The microbiome in adult acute appendicitis

Abstract

Acute appendicitis is a common acute surgical emergency; however, the pathogenesis of adult appendicitis remains poorly understood. The microbiome is increasingly thought to play a key role in inflammatory disease of the bowel and similarly, may play a role in appendicitis. This study aimed to characterise the microbiome of adult acute appendicitis in a prospective cohort. We recruited 60 adults with acute appendicitis and 20 healthy controls. Rectal swabs were taken from each patient. After DNA extraction, 16S rRNA amplicon sequencing was carried out for analysis of diversity and taxonomic abundance. Phylogenetic sequencing of the samples indicated that there is a difference between the microbial composition of those with acute appendicitis and healthy controls, with a statistically significant decrease in alpha diversity in rectal swabs of appendicitis patients compared to healthy controls. At the genus level, we saw an increased abundance of potential pathogens, for example, Parvimonas and Acinetobacter, and a decrease in commensal taxa such as Faecalibacterium, Blautia and Lachnospiraceae in appendicitis patients compared to healthy controls. There was a reduction in diversity and loss of commensals in the microbiome of those with acute appendicitis, which may play a role in the cascade leading to acute appendicitis or the result of this.

Unveiling the Role of Inflammatory Mediators and Gut Microbiome in Appendicitis: Types and Applications in Clinical Scoring

“…The gut microbiota, which refers to the trillions of microorganisms that live in the human gastrointestinal tract [17], mainly includes bacteria, fungi, protozoa, archaea, and viruses [18], among which bacteria are dominant that have been implicated in various aspects of human health and disease [19], including the development of appendicitis [20].…”

“…Appendicitis is an inflammatory condition of the appendix, and the exact mechanism by which the gut microbiota may contribute to appendicitis is not fully understood [8], but several theories have been proposed. One theory suggests that an imbalance or dysbiosis in the gut microbiota may trigger an inflammatory response in the appendix, leading to appendicitis [20]. Studies have shown that alterations in the composition and diversity of the gut microbiota, such as a decrease in beneficial bacteria and an increase in harmful bacteria, may be associated with an increased risk of appendicitis.…”