title: Function and clinical implications of short-chain fatty acids in patients with mixed refractory constipation.
abstract: OBJECTIVE
  The present study was designed to investigate the function and clinical implications of stool short-chain fatty acids (SCFAs) in patients with mixed refractory constipation.
  
  
  METHODS
  Ascending colon specimens obtained from 30 patients with ascending colon cancer were regarded as the control group. Ascending colon specimens obtained from patients with mixed refractory constipation were regarded as the experimental group and were divided into three subgroups, according to Wexner scores [A constipation scoring system to simplify evaluation and management of constipated patients. Dis Colon Rectum 1996; 39: 681-5] of 16-20, 21-25 and 26-30, with 30 patients in each group. The stool SCFAs were extracted and quantitatively analysed using gas chromatography-mass spectrometry (GC-MS). The expression of G protein-coupled receptor 43 (GPR43) and of choline acetyltransferase (ChAT) were detected by immunofluorescence, reverse transcription-polymerase chain reaction (RT-PCR) and western blotting of colon samples.
  
  
  RESULTS
  The levels of acetate, propionate and butyrate were significantly lower in the experimental group than in the control group (P < 0.05). Compared with the control group, the densitometric quantification and mean density of GPR43 and ChAT proteins, and expression of GPR43 and CHAT genes, were significantly decreased in the patients with mixed refractory constipation (P < 0.05).
  
  
  CONCLUSIONS
  In the patients with mixed refractory constipation, the levels of stool SCFAs, including acetate, propionate and butyrate, as well as the levels of GPR43 and ChAT expressed in the colon, which were all negatively correlated with the Wexner score, were decreased and may be associated with the pathogenesis of mixed refractory constipation.
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Chen
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Clinical School of Nanjing, Second Military Medical University, Nanjing, Jiangsu, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
authors.forename: L
authors.initials: L
authors.lastname: Ni
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Clinical School of Nanjing, Second Military Medical University, Nanjing, Jiangsu, China.
authors.forename: J
authors.initials: J
authors.lastname: Liu
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
authors.forename: J
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Research Institute of General Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, Jiangsu, China.
authors.forename: N
authors.initials: N
authors.lastname: Li
mesh_terms: D000085:Acetates / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D015153:Blotting, Western; D002087:Butyrates / Q000378:metabolism; D016022:Case-Control Studies; D002795:Choline O-Acetyltransferase / Q000235:genetics* / Q000378:metabolism; D044682:Colon, Ascending / Q000378:metabolism*; D003110:Colonic Neoplasms / Q000235:genetics / Q000378:metabolism; D003248:Constipation / Q000235:genetics / Q000378:metabolism*; D005232:Fatty Acids, Volatile / Q000378:metabolism*; D005243:Feces / Q000737:chemistry; D005260:Female; D005455:Fluorescent Antibody Technique; D008401:Gas Chromatography-Mass Spectrometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D011422:Propionates / Q000378:metabolism; D011956:Receptors, Cell Surface / Q000235:genetics* / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction; D055815:Young Adult; D043562:Receptors, G-Protein-Coupled
chemical_list: D000085:Acetates; D002087:Butyrates; D002795:Choline O-Acetyltransferase; D005232:Fatty Acids, Volatile; D011422:Propionates; D011956:Receptors, Cell Surface; C473103:FFAR2 protein, human; D043562:Receptors, G-Protein-Coupled
keywords: G protein-coupled receptor 43; Short-chain fatty acids; choline acetyltransferase; mixed refractory constipation