ABSTRACT
Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide, and its incidence is increasing year by year. The mechanism of NAFLD is not fully understood, and it lacks effective prevention and treatment. Recent studies have found that butyrate, as a short-chain fatty acids (SCFAs), plays an important role in gene regulation, immunoregulation, inhibition of tumor, regulation of intestinal mucosal barrier, and reduction of oxidative stress. Several studies have shown that butyrate could alleviate NAFLD. This article reviewed the mechanism of butyrate in the pathogenesis of NAFLD and its application in the treatment of NAFLD, so as to provide a new idea for the prevention and treatment of NAFLD.
ABSTRACT
Objective@#To investigate and compare the capability of metagenomic next-generation sequencing (mNGS) in detecting pathogens and diagnosing of periprosthetic joint infection (PJI) from synovial fluid and sonicate fluid of patients who underwent revision arthroplasty.@*Methods@#Thirty-five consecutive patients who underwent revision arthroplasty from May 2018 to November 2018 were included prospectively. There were 22 males and 13 females, 11 hip revisions and 24 knee revisions. All the patients were divided into the PJI group and aseptic loosening (AL) group. Synovial fluid and sonicate fluid of the explanted prostheses were obtained for microbiological culture and mNGS tests. Periprosthetic tissues were only collected for culture. Synovial fluid of three patients undergoing primary arthroplasty been treated by sonication as the negative control group concurrently. Comparisons of microbiological results and diagnostic value from mNGS and culture tests were performed.@*Results@#In the 13 culture-positive PJI patients, mNGS results of synovial fluid were positive in 12 cases, while culture and mNGS results were completely consistent at species level in 7 cases, consistent at the genus level in 1 case. mNGS results of sonicate fluid were positive in 13 cases, while culture and mNGS results were completely consistent at species level in 9 cases, consistent at the genus level in 1 case. In 7 culture-negative PJI patients, 6 cases had consistent mNGS results at species level both from synovial fluid and sonicate fluid, however, one case had positive mNGS result only from sonicate fluid. All culture results and mNGS results of synovial fluid were negative in all 15 AL patients, however, mNGS results of sonicate fluid was positive in 1 AL case. Cultures and mNGS results were negative in all three pairs of negative-control samples. In all 70 samples, mNGS detected 24 pathogens in sonicate fluids and 22 pathogens in synovial fluids. There was no significant difference in number of raw reads and human reads ratio between mNGS of sonicate fluid and synovial fluid. mNGS of sonicate fluid generated significantly higher number of microbial reads and of stringently mapped reads of pathogen in species-level than that of synovial fluids. There was no significant difference in diagnostic sensitivity of PJI between mNGS of sonicate fluids and synovial fluids (90.0% vs 100.0%). Both of them were significantly higher than that of culture of synovial fluid, periprosthetic tissues. Diagnostic sensitivity of sonicate fluid mNGS was not significantly higher than that in culture of sonicate fluid (65%). The specificities were similar among various microbiological testing methods.@*Conclusion@#mNGS of either synovial fluid or sonicate fluid from patients who underwent revision arthroplasty can be used to detect the presence of pathogens effectively and diagnose PJI accurately. mNGS can identify more pathogens and generate a higher number of pathogenic reads from sonicate fluids than synovial fluid. mNGS of synovial fluids has met the clinical diagnostic demands for most PJI patients. mNGS of sonicate fluid could be applied in some cases.
