Gallstone Disease and Bacterial Metabolic Performance of Gut Microbiota in Middle-Aged and Older Patients

Abstract

Background Gallstone disease (GSD) is more commonly presented in aged people. Purpose The purpose of the study was to explore the insights of metabolic performance of bacterial species from gut microbiota as well as the clinical background in middle-aged and elderly patients with GSD. Patients and Methods This is an observational study concerning 120 research participants. Of those, 90 patients with symptomatic GSD addressed for cholecystectomy, average age 59.83 ± 15.32 years: 45 with cholesterol rich gallstones (CGSs), 45 with pigment gallstones (PGSs) and 30 healthy controls joined this observational study. Clinical examination, lab work-ups, upper and lower digestive video-endoscopies, abdominal ultrasound/CT and gallbladder motility assessment by Dodd’s method were performed. Overall stool dysbiosis (DB) was assessed as 1 = minor, 2 = mild, 3 = severe, species being identified by matrix-assisted laser desorption ionization method. Stool samples from dysbiotic patients were analyzed by a next generation sequencing method with operational taxonomic unit identification. Results Patients with GSD presented with a significant high range of overall gut DB (p < 0.0001) when compared with controls. Those with CGSs compared with those having PGSs displayed significant clinical differences related to elderly age, lifestyle and diet particularities, obesity, dyslipidemia, nonalcoholic fatty liver disease, hypertension, type 2 diabetes mellitus or impaired glucose tolerance, as well as motility disturbances of gallbladder with a decrease of the ejection fraction. Significant increase of overall DB range and alterations of several functional bacterial species with a decrease of butyrate, lactate, acetate/propionate and methane producers, mucin degrading bacteria, biodiversity index of microbiota, as well as an increase of lipopolysaccharide positive bacteria were significantly present in patients with CGSs. Conclusion Middle-aged and elderly patients with GSD and a clinical background characterized by particular lifestyle, metabolic and gallbladder motility issues displayed significant modifications of biodiversity, overall gut DB and alterations of several functional bacterial species, with a decrease of their metabolic performance.

NASH/NAFLD-Related Hepatocellular Carcinoma: An Added Burden

“…are associated with lifestyle and dietary habits, with food high in saturated fat and low in vegetable fiber intake noted. These alterations in the gut microbiota are lately increasingly reported in several hepatobiliary conditions [58][59][60][61][62].…”

The gut microbiota: A new perspective for tertiary prevention of hepatobiliary and gallbladder diseases

“…Considerable changes in multiple functional bacteria are observed. Bacteria secreting the 7α-dehydroxy enzyme increase, and those lowering cholesterol decrease, leading to increased intestinal absorption of BAs and cholesterol ( 89 ). In middle-aged and elderly patients, decreased number of bacteria producing prebiotics, such as butyrate and acetate/propionate; decreased number of mucin-degrading bacteria; and increased number of bacteria producing endotoxin are observed.…”

The gut microbiome predicts response to UDCA/CDCA treatment in gallstone patients: comparison of responders and non-responders

“…The interaction between the gut microbiome and bile acids is closely coordinated by the bile acid-gut microbiome axis, suggesting that changes in bile acid composition directly influence the gut microbial environment. Recently, much research has been conducted on the gut microbiome, especially its role as a prognostic/predictive biomarker 16 , 17 . Grigor’eva et al concluded the presence of Helicobacter pylori ( H. pylori ) infection and other gut microbiome components, such as Clostridium , Bifidobacterium , Peptostreptococcus , Bacteroides , Eubacterium , and Escherichia coli , contribute to GB stone formation and affect the development of gallstone disease complications.…”

“…Grigor’eva et al concluded the presence of Helicobacter pylori ( H. pylori ) infection and other gut microbiome components, such as Clostridium , Bifidobacterium , Peptostreptococcus , Bacteroides , Eubacterium , and Escherichia coli , contribute to GB stone formation and affect the development of gallstone disease complications. Georgescu et al reported that patients with GB stone disease exhibited alterations in the abundances of several functional bacterial species, that is, reductions in abundances of butyrate, lactate, acetate/propionate, and methane producers, and mucin degrading bacteria, and reductions in microbiome biodiversity indices 17 . Furthermore, studies suggest that UDCA or CDCA treatments may impact gut microbiome composition and diversity.…”