Фекальні концентрації молочної кислоти та коротколанцюгових жирних кислот у дітей раннього віку, госпіталізованих в інфекційно-діагностичний стаціонар із діареєю

O. H. Ivanko; V. M. Bilykh

doi:10.14739/2310-1210.2022.3.247605

Authors

O. H. Ivanko Zaporizhzhia State Medical University, Ukraine, Ukraine https://orcid.org/0000-0001-7655-5529
V. M. Bilykh Zaporizhzhia State Medical University, Ukraine, Ukraine https://orcid.org/0000-0002-9873-2028

DOI:

https://doi.org/10.14739/2310-1210.2022.3.247605

Keywords:

children, diarrhea, intestinal infection, non-infectious diarrhea, lactic acid, short-chain fatty acids

Abstract

The aim of the study was to investigate the fecal levels of lactic acid and short-chain fatty acids (SCFAs) in children with acute diarrhea and to identify their role in the development of infectious or non-infectious diseases.

Materials and methods. The study included 42 children aged 6–24 months with an episode of acute bacterial, rotavirus, symptomatic or functional diarrhea hospitalized in the infectious biosafety unit of the Children’s Hospital. The control group comprised 18 children without symptoms of intestinal disease, matched to the main group for age, sex and stool consistency scored according to the Bristol Stool Scale of 4–6. All the children underwent comprehensive clinical, laboratory, virological examinations and stool cultures. Additionally, fecal calprotectin, reducing substances, lactic acid and short-chain fatty acids were studied.

Results. It was found that the lactic acid levels were low in healthy children and often approached the trace concentrations. In children with diarrhea, lactic acid was detected in all fecal samples, and the highest its level was in children with functional (non-infectious) diarrhea. Opposite results were obtained in the study of SCFA. A deficit of SCFA was revealed in patients with diarrhea, but least of all in functional one, in comparison with the control group. The role of microbiome damage and intestinal wall hypoxia was suggested based on the results obtained.

Conclusions. The use of lactic acid and SCFA as coprological tests can be helpful in the differential diagnosis of infectious or non-infectious causes of diarrhea in children aged 6–24 months.

Author Biographies

O. H. Ivanko, Zaporizhzhia State Medical University, Ukraine

MD, PhD, DSc, Professor, Head of the Department of Propaedeutics of Pediatric Diseases

V. M. Bilykh, Zaporizhzhia State Medical University, Ukraine

MD, PhD student, Department of Propaedeutics of Pediatric Diseases

References

Public Health Center of the Ministry of Health of Ukraine. (2020). Infektsiina zakhvoriuvannist naselennia Ukrainy za veresen 2019 - veresen 2020 r. [Infectious morbidity of the population of Ukraine for September 2019 - September 2020]. https://phc.org.ua/kontrol-zakhvoryuvan/inshi-infekciyni-zakhvoryuvannya/infekciyna-zakhvoryuvanist-naselennya-ukraini

Public Health Center of the Ministry of Health of Ukraine. (2020). Infektsiina zakhvoriuvannist naselennia Ukrainy za lystopad 2020 - lystopad 2021 r. [Infectious morbidity of the population of Ukraine for November 2020 - November 2021]. https://phc.org.ua/kontrol-zakhvoryuvan/inshi-infekciyni-zakhvoryuvannya/infekciyna-zakhvoryuvanist-naselennya-ukraini

Ng, Q. X., Soh, A., Loke, W., Lim, D. Y., & Yeo, W. S. (2018). The role of inflammation in irritable bowel syndrome (IBS). Journal of Inflammation Research, 11, 345-349. https://doi.org/10.2147/JIR.S174982

Akiho, H., Ihara, E., & Nakamura, K. (2010). Low-grade inflammation plays a pivotal role in gastrointestinal dysfunction in irritable bowel syndrome. World Journal of Gastrointestinal Pathophysiology, 1(3), 97-105. https://doi.org/10.4291/wjgp.v1.i3.97

Fasano, A. (2020). All disease begins in the (leaky) gut: role of zonulin-mediated gut permeability in the pathogenesis of some chronic inflammatory diseases. F1000Research, 9(F1000 Faculty Rev), 69. https://doi.org/10.12688/f1000research.20510.1

Cardile, S., Alterio, T., Candusso, M., Pietrobattista, A., Liccardo, D., Basso, M. S., Papadatou, B., Bracci, F., Knafelz, D., & Torre, G. (2017). Autoimmune liver diseases and inflammatory bowel diseases in children: current issues and future perspectives. Scandinavian Journal of Gastroenterology, 52(6-7), 662-667. https://doi.org/10.1080/00365521.2017.1298833

Nowak-Węgrzyn, A., Jarocka-Cyrta, E., & Moschione Castro, A. (2017). Food Protein-Induced Enterocolitis Syndrome. Journal of Investigational Allergology & Clinical Immunology, 27(1), 1-18. https://doi.org/10.18176/jiaci.0135

