Changes and influence of microbiome in perioperative period_West China Medical Journal

Authors：

LI Yicong , LIU Xin ,  HE Xin

Department of Anesthesiology, the 962nd Hospital of the PLA Joint Logistic Support Force, Haerbin, Heilongjiang 150080, P. R. China;

Corresponding author：

HE Xin, Email: hx327894@163.com

Keywords：

Perioperative period; microbiota; microbiome

DOI：

10.7507/1002-0179.202003366

Video：

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There is increasing evidence that microorganisms play a complex and important role in human health and disease, and that the in vivo microbiome can directly or indirectly affect the host’s immune system, endocrine system, and nervous system. Therefore, a relatively stable equilibrium between the host and the microbiome is crucial in human health. However, in the special pathophysiological state of the perioperative period, preoperative anxiety and sleep deprivation, anesthesia intervention and surgical injury, postoperative medication and complications may all have different effects on the microbial composition of various organs in the body, resulting in pathogenic microorganisms, and the balance between beneficial microorganisms is altered. This may affect patient the outcomes and prognosis in a direct or indirect manner. This paper will provide a systematic review of key studies to understand the impact of perioperative stress on the commensal microbiome, provide a fresh perspective on optimizing perioperative management strategies, and discuss possible potential interventions to restore microbiome-mediated steady state.

Citation： LI Yicong, LIU Xin, HE Xin. Changes and influence of microbiome in perioperative period. West China Medical Journal, 2022, 37(1): 146-150. doi: 10.7507/1002-0179.202003366 Copy

