Dysbiosis of the gut microbiota in children with severe motor and intellectual disabilities receiving enteral nutrition: A pilot study

• Published in: JPEN. Journal of parenteral and enteral nutrition 2023-01, Vol.47 (1), p.67-76
• Main Authors: Nakai, Yoko, Akagawa, Shohei, Fujishiro, Sadayuki, Akagawa, Yuko, Yamagishi, Mitsuru, Yamanouchi, Sohsaku, Kimata, Takahisa, Ohashi, Atsushi, Hashiyada, Masaki, Akane, Atsushi, Tsuji, Shoji, Kaneko, Kazunari
• Format: Article
• Language: English
• Subjects: Bacteria - genetics; Butyric Acid; Child; dysbiosis; Dysbiosis - microbiology; Dysbiosis - therapy; Enteral Nutrition; Feces - microbiology; Gastrointestinal Microbiome; gut microbiota, 16S rRNA gene sequencing; Humans; Intellectual Disability - therapy; Pilot Projects; Prebiotics; RNA, Ribosomal, 16S - genetics; severe motor and intellectual disability
• ISSN: 0148-6071; 1941-2444
• DOI: 10.1002/jpen.2435

Background Children with severe motor and intellectual disabilities (SMIDs) frequently and continuously receive enteral nutrition and medications and lack adequate exercise, which may lead to dysbiosis, an imbalance in the composition of the gut microbiota. However, studies on the composition of gut microbiota in children with SMIDs are limited. Therefore, we aimed to examine the characteristics of the gut microbiota in children with SMIDs. Methods 16S rRNA gene sequencing was performed using fecal samples of 10 children with SMIDs, who received enteral nutrition through a gastric fistula or gastric tube (SMID group: median age, 10.0 years), and 19 healthy children (healthy control [HC] group: median age, 9.0 years). Microbial diversity, microbial composition, and abundance of butyric acid‐producing bacteria were compared between the groups. Daily dietary fiber intake in the SMID group was evaluated using questionnaires. Results The Shannon and Simpson indices (alpha diversity indices) were significantly lower in the SMID group than those in the HC group. Beta diversity analysis identified different clusters. Compared with the HC group, Clostridiales and butyric acid‐producing bacteria were less abundant and Bacteroidales were more abundant in the SMID group. Dietary fiber intake in the SMID group was approximately two‐thirds of the estimated average requirement for healthy Japanese children. Conclusion Children with SMIDs showed dysbiosis with alteration in the microbial diversity, which could partly be attributed to their low dietary fiber intake. Further studies, with the intervention of prebiotics, probiotics, and synbiotics, are warranted to improve dysbiosis in children with SMIDs.