Vernetti, L., Gough, A., Baetz, N., Blutt, S., Broughman, J. R., Brown, J. A., Foulke-Abel, J., Hasan, N., In, J., Kelly, E., Kovbasnjuk, O., Repper, J., Senutovitch, N., Stabb, J., Yeung, C., Zachos, N. C., Donowitz, M., Estes, M., Himmelfarb, J., Truskey, G., … Taylor, D. L. (2017). Functional Coupling of Human Microphysiology Systems: Intestine, Liver, Kidney Proximal Tubule, Blood-Brain Barrier and Skeletal Muscle. Scientific Reports, 7, Article 42296. https://doi.org/10.1038/srep42296

Louis, P., & Flint, H. J. (2017). Formation of propionate and butyrate by the human colonic microbiota. Environmental Microbiology, 19(1), 29-41. https://doi.org/10.1111/1462-2920.13589

Lin, H. V., Frassetto, A., Kowalik, E. J., Jr, Nawrocki, A. R., Lu, M. M., Kosinski, J. R., Hubert, J. A., Szeto, D., Yao, X., Forrest, G., & Marsh, D. J. (2012). Butyrate and Propionate Protect against Diet-Induced Obesity and Regulate Gut Hormones via Free Fatty Acid Receptor 3-Independent Mechanisms. PLOS ONE, 7(4), Article e35240. https://doi.org/10.1371/journal.pone.0035240

Bridgman, S. L., Azad, M. B., Field, C. J., Haqq, A. M., Becker, A. B., Mandhane, P. J., Subbarao, P., Turvey, S. E., Sears, M. R., Scott, J. A., Wishart, D. S., Kozyrskyj, A. L., & CHILD Study Investigators. (2017). Fecal Short-Chain Fatty Acid Variations by Breastfeeding Status in Infants at 4 Months: Differences in Relative versus Absolute Concentrations. Frontiers in Nutrition, 4, Article 11. https://doi.org/10.3389/fnut.2017.00011

Schwiertz, A., Taras, D., Schäfer, K., Beijer, S., Bos, N. A., Donus, C., & Hardt, P. D. (2010). Microbiota and SCFA in lean and overweight healthy subjects. Obesity, 18(1), 190-195. https://doi.org/10.1038/oby.2009.167

Vorobiova, N. V., Usachova, O. V., & Kaplaushenko, A. H. (2021). Pathogenetic role of intestinal microflora in carbohydrate malabsorption syndrome in early-aged children with rotavirus infection. Zaporozhye medical journal, 23(5), 683-690. https://doi.org/10.14739/2310-1210.2021.5.231265

Zhang, Y. J., Li, S., Gan, R. Y., Zhou, T., Xu, D. P., & Li, H. B. (2015). Impacts of Gut Bacteria on Human Health and Diseases. International Journal of Molecular Sciences, 16(4), 7493-7519. https://doi.org/10.3390/ijms16047493

Flint, H. J., Duncan, S. H., Scott, K. P., & Louis, P. (2015). Links between diet, gut microbiota composition and gut metabolism. Proceedings of the Nutrition Society, 74(1), 13-22. https://doi.org/10.1017/S0029665114001463

Markowiak-Kopeć, P., & Śliżewska, K. (2020). The Effect of Probiotics on the Production of Short-Chain Fatty Acids by Human Intestinal Microbiome. Nutrients, 12(4), Article 1107. https://doi.org/10.3390/nu12041107

Tan, J., McKenzie, C., Vuillermin, P. J., Goverse, G., Vinuesa, C. G., Mebius, R. E., Macia, L., & Mackay, C. R. (2016). Dietary Fiber and Bacterial SCFA Enhance Oral Tolerance and Protect against Food Allergy through Diverse Cellular Pathways. Cell Reports, 15(12), 2809-2824. https://doi.org/10.1016/j.celrep.2016.05.047

Vorobiova, N. V. (2021). Faktory vplyvu na vyraznist kliniko-laboratornykh proiaviv syndromu malabsorbtsii vuhlevodiv u ditei rannoho viku z rotavirusnoiu infektsiieiu [Influencing factors on the severity of clinical and laboratory manifestations of carbohydrate malabsorption syndrome in early-aged children with rotavirus infection]. Suchasna pediatriia. Ukraina, (7), 25-33. https://doi.org/10.15574/SP.2021.119.25 [in Ukrainian].

Narayanappa, D., Rajani, H. S., & Sangameshwaran, A. (2015). Study of urinary tract infection in infants and young children with acute diarrhea. Indian Journal of Public Health Research & Development, 6(2), 237-240.

Arora, T., & Sharma, R. (2011). Fermentation potential of the gut microbiome: implications for energy homeostasis and weight management. Nutrition Reviews, 69(2), 99-106. https://doi.org/10.1111/j.1753-4887.2010.00365.x

Louis, P., Hold, G. L., & Flint, H. J. (2014). The gut microbiota, bacterial metabolites and colorectal cancer. Nature Reviews Microbiology, 12(10), 661-672. https://doi.org/10.1038/nrmicro3344

Stepanov, Yu. M., Budzak, I. Ya., & Klenina, I. A. (2019). Korotkolantsiuhovi zhyrni kysloty: rol u rozvytku syndromu podraznenoho kyshechnyka [Short-chain fatty acids: the role in the development of irritable bowel syndrome]. Hastroenterolohiia, 53(1), 49-53. https://doi.org/10.22141/2308-2097.53.1.2019.163458 [in Ukrainian].