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Advisor(s)
Abstract(s)
Introdução: Os microrganismos habitam o planeta Terra há 3.5 biliões de anos, há muito
menos tempo os próprios humanos, tornando-se a coevolução entre ambos essencial para
a existência de vida. O intestino humano é o habitat de um ecossistema microbiano
diverso e dinâmico, onde o microbioma intestinal tem um papel fundamental na função
imunitária, no metabolismo, na digestão e na comunicação intestino-cérebro. A
compreensão das modificações do microbioma após ressecção do cólon, reconhecendo as
alterações e complicações que possam surgir, é uma oportunidade para novas abordagens
preventivas e terapêuticas.
Objetivos: Pretende-se entender o papel do microbioma após colectomia, identificar
alterações na sua composição e possíveis complicações decorrentes da disbiose causada
pela cirurgia, assim como perceber a capacidade de alguns agentes modificadores da
microbiota restaurarem esse desequilíbrio iatrogénico.
Metodologia: Para a elaboração desta revisão de literatura, foi realizada uma pesquisa
bibliográfica na base de dados eletrónica Pubmed. No sentido de complementar esta
revisão, recorreu-se também a diretrizes da World Gastroenterology Organisation. A
pesquisa foi efetuada entre agosto de 2020 e dezembro de 2021 e foram selecionados
artigos escritos em língua inglesa e portuguesa.
Resultados: Apesar da extensa investigação sobre o papel do microbioma na saúde dos
indivíduos, pouco se sabe acerca do que acontece à tão importante microbiota após
ressecção cirúrgica do cólon. As bactérias pertencentes aos filos Firmicutes e Bacteroidetes
são predominantes num individuo “saudável”. Após a colectomia, identifica-se uma menor
interação ecológica, existindo uma diminuição de Lactobacillus e Bifidobacterium e, por
outro lado, um aumento de bactérias patogénicas, contribuindo estas alterações para a
desregulação da homeostasia intestinal. Estas modificações não parecem ser irrelevantes,
dada a possibilidade de existir uma relação entre a disrupção do microbioma intestinal e o
desenvolvimento de complicações, tanto a curto como longo prazo, com um maior risco de
complicações pós-cirúrgicas, de síndrome metabólico e de recidiva de cancro colorretal.
Conclusão: A disbiose do microbioma intestinal está relacionada com várias doenças
humanas, que se manifestam de forma sistémica e não apenas no intestino. Embora com
incertezas relativamente às consequências da colectomia no ecossistema intestinal, tudo
indica que este procedimento não lhe é indiferente. Uma melhor compreensão desta relação poderá ter um papel muito relevante na abordagem destes doentes, dada a
possibilidade de utilizar terapêuticas com capacidade de modular o microbioma.
Introduction: Microorganisms have lived on Earth for the last 3.5bilion years, much less than the humankind itself, and the coevolution between both has become essential for life. The human intestine is the habitat for a diverse and dynamic microbial ecosystem, where the microbiome intestine performs a significant role in the immune function, in metabolism, in digestion, and in the connection between the intestine and the brain. Learning the microbiome mutations after a colon resection, acknowledging the changes and complications that might happen, is an opportunity to introduce preventing approaches and new therapeutics. Objective: The aim of this literature review is to understand microbiome´s role after a colectomy, to identify mutations in its composition, and possible complications resulting from the dysbiosis caused by surgery, as well as, to understand the capacity of some microbiota´s modifiers agents of restoring the iatrogenic imbalance. Methodology: In order to prepare for this literature review, a bibliographic research has been made using Pubmed electronic data base. For the purpose of completing this review, books and guidelines from the World Gastroenterology Organisation have been read. The research has been made between august 2020 and december 2021 and the selected articles are written in english and portuguese. Results: Despite of the extensive investigation about the microbiome role in the human health, little is known about what happens to the important microbiota after a colon´s surgery resection. The bacteria belonging to the Firmicutes phyla and Bacteroidetes are predominant in a “healthy” individual. After the colectomy, a smaller ecologic interaction is identified, occurring a decrease of Lactobacillus e Bifidobacterium but also an increase of pathogenic bacteria, contributing to the intestinal homeostasis deregulation. Such modifications aren’t irrelevant because of the possible relation between the intestine microbiome and the complication development, both in the short and long term, with significant risk of post-surgical complications from metabolic syndrome and colorectal cancer recurrence. Conclusion: The intestine microbiome´s dysbiosis is related to various human diseases which manifest systematically and not just in the intestine. Although there are uncertainties about the colectomy consequences in the intestine ecosystem, research suggests that this procedure is not indifferent to it. A better knowledge of this relationship could be truly relevant to the patient’s approach, as it could allow the use of therapeutics with capacity to adjust the microbiome.
Introduction: Microorganisms have lived on Earth for the last 3.5bilion years, much less than the humankind itself, and the coevolution between both has become essential for life. The human intestine is the habitat for a diverse and dynamic microbial ecosystem, where the microbiome intestine performs a significant role in the immune function, in metabolism, in digestion, and in the connection between the intestine and the brain. Learning the microbiome mutations after a colon resection, acknowledging the changes and complications that might happen, is an opportunity to introduce preventing approaches and new therapeutics. Objective: The aim of this literature review is to understand microbiome´s role after a colectomy, to identify mutations in its composition, and possible complications resulting from the dysbiosis caused by surgery, as well as, to understand the capacity of some microbiota´s modifiers agents of restoring the iatrogenic imbalance. Methodology: In order to prepare for this literature review, a bibliographic research has been made using Pubmed electronic data base. For the purpose of completing this review, books and guidelines from the World Gastroenterology Organisation have been read. The research has been made between august 2020 and december 2021 and the selected articles are written in english and portuguese. Results: Despite of the extensive investigation about the microbiome role in the human health, little is known about what happens to the important microbiota after a colon´s surgery resection. The bacteria belonging to the Firmicutes phyla and Bacteroidetes are predominant in a “healthy” individual. After the colectomy, a smaller ecologic interaction is identified, occurring a decrease of Lactobacillus e Bifidobacterium but also an increase of pathogenic bacteria, contributing to the intestinal homeostasis deregulation. Such modifications aren’t irrelevant because of the possible relation between the intestine microbiome and the complication development, both in the short and long term, with significant risk of post-surgical complications from metabolic syndrome and colorectal cancer recurrence. Conclusion: The intestine microbiome´s dysbiosis is related to various human diseases which manifest systematically and not just in the intestine. Although there are uncertainties about the colectomy consequences in the intestine ecosystem, research suggests that this procedure is not indifferent to it. A better knowledge of this relationship could be truly relevant to the patient’s approach, as it could allow the use of therapeutics with capacity to adjust the microbiome.
Description
Keywords
Colectomia Complicações Microbioma Microbiota Intestinal Modulação