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4.	Haak BW, Wiersinga WJ. The role of the gut microbiota in sepsis. Lancet Gastroenterol Hepatol, 2017, 2(2): 135-143.
5.	Mukherjee S, Hanidziar D. More of the gut in the lung: how two microbiomes meet in ARDS. Yale J Biol Med, 2018, 91(2): 143-149.
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10.	David LA, Maurice CF, Carmody RN, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature, 2014, 505(7484): 559-563.
11.	Pamer EG. Resurrecting the intestinal microbiota to combat antibiotic-resistant pathogens. Science, 2016, 352(6285): 535-538.
12.	Lukovic E, Moitra VK, Freedberg DE. The microbiome: implications for perioperative and critical care. Curr Opin Anaesthesiol, 2019, 32(3): 412-420.
13.	Drago L, Toscano M, De Grandi R, et al. Persisting changes of intestinal microbiota after bowel lavage and colonoscopy. Eur J Gastroenterol Hepatol, 2016, 28(5): 532-537.
14.	Hayakawa M, Asahara T, Henzan N, et al. Dramatic changes of the gut flora immediately after severe and sudden insults. Dig Dis Sci, 2011, 56(8): 2361-2365.
15.	Serbanescu MA, Mathena RP, Xu J, et al. General anesthesia alters the diversity and composition of the intestinal microbiota in mice. Anesth Analg, 2019, 129(4): e126-e129.
16.	Guyton K, Alverdy JC. The gut microbiota and gastrointestinal surgery. Nat Rev Gastroenterol Hepatol, 2017, 14(1): 43-54.
17.	Becattini S, Littmann ER, Carter RA, et al. Commensal microbes provide first line defense against Listeria monocytogenes infection. J Exp Med, 2017, 214(7): 1973-1989.
18.	Schoster A, Mosing M, Jalali M, et al. Effects of transport, fasting and anaesthesia on the faecal microbiota of healthy adult horses. Equine Vet J, 2016, 48(5): 595-602.
19.	Shakhsheer BA, Versten LA, Luo JN, et al. Morphine promotes colonization of anastomotic tissues with collagenase-producing Enterococcus faecalis and causes leak. J Gastrointest Surg, 2016, 20(10): 1744-1751.
20.	Banerjee S, Sindberg G, Wang F, et al. Opioid-induced gut microbial disruption and bile dysregulation leads to gut barrier compromise and sustained systemic inflammation. Mucosal Immunol, 2016, 9(6): 1418-1428.
21.	Wang F, Meng J, Zhang L, et al. Morphine induces changes in the gut microbiome and metabolome in a morphine dependence model. Sci Rep, 2018, 8(1): 3596.
22.	Babrowski T, Holbrook C, Moss J, et al. Pseudomonas aeruginosa virulence expression is directly activated by morphine and is capable of causing lethal gut-derived sepsis in mice during chronic morphine administration. Ann Surg, 2012, 255(2): 386-393.
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24.	Bassis CM, Erb-Downward JR, Dickson RP, et al. Analysis of the upper respiratory tract microbiotas as the source of the lung and gastric microbiotas in healthy individuals. MBio, 2015, 6(2): e00037.
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28.	Harris B, Morjaria SM, Littmann ER, et al. Gut microbiota predict pulmonary infiltrates after allogeneic hematopoietic cell transplantation. Am J Respir Crit Care Med, 2016, 194(4): 450-463.
29.	Sands KM, Wilson MJ, Lewis MAO, et al. Respiratory pathogen colonization of dental plaque, the lower airways, and endotracheal tube biofilms during mechanical ventilation. J Crit Care, 2017, 37: 30-37.
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31.	Dinan TG, Cryan JF. Gut-brain axis in 2016: brain-gut-microbiota axis-mood, metabolism and behavior. Nat Rev Gastroenterol Hepatol, 2017, 14(2): 69-70.
32.	Feng Q, Chen WD, Wang YD. Gut microbiota: an integral moderator in health and disease. Front Microbiol, 2018, 9: 151.
33.	Kennedy PJ, Cryan JF, Dinan TG, et al. Kynurenine pathway metabolism and the microbiota-gut-brain axis. Neuropharmacology, 2017, 112(Pt B): 399-412.
34.	Mackos AR, Maltz R, Bailey MT. The role of the commensal microbiota in adaptive and maladaptive stressor-induced immunomodulation. Horm Behav, 2017, 88: 70-78.
35.	Cui B, Su D, Li W, et al. Effects of chronic noise exposure on the microbiome-gut-brain axis in senescence-accelerated prone mice: implications for Alzheimers disease. J Neuroinflammation, 2018, 15(1): 190.
36.	Hovens IB, van Leeuwen BL, Mariani MA, et al. Postoperative cognitive dysfunction and neuroinflammation; cardiac surgery and abdominal surgery are not the same. Brain Behav Immun, 2016, 54: 178-193.
37.	Erny D, Prinz M. Microbiology: gut microbes augment neurodegeneration. Nature, 2017, 544(7650): 304-305.
38.	Yang XD, Wang LK, Wu HY, et al. Effects of prebiotic galacto-oligosaccharide on postoperative cognitive dysfunction and neuroinflammation through targeting of the gut-brain axis. BMC Anesthesiol, 2018, 18(1): 177.
39.	Peng J, Xiao X, Hu M, et al. Interaction between gut microbiome and cardiovascular disease. Life Sci, 2018, 214: 153-157.
40.	Jie Z, Xia H, Zhong SL, et al. The gut microbiome in atherosclerotic cardiovascular disease. Nat Commun, 2017, 8(1): 845.
41.	Tang WHW, Li DY, Hazen SL. Dietary metabolism, the gut microbiome, and heart failure. Nat Rev Cardiol, 2018, 16(3): 137-154.
42.	Zhu W, Gregory JC, Org E, et al. Gut microbial metabolite TMAO enhances platelet hyperreactivity and thrombosis risk. Cell, 2016, 165(1): 111-124.
43.	Randrianarisoa E, Lehn-Stefan A, Wang X, et al. Relationship of serum trimethylamine N-oxide (TMAO) levels with early atherosclerosis in humans. Sci Rep, 2016, 6: 26745.
44.	Svingen GFT, Zuo H, Ueland PM, et al. Increased plasma trimethylamine-N-oxide is associated with incident atrial fibrillation. Int J Cardiol, 2018, 267: 100-106.
45.	Yu L, Meng G, Huang B, et al. A potential relationship between gut microbes and atrial fifibrillation: trimethylamine N-oxide, a gut microbe-derived metabolite, facilitates the progression of atrial fibrillation. Int J Cardiol, 2018, 255: 92-98.
46.	Pluznick JL. Gut microbiota in renal physiology: focus on short-chain fatty acids and their receptors. Kidney Int, 2016, 90(6): 1191-1198.
47.	Yan Q, Gu Y, Li X, et al. Alterations of the gut microbiome in hypertension. Front Cell Infect Microbiol, 2017, 7: 381.
48.	Natarajan N, Hori D, Flavahan S, et al. Microbial short chain fatty acid metabolites lower blood pressure via endothelial G protein-coupled receptor 41. Physiol Genomics, 2016, 48(11): 826-834.
49.	Pluznick JL, Protzko RJ, Gevorgyan H, et al. Olfactory receptor responding to gut microbiota-derived signals plays a role in renin secretion and blood pressure regulation. Proc Natl Acad Sci USA, 2013, 110(11): 4410-4415.
50.	Andrade-Oliveira V, Amano MT, Correa-Costa M, et al. Gut bacteria products prevent AKI induced by ischemia-reperfusion. J Am Soc Nephrol, 2015, 26(8): 1877-1888.

