The Significance And Change Of Fecal Bile Acids And Its Receptor TGR5 In The Functional Constipation Patients

?Background? Functional constipation is a common and frequently-occurring functional gastrointestinal disorder.It seriously affect society,family and individuals.At present,There are many ways to treat constipation.Constipation treatment center of General Surgery of Nanjing General Hospital of Nanjing Military Region firstly Use not only the medical treatment method such as fecal transplants,probiotics and soluble dietary fiber but also an innovative method of surgical treatment named ”Jinling procedur” in the domestic.However,there are still many confusions because the pathogenesis of functional constipation is complex and not fully clear.Nowadays,A series of research focused on intestinal nerve dysfunction as the the mechanism of functional constipation,while there is little studies about bile acids role in the constipation.?Objectives? The present study was designed to investigate the function and clinical implications of fecal bile acids in patients with functional constipation through the changes in fecal bile acid content including its components and the expressions of G protein-coupled receptor for bile acid(TGR5)by comparison of patients with functional constipation and control group.?Methods? Ascending colon specimens obtained from ten patients with ascending colon cancer were regarded as the control group.Ascending colon specimens obtained from patients with functional constipation were regarded as the experimental group and were divided into three groups according to Wexner scores1 of 16-20,21-25,and 26-30,respectively,with ten cases in each group.The stool total bile acids(TBA)and its different components chenodeoxycholic acid(CDCA),cholic acid(C A),deoxycholic acid(DC A),lithocholic acid(LCA)were extracted and quantitatively analysed by gas chromatography-mass spectrometry(GC-MS).The expressions of TGR5 were detected by immunofluorescence,real-time polymerase chain reaction(RT-PCR),and Western blotting of colon samples.?Results? The levels of TBA,CDCA,CA in the experimental group were all significantly decreased compared to those of the control group(P<0.05),while the level of LCA was significantly lower.Compared to the control group,the densitometric quantification,mean density,and gene expression of TGR5 were significantly decreased in the patients with functional constipation(P<0.05).all these differences were highly associated with Wexner scores.?Conclusions? In the patients with functional constipation,the levels of stool TBA including CDC A and CA,as well as the expression levels of TGR5 in the colon,which were all negatively correlated with the Wexner score,were obviously decreased and may be associated with the pathogenesis of functional constipation.Fecal bile acids and its receptor TGR5 will provide more biological targets for molecular diagnosis,medicine treatment and prognosis assessment of functional constipation.