Paganelli, F. L. | Search bioRxiv

bioRxiv2018

Bariatric surgery changes gut microbiota composition independent of operation type

BackgroundBariatric surgery in patients with morbid obesity, either through gastric sleeve gastrectomy or Roux-Y gastric bypass surgery, leads to sustainable weight loss, improvement of metabolic disorders and changes in the intestinal microbiota. Yet, the relationship between changes in gut microbiota, weight loss and the surgical procedure remains incompletely understood.\n\nSubjects/MethodsWe determined temporal changes in microbiota composition in 45 obese patients undergoing a crash diet followed by gastric sleeve gastrectomy (n= 22) or Roux-Y gastric bypass (n= 23). Intestinal microbiota composition was determined before intervention (baseline, S1), 2 weeks after a crash diet (S2), and 1 week (S3), 3 months (S4) and 6 months (S5) after surgery.\n\nResultsRelative to S1, the microbial diversity index declined at S2 and S3 (p< 0.05), and gradually returned to baseline levels at S5. The crash diet was associated with an increased abundance of Rikenellaceae and decreased abundances of Ruminococcaceae and Streptococcaceae (p< 0.05). After surgery, at S3, the relative abundance of Bifidobacteriaceae had decreased (compared to the moment directly after the crash diet), whereas those of Streptococcaceae and Enterobacteriaceae had increased (p< 0.05). Increased weight loss during the next 6 months was not associated without major changes in microbiota composition. Significant differences between both surgical procedures were not observed at any of the time points.\n\nConclusionsIn conclusion, undergoing a crash diet and bariatric surgery were associated with an immediate but temporary decline in the microbial diversity, with immediate and permanent changes in microbiota composition, with no differences between patients undergoing gastric sleeve gastrectomy or Roux-Y gastric bypass surgery.

microbiology↗

bioRxiv2018

Group IIA secreted phospholipase A2 in human serum kills commensal but not clinical Enterococcus faecium isolates

Human innate immunity employs cellular and humoral mechanisms to facilitate rapid killing of invading bacteria. The direct killing of bacteria by human serum is mainly attributed to the activity of the complement system that forms pores in Gram-negative bacteria. Although Gram-positive bacteria are considered resistant to serum killing, we here uncover that normal human serum effectively kills Enterococcus faecium. Comparison of a well-characterized collection of commensal and clinical E. faecium isolates revealed that human serum specifically kills commensal E. faecium strains isolated from normal gut microbiota, but not clinical isolates. Inhibitor studies show that the human group IIA secreted phospholipase A2 (hGIIA), but not complement, is responsible for killing of commensal E. faecium strains in human normal serum. This is remarkable since hGIIA concentrations in non-inflamed serum were considered too low to be bactericidal against Gram-positive bacteria. Mechanistic studies showed that serum hGIIA specifically causes permeabilization of commensal E. faecium membranes. Altogether, we find that a normal serum concentration of hGIIA effectively kills commensal E. faecium and that hGIIA resistance of clinical E. faecium could have contributed to the ability of these strains to become opportunistic pathogens in hospitalized patients.\n\nImportanceHuman normal serum contains antimicrobial components that effective kill invading Gram-negative bacteria. Although Gram-positive bacteria are generally considered resistant to serum killing, here we show that normal human effectively kills the Gram-positive Enterococcus faecium strains that live as commensals in the gut of humans. In contrast, clinical E. faecium strains that are responsible for opportunistic infections in debilitated patients are resistant against human serum. The key factor in serum responsible for killing is group IIA secreted phospholipase A2 (hGIIA) that effectively destabilizes commensal E. faecium membranes. We believe that hGIIA resistance by clinical E. faecium could have contributed to the ability of these strains to cause opportunistic infections in hospitalized patients. Altogether, understanding mechanisms of immune defense and bacterial resistance could aid in further development of novel anti-infective strategies against medically important multidrug resistant Gram-positive pathogens.

microbiology↗