1. Gilbert JA, Blaser MJ, Caporaso JG, et al. Current understanding of the human microbiome. Nat Med, 2018, 24(4): 392-400.
2. Sender R, Fuchs S, Milo R. Are we really vastly outnumbered? Revisiting the ratio of bacterial to host cells in humans. Cell, 2016, 164(3): 337-340.
3. Qin J, Li R, Raes J, et al. A human gut microbial gene catalogue established by metagenomic sequencing. Nature, 2010, 464(7285): 59-65.
4. Haak BW, Wiersinga WJ. The role of the gut microbiota in sepsis. Lancet Gastroenterol Hepatol, 2017, 2(2): 135-143.
5. Mukherjee S, Hanidziar D. More of the gut in the lung: how two microbiomes meet in ARDS. Yale J Biol Med, 2018, 91(2): 143-149.
6. D’Argenio V, Salvatore F. The role of the gut microbiome in the healthy adult status. Clin Chim Acta, 2015, 451(Pt A): 97-102.
7. Dickson RP. The microbiome and critical illness. Lancet Respir Med, 2016, 4(1): 59-72.
8. Krezalek MA, DeFazio J, Zaborina O, et al. The shift of an intestinal “microbiome” to a “pathobiome” governs the course and outcome of sepsis following surgical injury. Shock, 2016, 45(5): 475-482.
9. Lloyd-Price J, Abu-Ali G, Huttenhower C. The healthy human microbiome. Genome Med, 2016, 8(1): 51.
10. David LA, Maurice CF, Carmody RN, et al. Diet rapidly and reproducibly alters the human gut microbiome. Nature, 2014, 505(7484): 559-563.
11. Pamer EG. Resurrecting the intestinal microbiota to combat antibiotic-resistant pathogens. Science, 2016, 352(6285): 535-538.
12. Lukovic E, Moitra VK, Freedberg DE. The microbiome: implications for perioperative and critical care. Curr Opin Anaesthesiol, 2019, 32(3): 412-420.
13. Drago L, Toscano M, De Grandi R, et al. Persisting changes of intestinal microbiota after bowel lavage and colonoscopy. Eur J Gastroenterol Hepatol, 2016, 28(5): 532-537.
14. Hayakawa M, Asahara T, Henzan N, et al. Dramatic changes of the gut flora immediately after severe and sudden insults. Dig Dis Sci, 2011, 56(8): 2361-2365.
15. Serbanescu MA, Mathena RP, Xu J, et al. General anesthesia alters the diversity and composition of the intestinal microbiota in mice. Anesth Analg, 2019, 129(4): e126-e129.
16. Guyton K, Alverdy JC. The gut microbiota and gastrointestinal surgery. Nat Rev Gastroenterol Hepatol, 2017, 14(1): 43-54.
17. Becattini S, Littmann ER, Carter RA, et al. Commensal microbes provide first line defense against Listeria monocytogenes infection. J Exp Med, 2017, 214(7): 1973-1989.
18. Schoster A, Mosing M, Jalali M, et al. Effects of transport, fasting and anaesthesia on the faecal microbiota of healthy adult horses. Equine Vet J, 2016, 48(5): 595-602.
19. Shakhsheer BA, Versten LA, Luo JN, et al. Morphine promotes colonization of anastomotic tissues with collagenase-producing Enterococcus faecalis and causes leak. J Gastrointest Surg, 2016, 20(10): 1744-1751.
20. Banerjee S, Sindberg G, Wang F, et al. Opioid-induced gut microbial disruption and bile dysregulation leads to gut barrier compromise and sustained systemic inflammation. Mucosal Immunol, 2016, 9(6): 1418-1428.
21. Wang F, Meng J, Zhang L, et al. Morphine induces changes in the gut microbiome and metabolome in a morphine dependence model. Sci Rep, 2018, 8(1): 3596.
22. Babrowski T, Holbrook C, Moss J, et al. Pseudomonas aeruginosa virulence expression is directly activated by morphine and is capable of causing lethal gut-derived sepsis in mice during chronic morphine administration. Ann Surg, 2012, 255(2): 386-393.
23. Yatera K, Noguchi S, Mukae H. The microbiome in the lower respiratory tract. Respir Investig, 2018, 56(6): 432-439.
24. Bassis CM, Erb-Downward JR, Dickson RP, et al. Analysis of the upper respiratory tract microbiotas as the source of the lung and gastric microbiotas in healthy individuals. MBio, 2015, 6(2): e00037.
25. Segal LN, Clemente JC, Tsay JC, et al. Enrichment of the lung microbiome with oral taxa is associated with lung inflammation of a Th17 phenotype. Nat Microbiol, 2016, 1: 16031.
26. Panzer AR, Lynch SV, Langelier C, et al. Lung microbiota is related to smoking status and to development of acute respiratory distress syndrome in critically ill trauma patients. Am J Respir Crit Care Med, 2018, 197(5): 621-631.
