Gut Microbiome Profile After Pancreatectomy in Infants With Congenital Hyperinsulinism.

To characterize gut microbiome profiles of infants with congenital hyperinsulinism (HI) who underwent near-total or partial pancreatectomy for hypoglycemia management, as compared to healthy controls. Prospective observational cohort. Subjects were infants (0-6 months) with HI who underwent removal of pancreatic tissue for management of intractable hypoglycemia February 2017—February 2018 at The Children’s Hospital of Philadelphia. Fecal samples were collected postoperatively, on full enteral nutrition. The gut microbiome of HI subjects was analyzed and compared to age-matched samples from healthy infants. Seven subjects with ≥50% pancreatectomy and six with <50% pancreatectomy were included. Alpha (within-sample) diversity was lowest among infants with ≥50% pancreatectomy (Richness: False discovery rate = 0.003; Shannon Index: False discovery rate = 0.01). Beta (between-sample) diversity (Bray-Curtis dissimilarity: P = 0.02; Jaccard distance: P = 0.001) differed across groups (≥ or < 50% pancreatectomy, controls). Bifidobacteria and Klebsiella species were least abundant among infants with ≥50% pancreatectomy but did not differ between infants with <50% pancreatectomy and historical controls. Infants with HI who underwent ≥50% pancreatectomy differed from age-matched infants in gut microbiome profile, while those with <50% pancreatectomy more closely resembled control profiles. The durability of this difference should be investigated.

旨在描述为控制低血糖而接受近全胰切除术或部分胰切除术的先天性高胰岛素血症（HI）婴儿的肠道微生物群特征，并与健康对照组进行对比。 本研究为前瞻性观察性队列研究。研究对象为2017年2月至2018年2月在费城儿童医院因顽固性低血糖接受胰腺组织切除的HI婴儿（0 - 6个月）。术后在完全肠内营养阶段采集粪便样本。对HI患儿的肠道微生物群进行分析，并与年龄匹配的健康婴儿样本进行比较。 研究纳入了7名胰腺切除≥50%的患儿和6名胰腺切除＜50%的患儿。胰腺切除≥50%的婴儿样本内（α）多样性最低（丰富度：错误发现率 = 0.003；香农指数：错误发现率 = 0.01）。样本间（β）多样性（布雷 - 柯蒂斯相异度：P = 0.02；杰卡德距离：P = 0.001）在不同组间（胰腺切除≥50%、胰腺切除＜50%以及对照组）存在差异。双歧杆菌和克雷伯菌属在胰腺切除≥50%的婴儿中含量最少，但在胰腺切除＜50%的婴儿与历史对照组之间无差异。 胰腺切除≥50%的HI婴儿肠道微生物群特征与年龄匹配的婴儿不同，而胰腺切除＜50%的婴儿肠道微生物群特征更接近对照组。这种差异的持续性有待进一步研究。