Roux-en-Y gastric bypass surgery changes fungal and bacterial microbiota in morbidly obese patients-A pilot study.
Robert E SteinertAteequr RehmanEverton Job Souto LimaValeria AgamennoneFrank H J SchurenDaniel GeroPhillip SchreinerRené VonlanthenAiman IsmaeilStefanos TzafosHanna HosaDiana VetterBenjamin MisselwitzMarco BueterPublished in: PloS one (2020)
The Roux-en-Y gastric bypass (RYGB) remains the most effective treatment for morbidly obese patients to lower body weight and improve glycemic control. There is recent evidence that the mycobiome (fungal microbiome) can aggravate disease severity in a number of diseases including inflammatory bowel disease (IBD), irritable bowel syndrome (IBS) and hepatitis; moreover, a dysbiotic fungal microbiota has been reported in the obese. We characterized fungal and bacterial microbial composition in fecal samples of 16 morbidly obese patients before and three months after RYGB surgery and compared with nine healthy controls. We found that RYGB surgery induced a clear alteration in structure and composition of the gut fungal and bacterial microbiota. Beta diversity analysis revealed significant differences in bacterial microbiota between obese patients before surgery and healthy controls (P < 0.005) and a significant, unidirectional shift in RYGB patients after surgery (P < 0.001 vs. before surgery). In contrast, there was no significant difference in fungal microbiota between groups but individually specific changes after RYGB surgery. Interestingly, RYGB surgery induced a significant reduction in fungal alpha diversity namely Chao1, Sobs, and Shannon diversity index (P<0.05, respectively) which contrasts the trend for uniform changes in bacteria towards increased richness and diversity post-surgery. We did not observe any inter-kingdom relations in RYGB patients but in the healthy control cohort and there were several correlations between fungi and bacteria and clinical parameters (P<0.05, respectively) that warrant further research. Our study identifies changes in intestinal fungal communities in RYGB patients that are distinct to changes in the bacterial microbiota.
Keyphrases
- roux en y gastric bypass
- obese patients
- bariatric surgery
- gastric bypass
- minimally invasive
- weight loss
- coronary artery bypass
- end stage renal disease
- ejection fraction
- surgical site infection
- magnetic resonance
- chronic kidney disease
- type diabetes
- glycemic control
- prognostic factors
- irritable bowel syndrome
- magnetic resonance imaging
- metabolic syndrome
- gene expression
- cell wall
- computed tomography
- insulin resistance
- percutaneous coronary intervention
- blood glucose
- acute coronary syndrome
- single cell
- genome wide
- body weight
- combination therapy
- stress induced