Journal Article

Faecal D/L lactate ratio is a metabolic signature of microbiota imbalance in patients with short bowel syndrome

Thomas, Muriel, Bridonneau, Chantal, Chegdani, Fatima, Joly, Francisca, Hôpital Beaujon, Serv Gastroenterol & Assistance Nutr, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Gratadoux, Jean-Jacques, Mayeur, Camille, Epidemiol & Clin Res Unit, Kapel, Nathalie, Larroque, Beatrice, APHP (Assistance Publique - Hopitaux de Paris) grant, Ferring-SAS France laboratory grant, Corcos, Olivier, MICrobiologie de l'ALImentation au Service de la Santé (MICALIS)

2013

Overview

Our objective was to understand the functional link between the composition of faecal microbiota and the clinical characteristics of adults with short bowel syndrome (SBS). Sixteen patients suffering from type II SBS were included in the study. They displayed a total oral intake of 2661 +/- 1005 Kcal/day with superior sugar absorption (83 +/- 12%) than protein (42 +/- 13%) or fat (39 +/- 26%). These patients displayed a marked dysbiosis in faecal microbiota, with a predominance of Lactobacillus/Leuconostoc group, while Clostridium and Bacteroides were under-represented. Each patient exhibited a diverse lactic acid bacteria composition (L. delbrueckii subsp. bulgaricus, L. crispatus, L. gasseri, L. johnsonii, L. reuteri, L. mucosae), displaying specific D and L-lactate production profiles in vitro. Of 16 patients, 9/16 (56%) accumulated lactates in their faecal samples, from 2 to 110 mM of D-lactate and from 2 to 80 mM of L-lactate. The presence of lactates in faeces (56% patients) was used to define the Lactate-accumulator group (LA), while absence of faecal lactates (44% patients) defines the Non lactate-accumulator group (NLA). The LA group had a lower plasma HCO3(-) concentration (17.1 +/- 2.8 mM) than the NLA group (22.8 +/- 4.6 mM), indicating that LA and NLA groups are clinically relevant sub-types. Two patients, belonging to the LA group and who particularly accumulated faecal D-lactate, were at risk of D-encephalopathic reactions. Furthermore, all patients of the NLA group and those accumulating preferentially L isoform in the LA group had never developed D-acidosis. The D/L faecal lactate ratio seems to be the most relevant index for a higher D-encephalopathy risk, rather than D-and L-lactate faecal concentrations per se. Testing criteria that take into account HCO3(-) value, total faecal lactate and the faecal D/L lactate ratio may become useful tools for identifying SBS patients at risk for D-encephalopathy.

• Publisher: HAL CCSD,Public Library of Science,Public Library of Science (PLoS)
• Subject: Accumulators / Acidosis / Adult / Adults / Aged / Bacteria / Bacteroides - isolation & purification / Bicarbonates - analysis / Bicarbonates - metabolism / Biology / Brain Diseases, Metabolic - etiology / Brain Diseases, Metabolic - metabolism / Brain Diseases, Metabolic - microbiology / Brain Diseases, Metabolic - pathology / Care and treatment / Clostridium / Clostridium - isolation & purification / Colon / Dysbacteriosis / Encephalopathy / Family medical history / Feces / Feces - chemistry / Feces - microbiology / Female / Group dynamics / Humans / Intestine / Laboratories / Lactates / Lactic acid / Lactic Acid - analysis / Lactic Acid - metabolism / Lactic acid bacteria / Lactobacillus / Lactobacillus - isolation & purification / Leuconostoc / Life Sciences / Malabsorption syndromes / Male / Medical research / Medicine / Metabolism / Metagenome - physiology / Microbiota / Microbiota (Symbiotic organisms) / Middle Aged / Neurological disorders / Nutrition research / Parenteral nutrition / Patients / Probiotics / Risk / Short bowel syndrome / Short Bowel Syndrome - complications / Short Bowel Syndrome - metabolism / Short Bowel Syndrome - microbiology / Short Bowel Syndrome - pathology / Stereoisomerism / Studies / Sugar
• ISBN: 0003140215000