Journal of Pediatric Gastroenterology and Nutrition

ORIGINAL ARTICLE

Intestinal dysbiosis and inflammation in children with repaired esophageal atresia

Isabelle Traini

Discipline of Pediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia

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Sin Y. Chan,

Sin Y. Chan

Discipline of Pediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia

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Jessica Menzies,

Jessica Menzies

Department of Nutrition and Dietetics, Sydney Children's Hospital, Randwick, New South Wales, Australia

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Jennifer Hughes,

Jennifer Hughes

Department of Speech Pathology, Sydney Children's Hospital, Randwick, New South Wales, Australia

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Michael J. Coffey,

Michael J. Coffey

Discipline of Pediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia

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Isabelle R. McKay,

Isabelle R. McKay

Discipline of Pediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia

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Chee Y. Ooi,

Chee Y. Ooi

Discipline of Pediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia

Department of Gastroenterology, Sydney Children's Hospital, Randwick, New South Wales, Australia

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Steven T. Leach,

Steven T. Leach

Discipline of Pediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia

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Usha Krishnan,

Corresponding Author

Usha Krishnan

[email protected]

Discipline of Pediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia

Department of Gastroenterology, Sydney Children's Hospital, Randwick, New South Wales, Australia

Correspondence Usha Krishnan, Senior Staff Specialist in Pediatric Gastroenterology, Director of Motility Services and Director of Esophageal Atresia Clinic, Department of Pediatric Gastroenterology, Sydney Children's Hospital, High St, Randwick, NSW 2031, Australia.

Email: [email protected]

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Isabelle Traini,

Isabelle Traini

Discipline of Pediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia

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Sin Y. Chan,

Sin Y. Chan

Discipline of Pediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia

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Jessica Menzies,

Jessica Menzies

Department of Nutrition and Dietetics, Sydney Children's Hospital, Randwick, New South Wales, Australia

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Jennifer Hughes,

Jennifer Hughes

Department of Speech Pathology, Sydney Children's Hospital, Randwick, New South Wales, Australia

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Michael J. Coffey,

Michael J. Coffey

Discipline of Pediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia

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Isabelle R. McKay,

Isabelle R. McKay

Discipline of Pediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia

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Chee Y. Ooi,

Chee Y. Ooi

Discipline of Pediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia

Department of Gastroenterology, Sydney Children's Hospital, Randwick, New South Wales, Australia

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Steven T. Leach,

Steven T. Leach

Discipline of Pediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia

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Usha Krishnan,

Corresponding Author

Usha Krishnan

[email protected]

Discipline of Pediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Randwick, New South Wales, Australia

Department of Gastroenterology, Sydney Children's Hospital, Randwick, New South Wales, Australia

Email: [email protected]

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First published: 10 December 2023

https://doi.org/10.1002/jpn3.12053

CME module may be found at https://learnonline.naspghan.org/jpgn2

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Abstract

Objectives

This study aims to compare the intestinal microbiota and intestinal inflammation of children with esophageal atresia (EA) to matched healthy controls, and to investigate the relationship between these factors and clinical outcomes.

Methods

A cross-sectional study of 35 children with EA and 35 matched healthy controls (HC) from a single tertiary pediatric hospital in Australia was conducted. Demographic and dietary data were collected using surveys. Stool samples were analyzed using 16S rRNA sequencing, and fecal calprotectin measurements were used to measure intestinal inflammation. Comparisons were made between the groups, and correlations between the microbiota and clinical factors were investigated in the EA cohort.

Results

Compared to HC, children with EA had similar alpha diversity, but beta diversity analysis revealed clustering of EA and HC cohorts. Children with EA had a significantly higher relative abundance of the order Lactobacillales, and a lower abundance of the genus uncultured Bacteroidales S24-7. Fecal calprotectin was significantly higher in children with EA compared to HC. In the EA cohort, children taking proton pump inhibitors (PPI's) had lower alpha diversity and higher calprotectin levels compared to those not taking PPI's. There was a negative correlation between calprotectin and length/height-for-age z scores, and children with higher calprotectin levels had a greater burden of gastrointestinal symptoms.

Conclusions

Children with EA have an altered intestinal microbiota compared to HC, which is likely related to PPI use, and may be impacting on growth and quality of life. It is important to rationalize PPI use in this cohort.

Graphical Abstract

Intestinal dysbiosis and inflammation in children with esophageal atresia.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflict of interest.

Supporting Information

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Volume78, Issue1

January 2024

Pages 43-51

Filename	Description
jpn312053-sup-0001-Table_online_1.docx14.7 KB	Supporting information.
jpn312053-sup-0002-Table_online_2.docx17.9 KB	Supporting information.
jpn312053-sup-0003-Table_online_3.docx18.3 KB	Supporting information.