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The role of the gut microbiota in the genesis of gallstone formation in childhood

https://doi.org/10.31146/1682-8658-ecg-221-1-53-61

Abstract

Cholelithiasis has been and remains a frequent socially significant public health problem worldwide. The pathomorphosis of the disease has also undergone significant changes, which has significantly rejuvenated, occurring not only at a young age, but also in childhood. More than 175,000 cholecystectomies are performed annually for cholelithiasis. Cholelithiasis affects 10-20% of the adult population in our country. At the same time, cholecystectomy came in second place after appendectomy. There are no official statistics on the prevalence of GCD in the general population of children in Russia. In the Krasnodar Territory, the incidence of cholelithiasis in childhood, according to the data of circulation, is 1.8-3.3%. Over the past decade, a number of studies have been conducted confirming the role of the microbiota in various parts of the gastrointestinal tract as a new link in the etiopathogenesis of GI. Intestinal bacteria (Clostridium, Bifidobacterium, Peptostreptococcus, Bacteroides, Eubacterium, Escherichia coli), involved in the oxidation and epimerization of bile acids, can disrupt enterohepatic circulation and lead to the formation of gallstones. At the same time, cholecystectomy leads to further transformation of the microbiota composition in various parts of the gastrointestinal tract, increasing the risk of developing stomach cancer and colorectal cancer. Further research is needed to determine the possibility of using the assessment of the composition of the gastrointestinal microbiota as a marker for the early diagnosis of various gastroenterological diseases of cholelithiasis in particular. The purpose of the study: To determine the role of the intestinal microbiota in the development of metabolic disorders in children with cholelithiasis in order to predict the complicated course of the disease. Material and methods. The work was carried out on the basis of the children’s city polyclinic No. 122 Moscow`s Health Department (chief physician - A.I. Bragin), 194 children with housing and communal services were under supervision. The control group consisted of 78 practically healthy children of the I Health group. The study groups were comparable in gender and age. Criteria for inclusion in the study: children with an established diagnosis of cholelithiasis, asymptomatic course at the age of 3 to 15 years. Exclusion criteria from the study: refusal of the child’s legal representative from the study, the presence of diagnosed acute diseases in the child during the last month, chronic somatic diseases, taking antibiotics and probiotics in the last 6 months, catamnestic observation for less than 12 months. General clinical studies were conducted: questionnaires, health assessment, anthropometry, biochemical examination of blood serum, including lipidogram, ultrasound examination of the abdominal cavity and gallbladder. To assess the intestinal microbiome, the following methods were used: standard bacteriological analysis of feces (method of sowing feces on liquid agarized nutrient media); complex coprological examination with the determination of pancreatic elastase (ELISA method) and fecal carbohydrates (Benedict method); biochemical examination of feces with the determination of short-chain fatty acids (SCFCS) (gas-liquid chromatography method); The Shannon index was adopted as a measure of intestinal dysbiosis. Statistical analysis was performed using the software package Statistica8.0 and MS OfficeExcel 2010/ The results of the study and the conclusion. The biotransformation of the bile acid pool mediated by the gut microbiota regulates the metabolism of bile, glucose and lipids. In children with GI, the number of bacteria representing the indigenous microbiota is generally lower, the intensity of colonization of the intestinal mucosa by them is significantly less, the species diversity of opportunistic and pathogenic bacteria is significantly higher compared with those in practically healthy children. There is an unstable and poor-quality system of interrelation with the macroorganism, disparate metabolic pathways. MK is not able to qualitatively maintain homeostasis within its own consortium. All this creates conditions for disruption of bile acid metabolism and the formation of lithogenic bile. The presence of intestinal dysbiosis in children with GI can cause not only the formation of gallstones, but also negatively affect the further growth and development of children, including the formation of metabolic complications and inflammatory processes.

About the Authors

L. A. Kharitonova
Russian National Research Medical University named after. N.I. Pirogov
Russian Federation


T. V. Kucherya
Russian National Research Medical University named after. N.I. Pirogov
Russian Federation


References

1. Kharitonova L.A., Grigoriev K.I. Diseases of the biliary tract in children. GEOTAR-Media Publishing Group LLC, Moscow, 2022. 351 P. (in Russ.)@@ Харитонова Л.А., Григорьев К.И. Болезни билиарного тракта у детей, ООО издательская группа «ГЕОТАР-Медиа», Москва, - 2022 г. - C. 351.

2. Everhart JE, Ruhl CE. Burden of digestive diseases in the United States part I: overall and upper gastrointestinal diseases. Gastroenterology. 2009 Feb;136(2):376-86. doi: 10.1053/j.gastro.2008.12.015.

3. Pak M, Lindseth G. Risk Factors for Cholelithiasis. Gastroenterol Nurs. 2016 Jul-Aug;39(4):297-309. doi: 10.1097/SGA.0000000000000235.

4. Monstein HJ, Jonsson Y, Zdolsek J, Svanvik J. Identification of Helicobacter pylori DNA in human cholesterol gallstones. Scand J Gastroenterol. 2002 Jan;37(1):112-9. doi: 10.1080/003655202753387455.

5. Wang Y., Qi M., Qin C., Hong J. Role of the biliary microbiome in gallstone disease. Expert Rev Gastroenterol Hepatol. 2018 Dec;12(12):1193-1205. doi: 10.1080/17474124.2018.1533812.

6. Xu M.Y., Ma J.H., Yuan B.S., Yin J., Liu L., Lu Q.B. Association between Helicobacter pylori infection and gallbladder diseases: A retrospective study. J Gastroenterol Hepatol. 2018 Jun;33(6):1207-1212. doi: 10.1111/jgh.14054.