ABSTRACT
Objective To investigate and compare the capability of metagenomic next?generation sequencing (mNGS) in detecting pathogens and diagnosing of periprosthetic joint infection (PJI) from synovial fluid and sonicate fluid of patients who un?derwent revision arthroplasty. Methods Thirty?five consecutive patients who underwent revision arthroplasty from May 2018 to November 2018 were included prospectively. There were 22 males and 13 females, 11 hip revisions and 24 knee revisions. All the patients were divided into the PJI group and aseptic loosening (AL) group. Synovial fluid and sonicate fluid of the explanted pros?theses were obtained for microbiological culture and mNGS tests. Periprosthetic tissues were only collected for culture. Synovial fluid of three patients undergoing primary arthroplasty been treated by sonication as the negative control group concurrently. Com?parisons of microbiological results and diagnostic value from mNGS and culture tests were performed. Results In the 13 culture? positive PJI patients, mNGS results of synovial fluid were positive in 12 cases, while culture and mNGS results were completely consistent at species level in 7 cases, consistent at the genus level in 1 case. mNGS results of sonicate fluid were positive in 13 cas?es, while culture and mNGS results were completely consistent at species level in 9 cases, consistent at the genus level in 1 case. In 7 culture?negative PJI patients, 6 cases had consistent mNGS results at species level both from synovial fluid and sonicate fluid, however, one case had positive mNGS result only from sonicate fluid. All culture results and mNGS results of synovial fluid were negative in all 15 AL patients, however, mNGS results of sonicate fluid was positive in 1 AL case. Cultures and mNGS results were negative in all three pairs of negative?control samples. In all 70 samples, mNGS detected 24 pathogens in sonicate fluids and 22 pathogens in synovial fluids. There was no significant difference in number of raw reads and human reads ratio between mNGS of sonicate fluid and synovial fluid. mNGS of sonicate fluid generated significantly higher number of microbial reads and of stringent?ly mapped reads of pathogen in species?level than that of synovial fluids. There was no significant difference in diagnostic sensitivi?ty of PJI between mNGS of sonicate fluids and synovial fluids (90.0% vs 100.0%). Both of them were significantly higher than that of culture of synovial fluid, periprosthetic tissues. Diagnostic sensitivity of sonicate fluid mNGS was not significantly higher than that in culture of sonicate fluid (65%). The specificities were similar among various microbiological testing methods. Conclusion mNGS of either synovial fluid or sonicate fluid from patients who underwent revision arthroplasty can be used to detect the pres?ence of pathogens effectively and diagnose PJI accurately. mNGS can identify more pathogens and generate a higher number of pathogenic reads from sonicate fluids than synovial fluid. mNGS of synovial fluids has met the clinical diagnostic demands for most PJI patients. mNGS of sonicate fluid could be applied in some cases.
ABSTRACT
Objective To investigate the role of next generation sequencing technology in the detection of pathogenic bacteria in synovial fluid of prosthetic joint infection.Methods Nine samples of synovial fluid specimens of prosthetic joint infection patients with positive microbial culture from October,1 2016 to April 1,2017 were collected.Each specimen (200 μl) was used for next generation sequencing.Total DNA was extracted from synovial fluid samples.The collected DNA samples were amplified by PCR in the V4 region of 16S rDNA gene.The amplified products were sequenced using the Illumina Miseq platform,2× 250 bp double-end sequencing strategy.The sequencing results were compared with the SILVA database to analyze the types of bacteria and relative abundance in the DNA samples.A total of 200 μl sterile double-distilled deionized water was used as control.Results Nine cases of microbial culture positive prosthetic joint infection synovial fluid DNA samples were sequenced by 16S rDNA amplicon sequencing and yielded 3 132 415 high-quality reads and 3 752 operational taxonomic units (OTU).At the level of bacteria,a total of 9 different bacterial gates were detected on 9 DNA samples.At the level of bacteria,34 different bacteria were detected by 16S rDNA amplicon sequencing.Each DNA sample was detected by 16S rDNA amplicon sequencing and the bacterial genus was identical to that of laboratory culture.16S rDNA amplicon sequencing detected more species of bacteria [6(3,9.5)] than bacterial cultures [(1.0(1.0,1.0)].There was statistically significant difference in the number of bacteria detected in the same specimen between the 16S rDNA amplicon sequencing and the laboratory culture (Z=2.533,P=0.011).Among them,the dominant bacterial population (highest abundance) detected by 16S rDNA amplicon sequencing in four DNA samples was consistent with the results of laboratory culture.Conclusion In the prosthetic joint infection,the 16S rDNA amplicon sequencing technology can accurately detect pathogens that are consistent with the laboratory culture,and can detect other bacteria outside the laboratory culture.This technology can provide the basis for clinical diagnosis and antibiotic selection.