PANCREAS INSUFFICIENCY IN CYSTIC FIBROSIS PATIENTS DRIVES A DIFFERENT FECAL MICROBIOTA AND METABOLIC PHENOTYPE

Objectives Clinical evidence indicates a role for intestinal microbiota in Cystic fibrosis (CF) manifestations, but a report on how pancreas insufficiency could affect gut microbiota composition and function was never reported. We aimed at describing the fecal dominant microbiota and fecal/urinary metabolites in CF patients with (PS) and without (PI) pancreas sufficiency. Methodology Two cohorts of CF patients underwent 16S MiSeq NGS sequencing (region V3-V4) to have a ‘snapshot’ of predominant microbial community in fecal samples (metagenomics), and Solid Phase Micro Extraction-Gas Chromatography/Mass Spectrometry (SPME-GC/MS) was used to characterize fecal/urinary metabolites (metabolomics). Results Fecal microbiota composition significantly differed among PS and PI patients (χ2=6.107, P=0.0135), with PI patients showing a peculiar fecal and urinary metabolites profiles (χ2=11.827, P=0.0006). Multivariate analysis gave a model predictability of 100% for NGS profiles (Fig. 1), and 91% for SPME-GC/MS ones. PI patients showed a marked prevalence of Gammaproteobacteria (P=0.0143), Veillonella (P=0.0019) and Haemophilus (P=0.0113) (Fig. 2), along with toxic metabolites (cadaverine and putrescine) in both feces and urines. Conclusion Preliminary results showed a predominant fecal microbiota associated with PI status, along with a peculiar fecal/urinary metabolite profile. These results could have a pitfall in diagnosis and CF patients’ care having a pancreas insufficiency.