Microbiota is Related With Increasing Infection Rates After Splenectomy

Study Overview
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Brief Summary
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Studies has shown an increasingly infection rate after splenectomy, and there is a potential correlation between microbiota and immune system. investigators suppose that increasingly infection can be associated with the alteration composition of the gut microbiota after splenectomy. It's investigators' aim to discover if any difference of gut microbiota is exist in patients who suffer from traumatic splenectomy compared with normal people, ultimately aim toreduce and mitigation infection rate through controlling gut microbiota.

Detailed Description
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The spleen is crucial in regulating immune homoeostasis through its ability to link innate and adaptive immunity and to protect against infections. Asplenia refers to the absence of the spleen, a disorder that is rarely congenital and is more frequently as a result of surgery. Splenic hypofunction, as a result of asplenia can lead a series of changes in body systems. Recent study has show an increasingly infection rate after splenectomy including abdominal infection, pulmonary infection and cranial cavity infection. The gastrointestinal tract plays host to a diverse and metabolically complex community of microorganisms. Recent literature suggests that organisms in the gastrointestinal tract, referred to collectively as gut microbiota, play an indispensable role in the maintenance of host's homeostasis. Study has proved a potential correlation between microbiota and immune system. Lymphocyte, in either peripheral circulation or mesenteric lymph node, altered can lead to an composition change in microbiota. Investigators suppose that this phenomenon can be associated with the alteration of the resident commensal microenvironment after splenectomy compared to commensal communities. It's investigators' aim to discover if any difference of gut microbiota is exist in patients who suffer from traumatic splenectomy compared with normal people, ultimately aim toreduce and mitigation infection rate through controlling gut microbiota.

Official Title
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Altered Microbiota is Related Increased Infection Rates After Traumatic Splenectomy

Conditions
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Gut Microbiota, Spleen Injury, Infection

Intervention / Treatment
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* Procedure: splenectomy


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All the patients underwent an total splenectomy in the First Affiliated Hospital of Harbin Medical University from January 1st, 2015 to May 1st, 2017. Each participant provided a fresh stool sample in hospital when following-up. Exclusion Criteria: Use antibiotics and probiotics 3 mouth before samples collection. Other severe abdomen injury Underwent abdomen organ resection surgery Other digestive system disease

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| health control<br>healthy controls are all from normal volunteers | |
| splenectomy<br>Traumatic patients after total splenectomy | Procedure: splenectomy<br>* Traumatic patients who performed total splenectomy<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Transcriptional changes in gut microbiota | 16S rRNA gene sequencing will be performed with stander procedure | Baseline, 6 months after surgery, 12 months after surgery, 24 months after surgery | 
| Transcriptional changes in plasma LPS levels | Plasma LPS level will be measured by ELISA | Baseline, 6 months after surgery, 12 months after surgery, 24 months after surgery | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Fecal SIgA | Fecal SIgA antibody will be measured by ELISA | Baseline, 6 months after surgery, 12 months after surgery, 24 months after surgery | 
| Fecal calprotectin | Fecal SIgA antibody will be measured by ELISA | Baseline, 6 months after surgery, 12 months after surgery, 24 months after surgery | 
| Plasma DAO | Plasma DAO antibody will be measured by ELISA | Baseline, 6 months after surgery, 12 months after surgery, 24 months after surgery | 
| Plasma D-Lac | Plasma D-Lac antibody will be measured by ELISA | Baseline, 6 months after surgery, 12 months after surgery, 24 months after surgery | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Gut microbiota, Splenectomy, Infection, Immune, Cytokines