32This study examined the diversity and structure of gut microbiota in healthy adults 33 and chronic traumatic complete spinal cord injury (SCI) patients, documented 34 neurogenic bowel management of SCI patients. The V3-V4 region of 16S rRNA gene 35 from DNA of 91 fecal samples of 48 healthy and 43 diseased subjects was amplified 36 and sequenced. There was difference in gut microbiota between healthy adult males 37 and females. Neurogenic bowel dysfunction (NBD) was common in patients with 38 chronic traumatic complete SCI, patients with quadriplegia have longer time to 39 defecate than paraplegic patients, with higher NBD scores and heavier neurogenic 40 bowel symptoms. Gut microbiota dysbiosis existed in SCI patients. The abundance of 41 Veillonellaceae and Prevotellaceae increased while Bacteroidaceae and Bacteroides 42 decreased in SCI group. The abundance of Bacteroidaceae, Bacteroides in 43 quadriplegia group and Acidaminococcaceae, Blautia in paraplegia group were 44 significant high than the health male group. Serum biomarkers GLU, HDL, CR and 45 NBD symptoms defecation time, COURSE had significant correlation with microbial 46 community structure. This study presents a comprehensive landscape of gut 47 microbiota in adult male patients with chronic traumatic complete SCI and documents 48 their neurogenic bowel management. The gut microbiota dysbiosis of SCI patients 49 was correlation with serum biomarkers and NBD symptoms.50 IMPORTANCE: Neurogenic bowel dysfunction is a major physical and 51 psychological problem in patients with spinal cord injury, which can seriously affect 52 the quality life of them. Gut dysbiosis are highly likely to occur in spinal cord injury 53 patients There are few studies on intestinal microecology after spinal cord injury, and 54 the clinical studies are fewer. It is importance to document their neurogenic bowel 55 management and present a landscape of gut microbiota in them. We found the gut 56 microbiota dysbiosis of spinal cord injury patients was correlation with serum 57 biomarkers and neurogenic bowel dysfunction symptoms. These results may have 58 implications in the next study about metagenomics and precision treatment of 59 neurogenic bowel dysfunction in spinal cord injury patients. 60 Keywords: gut microbiota dysbiosis; chronic traumatic complete SCI; neurogenic 61 bowel management, NBD symptoms, serum biomarkers; 62 Running title: Gut microbiota in spinal cord injury patients 63 Introduction: 64After complete spinal cord injury, the loss of descending control over sympathetic 65 preganglionic neurons causes autonomic reflex circuitry to become dysfunctional 66 creating pathology including autonomic dysreflexia and SCI-immune depression 67 syndrome (1,2,3,4,5), it causes an autonomic imbalance in the gastrointestinal tract, 68 which leads to deficits in colonic motility, mucosal secretions, and vascular tone (6,7).
69The early survival rate of such patients has been significantly improved, but the 70 quality of life of such patients is still not satisfactory. Am...