Gut microbial community structure in patients with chronic pancreatitis before and after total pancreatectomy with islet autotransplantation.

Abstract

Chronic pancreatitis (CP) is characterized by abdominal pain, recurrent hospitalizations, frequent exposure to antibiotics, nutritional deficiencies, and chronic opioid use. Data describing the gut microbial community structure of patients with CP is limited. We aimed to compare gut microbial community structure of a group of patients with severe CP being considered for total pancreatectomy with islet autotransplantation (TPIAT) to that of healthy controls, and to associate these changes with the severity of clinical symptoms. We collected stool samples from healthy donors (n = 14) and patients with CP under consideration for TPIAT (n = 20), in addition to clinical metadata and a clinically validated abdominal symptoms severity survey. Patients with CP had, on average, significantly lower alpha diversity than healthy controls (P < 0.001). There was a significantly increased mean relative abundance of Faecalibacterium in healthy controls compared with CP (P = 0.02). Among participants with CP, those with a lower alpha diversity reported significantly worse functional abdominal symptoms (P = 0.006). These findings indicate that changes in gut microbial community structure may contribute to CP symptom severity, and provide a basis for future studies on whether enrichment of healthy commensal bacteria such as Faecalibacterium could provide clinically meaningful improvement in outcomes for patients with CP.