Roux-en-Y gastric bypass-induced bacterial perturbation contributes to altered host-bacterial co-metabolic phenotype

Li, Jia V.; Ashrafian, Hutan; Sarafian, Magali; Homola, Daniel; Rushton, Laura; Barker, Grace; Cabrera, Paula Momo; Lewis, Matthew R.; Darzi, Ara; Lin, Edward; Gletsu-Miller, Nana Adwoa; Atkin, Stephen L.; Sathyapalan, Thozhukat; Gooderham, Nigel J.; Nicholson, Jeremy K.; Marchesi, Julian R.; Athanasiou, Thanos; Holmes, Elaine

Abstract

Background: Bariatric surgery, used to achieve effective weight loss in individuals with severe obesity, modifies the gut microbiota and systemic metabolism in both humans and animal models. The aim of the current study was to understand better the metabolic functions of the altered gut microbiome by conducting deep phenotyping of bariatric surgery patients and bacterial culturing to investigate causality of the metabolic observations. Methods: Three bariatric cohorts (n = 84, n = 14 and n = 9) with patients who had undergone Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG) or laparoscopic gastric banding (LGB), respectively, were enrolled. Metabolic and 16S rRNA bacterial profiles were compared between pre- and post-surgery. Faeces from RYGB patients and bacterial isolates were cultured to experimentally associate the observed metabolic changes in biofluids with the altered gut microbiome. Results: Compared to SG and LGB, RYGB induced the greatest weight loss and most profound metabolic and bacterial changes. RYGB patients showed increased aromatic amino acids-based host-bacterial co-metabolism, resulting in increased urinary excretion of 4-hydroxyphenylacetate, phenylacetylglutamine, 4-cresyl sulphate and indoxyl sulphate, and increased faecal excretion of tyramine and phenylacetate. Bacterial degradation of choline was increased as evidenced by altered urinary trimethylamine-N-oxide and dimethylamine excretion and faecal concentrations of dimethylamine. RYGB patients’ bacteria had a greater capacity to produce tyramine from tyrosine, phenylalanine to phenylacetate and tryptophan to indole and tryptamine, compared to the microbiota from non-surgery, normal weight individuals. 3-Hydroxydicarboxylic acid metabolism and urinary excretion of primary bile acids, serum BCAAs and dimethyl sulfone were also perturbed following bariatric surgery. Conclusion: Altered bacterial composition and metabolism contribute to metabolic observations in biofluids of patients following RYGB surgery. The impact of these changes on the functional clinical outcomes requires further investigation.

Citation

Li, J. V., Ashrafian, H., Sarafian, M., Homola, D., Rushton, L., Barker, G., …Holmes, E. (2021). Roux-en-Y gastric bypass-induced bacterial perturbation contributes to altered host-bacterial co-metabolic phenotype. Microbiome, 9(1), Article 139. https://doi.org/10.1186/s40168-021-01086-x

• Journal Article Type: Article
• Acceptance Date: Apr 27, 2021
• Online Publication Date: Jun 14, 2021
• Publication Date: Dec 1, 2021
• Deposit Date: Oct 1, 2021
• Publicly Available Date: Oct 4, 2021
• Journal: Microbiome
• Electronic ISSN: 2049-2618
• Publisher: BioMed Central
• Peer Reviewed: Peer Reviewed
• Volume: 9
• Issue: 1
• Article Number: 139
• DOI: https://doi.org/10.1186/s40168-021-01086-x
• Keywords: Bariatric surgery; Bile acids; Host-microbial metabolism; Metabolic profiling; Microbiome
• Public URL: https://hull-repository.worktribe.com/output/3793914