.8 vs. 59.0 months) than those without POI. Multivariate analysis showed that POI was an independent predictor for worse PFS (HR=1.410, 95% CI: 1.065-1.869, P=0.017) and worse OS (HR=1.682, 95% CI: 1.113-2.544, P=0.014).ConclusionsPOI can significantly worsen the long-term outcomes of CRLM patients receiving simultaneous resection of colorectal cancer and liver metastases and should be considered to improve postoperative management and make better treatment decisions for these patients.

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Blood Loss Leads to Increase in Relative Abundance of Opportunistic Pathogens in the Gut Microbiome of Rabbits

Cited by 5 publications

References 27 publications

Stress-related changes in the gut microbiome after trauma

Stress-related changes in the gut microbiome after trauma

Multicompartmental traumatic injury and the microbiome: Shift to a pathobiome

Impact of Postoperative Infectious Complications on Long-Term Outcomes for Patients Undergoing Simultaneous Resection for Colorectal Cancer Liver Metastases: A Propensity Score Matching Analysis

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