Assessment of Fecal Microbiota and Fecal Metabolome in Symptomatic Uncomplicated Diverticular Disease of the Colon.
The aim of this study was to assess fecal microbiota and metabolome in a population with symptomatic uncomplicated diverticular disease (SUDD).



Whether intestinal microbiota and metabolic profiling may be altered in patients with SUDD is unknown.



Stool samples from 44 consecutive women [15 patients with SUDD, 13 with asymptomatic diverticulosis (AD), and 16 healthy controls (HCs)] were analyzed. Real-time polymerase chain reaction was used to quantify targeted microorganisms. High-resolution proton nuclear magnetic resonance spectroscopy associated with multivariate analysis with partial least-square discriminant analysis (PLS-DA) was applied on the metabolite data set.



The overall bacterial quantity did not differ among the 3 groups (P=0.449), with no difference in Bacteroides/Prevotella, Clostridium coccoides, Bifidobacterium, Lactobacillus, and Escherichia coli subgroups. The amount of Akkermansia muciniphila species was significantly different between HC, AD, and SUDD subjects (P=0.017). PLS-DA analysis of nuclear magnetic resonance -based metabolomics associated with microbiological data showed significant discrimination between HCs and AD patients (R=0.733; Q=0.383; P<0.05, LV=2). PLS analysis showed lower N-acetyl compound and isovalerate levels in AD, associated with higher levels of A. municiphila, as compared with the HC group. PLS-DA applied on AD and SUDD samples showed a good discrimination between these 2 groups (R=0.69; Q=0.35; LV=2). SUDD patients were characterized by low levels of valerate, butyrate, and choline and by high levels of N-acetyl derivatives and U1.



SUDD and AD do not show colonic bacterial overgrowth, but a significant difference in the levels of fecal A. muciniphila was observed. Moreover, increasing expression of some metabolites as expression of different AD and SUDD metabolic activity was found.
*Gastroenterology Service, ASL BAT, Andria (BT) Departments of †Public Health and Infectious Diseases, Section of Microbiology §Chemistry ∥Experimental Medicine, Sapienza University ‡Division of Gastroenterology, ASL RMH, Albano Laziale ¶Division of Surgery, "P. Colombo" Hospital, ASL RMH, Velletri #Digestive Endoscopy and Nutrition Unit, "S. Eugenio" Hospital **Division of Gastroenterology, "Cristo Re" Hospital, GIOMI Group, Rome, Italy.
Antonio
A
Tursi
Paola
P
Mastromarino
Daniela
D
Capobianco
Walter
W
Elisei
Alfredo
A
Miccheli
Giorgio
G
Capuani
Alberta
A
Tomassini
Giuseppe
G
Campagna
Marcello
M
Picchio
GianMarco
G
Giorgetti
Federica
F
Fabiocchi
Giovanni
G
Brandimarte
D000368:Aged; D016022:Case-Control Studies; D043963:Diverticulosis, Colonic / Q000382:microbiology*; D005243:Feces / Q000382:microbiology*; D005260:Female; D000069196:Gastrointestinal Microbiome; D006801:Humans; D009682:Magnetic Resonance Spectroscopy; D055442:Metabolome; D055432:Metabolomics / Q000379:methods; D064307:Microbiota; D008875:Middle Aged; D060888:Real-Time Polymerase Chain Reaction