Function And Clinical Implications Of Short-chain Fatty Acids In Patients With Mixed Refractory Constipation

Objective:The present study was designed to investigate the function and clinical implications of stool short-chain fatty acids(SCFAs)in patients with mixed refractory constipation.Methods:Ascending colon specimens obtained from patients with mixed refractory constipation were regarded as the experimental group and were divided into three groups according to Wexner scores[1]of 16-20,21-25,and 26-30,respectively,with 20 cases in each group.Ascending colon specimens obtained from ten patients with ascending colon cancer were regarded as the control group.The stool SCFAs were extracted and quantitatively analysed by gas chromatography-mass spectrometry(GC-MS).The expressions of G protein-coupled receptor 43(GPR43)and choline acetyltransferase(ChAT)were detected by Western blotting,immunofluorescence,and reverse transcription-polymerase chain reaction(RT-PCR)of colon samples.Results:The levels of acetate,propionate,and butyrate in the experimental group were all significantly decreased compared to those of the control group(P<0.05).Compared to the control group,the densitometric quantification,mean density,and gene expression of GPR43 and ChAT were significantly decreased in the patients with mixed refractory constipation(P<0.05).Conclusion:In the patients with mixed refractory constipation,the levels of stool SCFAs,including acetate,propionate,and butyrate,as well as the expression levels of GPR43 and ChAT in the colon,which were all negatively correlated with the Wexner score,were obviously decreased and may be associated with the pathogenesis of mixed refractory constipation.