7. Fatemi S.M., Doosti A., Shokri D. et al. Is There a Correlation between Helicobacter Pylori and Enterohepatic Helicobacter Species and Gallstone Cholecystitis? Middle East J Dig Dis. 2018 Jan;10(1):24-30. doi: 10.15171/mejdd.2017.86.

8. Chen Y.K., Yeh J.H., Lin C.L., Peng C.L., Sung F.C., Hwang I.M., Kao C.H. Cancer risk in patients with cholelithiasis and after cholecystectomy: a nationwide cohort study. J Gastroenterol. 2014 May;49(5):923-31. doi: 10.1007/s00535-013-0846-6.

9. Molinero N., Ruiz L., Sánchez B., Margolles A., Delgado S.Intestinal Bacteria Interplay With Bile and Cholesterol Metabolism: Implications on Host Physiology. Front Physiol. 2019 Mar 14;10:185. doi: 10.3389/fphys.2019.00185.

10. Wang L., Guo M.J., Gao Q., Yang J.F., Yang L., Pang X.L., Jiang X.J. The effects of probiotics on total cholesterol: A meta-analysis of randomized controlled trials. Medicine (Baltimore). 2018 Feb;97(5):e9679. doi: 10.1097/MD.0000000000009679.

11. Jones M.L., Martoni C.J., Parent M., Prakash S. Cholesterol-lowering efficacy of a microencapsulated bile salt hydrolase-active Lactobacillus reuteri NCIMB 30242 yoghurt formulation in hypercholesterolaemic adults. Br J Nutr. 2012 May;107(10):1505-13. doi: 10.1017/S0007114511004703.

12. Ridlon J.M., Kang D.J., Hylemon P.B., Bajaj J.S. Bile acids and the gut microbiome. Curr Opin Gastroenterol. 2014 May;30(3):332-8. doi: 10.1097/MOG.0000000000000057.

13. Ridlon J.M., Harris S.C., Bhowmik S., Kang D.J., Hylemon P.B. Consequences of bile salt biotransformations by intestinal bacteria. Gut Microbes. 2016;7(1):22-39. doi: 10.1080/19490976.2015.1127483.

14. Grigorieva I.N., Logvinenko E.V., Yamlikhanova A.Yu., Romanova T.I. A look at gallstone disease through the prism of metabolic syndrome. Siberian Branch of the Russian Academy of Medical Sciences. 2011;(31):72-78. (in Russ.) @@ Григорьева И.Н., Логвиненко Е.В., Ямлиханова А.Ю., Романова Т.И. Взгляд на желчнокаменную болезнь через призму метаболического синдрома. Сибирский филиал РАМН 2011, 31, 72-78.

15. Zatevalov A.M., Aleshkin V.A., Selkova E.P., Grenkova T.A. Determination of the concentration of butyric acid in the feces of patients of the intensive care unit and intensive care unit on probe feeding critical for the functional activity of the normal intestinal and oropharyngeal microflora. Fundamental and clinical medicine. 2017;2(1):14-22. (in Russ.)@@ Затевалов А.М., Алёшкин В.А., Селькова Е.П., Гренкова Т.А. Определение критической для функциональной активности нормальной микрофлоры кишечника и ротоглотки величины концентрации масляной кислоты в кале пациентов отделения реанимации и интенсивной терапии, находящихся на зондовом питании. Фундаментальная и клиническая медицина. 2017. Т. 2. № 1. С. 14-22.

16. Potapova E.A., Kharitonova L.A., Bokova T.A. The role of metabolic disorders in the genesis of cholelithiasis in children. Exp. Klin. Gastroenterol. 2012;(1):23-27. (in Russ.)@@ Потапова Е.А., Харитонова Л.А., Бокова Т.А. Роль обменных нарушений в генезе желчнокаменной болезни у детей. Экспериментальная и клиническая гастроэнтерология. 2012;(1):23-27.

17. Potapova E.A., Kharitonova L.A., Milova Yu.E. The state of carbohydrate metabolism in children with gallstone disease. Experimental and Clinical Gastroenterology. 2021;1(1):118-126. (In Russ.) doi: 10.31146/1682-8658-ecg-185-1-118-126.@@ Потапова Е.А., Харитонова Л.А., Милова Ю.Е. Состояние углеводного обмена у детей с желчно каменной болезнью. Экспериментальная и клиническая гастроэнтерология. 2021;1(1):118-126. doi: 10.31146/1682-8658-ecg-185-1-118-126.

18. Potapova E.A. Metabolic syndrome in children. Exp. Klin. Gastroenterol. 2012;(1):59-62. (in Russ.)@@ Потапова Е.А. Метаболический синдром у детей. Экспериментальная и клиническая гастроэнтерология. 2012;(1):59-62.

19. Potapova E.A. Mechanisms of formation of metabolic syndrome in children with cholelithiasis. Exp. Klin. Gastroenterol. 2016;(1):54-58. (in Russ.)@@ Потапова Е.А. Механизмы формирования метаболического синдрома у детей с желчнокаменной болезнью. Экспериментальная и клиническая гастроэнтерология. 2016;(1):54-58.


Review

For citations:


Kharitonova L.A., Kucherya T.V. The role of the gut microbiota in the genesis of gallstone formation in childhood. Experimental and Clinical Gastroenterology. 2024;(1):53-61. (In Russ.) https://doi.org/10.31146/1682-8658-ecg-221-1-53-61

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