27. Dickson RP, Singer BH, Newstead MW, et al. Enrichment of the lung microbiome with gut bacteria in sepsis and the acute respiratory distress syndrome. Nat Microbiol, 2016, 1(10): 16113.
28. Harris B, Morjaria SM, Littmann ER, et al. Gut microbiota predict pulmonary infiltrates after allogeneic hematopoietic cell transplantation. Am J Respir Crit Care Med, 2016, 194(4): 450-463.
29. Sands KM, Wilson MJ, Lewis MAO, et al. Respiratory pathogen colonization of dental plaque, the lower airways, and endotracheal tube biofilms during mechanical ventilation. J Crit Care, 2017, 37: 30-37.
30. Pirrone M, Pinciroli R, Berra L. Microbiome, biofilms, and pneumonia in the ICU. Curr Opin Infect Dis, 2016, 29(2): 160-166.
31. Dinan TG, Cryan JF. Gut-brain axis in 2016: brain-gut-microbiota axis-mood, metabolism and behavior. Nat Rev Gastroenterol Hepatol, 2017, 14(2): 69-70.
32. Feng Q, Chen WD, Wang YD. Gut microbiota: an integral moderator in health and disease. Front Microbiol, 2018, 9: 151.
33. Kennedy PJ, Cryan JF, Dinan TG, et al. Kynurenine pathway metabolism and the microbiota-gut-brain axis. Neuropharmacology, 2017, 112(Pt B): 399-412.
34. Mackos AR, Maltz R, Bailey MT. The role of the commensal microbiota in adaptive and maladaptive stressor-induced immunomodulation. Horm Behav, 2017, 88: 70-78.
35. Cui B, Su D, Li W, et al. Effects of chronic noise exposure on the microbiome-gut-brain axis in senescence-accelerated prone mice: implications for Alzheimers disease. J Neuroinflammation, 2018, 15(1): 190.
36. Hovens IB, van Leeuwen BL, Mariani MA, et al. Postoperative cognitive dysfunction and neuroinflammation; cardiac surgery and abdominal surgery are not the same. Brain Behav Immun, 2016, 54: 178-193.
37. Erny D, Prinz M. Microbiology: gut microbes augment neurodegeneration. Nature, 2017, 544(7650): 304-305.
38. Yang XD, Wang LK, Wu HY, et al. Effects of prebiotic galacto-oligosaccharide on postoperative cognitive dysfunction and neuroinflammation through targeting of the gut-brain axis. BMC Anesthesiol, 2018, 18(1): 177.
39. Peng J, Xiao X, Hu M, et al. Interaction between gut microbiome and cardiovascular disease. Life Sci, 2018, 214: 153-157.
40. Jie Z, Xia H, Zhong SL, et al. The gut microbiome in atherosclerotic cardiovascular disease. Nat Commun, 2017, 8(1): 845.
41. Tang WHW, Li DY, Hazen SL. Dietary metabolism, the gut microbiome, and heart failure. Nat Rev Cardiol, 2018, 16(3): 137-154.
42. Zhu W, Gregory JC, Org E, et al. Gut microbial metabolite TMAO enhances platelet hyperreactivity and thrombosis risk. Cell, 2016, 165(1): 111-124.
43. Randrianarisoa E, Lehn-Stefan A, Wang X, et al. Relationship of serum trimethylamine N-oxide (TMAO) levels with early atherosclerosis in humans. Sci Rep, 2016, 6: 26745.
44. Svingen GFT, Zuo H, Ueland PM, et al. Increased plasma trimethylamine-N-oxide is associated with incident atrial fibrillation. Int J Cardiol, 2018, 267: 100-106.
45. Yu L, Meng G, Huang B, et al. A potential relationship between gut microbes and atrial fifibrillation: trimethylamine N-oxide, a gut microbe-derived metabolite, facilitates the progression of atrial fibrillation. Int J Cardiol, 2018, 255: 92-98.
46. Pluznick JL. Gut microbiota in renal physiology: focus on short-chain fatty acids and their receptors. Kidney Int, 2016, 90(6): 1191-1198.
47. Yan Q, Gu Y, Li X, et al. Alterations of the gut microbiome in hypertension. Front Cell Infect Microbiol, 2017, 7: 381.
48. Natarajan N, Hori D, Flavahan S, et al. Microbial short chain fatty acid metabolites lower blood pressure via endothelial G protein-coupled receptor 41. Physiol Genomics, 2016, 48(11): 826-834.
49. Pluznick JL, Protzko RJ, Gevorgyan H, et al. Olfactory receptor responding to gut microbiota-derived signals plays a role in renin secretion and blood pressure regulation. Proc Natl Acad Sci USA, 2013, 110(11): 4410-4415.
50. Andrade-Oliveira V, Amano MT, Correa-Costa M, et al. Gut bacteria products prevent AKI induced by ischemia-reperfusion. J Am Soc Nephrol, 2015, 26(8): 1877-1888.

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