Metabolic cooperation and proteolytic activity of the gut microbiome in children with congenital heart disease
Abstract
Introduction. Children with congenital heart disease exhibit alterations in the gut microbiome accompanied by changes in its metabolic activity. Short-chain fatty acids (SCFAs) are considered the most informative functional biomarkers of these metabolic changes. Objective. To investigate age-related characteristics of short-chain fatty acid production and the functional state of the gut microbiome in young children with congenital heart disease. Materials and Methods. The profile of short-chain fatty acids was analyzed in fecal samples obtained from young children with congenital heart disease and age-matched healthy controls. Concentrations of acetate, propionate, butyrate, total branched-chain fatty acids, the IsoCn/Cn ratio, and the anaerobic index were determined by gas–liquid chromatography according to the method developed by M.D. Ardatskaya. Participants were stratified into three age groups: 0–6 months, 6–12 months, and 1–3 years. Results and Discussion. Children with congenital heart disease demonstrated impaired metabolic activity of the gut microbiome across all age groups. The most pronounced finding was a reduction in butyrate production, reaching a 3.7-fold decrease in children aged 6–12 months compared with healthy controls. These changes were accompanied by reduced propionate levels, a lower anaerobic index, and an increased IsoCn/Cn ratio, indicating a predominance of proteolytic metabolism. The observed metabolic alterations suggest decreased activity of butyrate-producing obligate anaerobes, impaired saccharolytic fermentation, and the development of functional metabolic insufficiency of the gut microbiota. Conclusion. Young children with congenital heart disease exhibit age-dependent disturbances in short-chain fatty acid production, characterized by butyrate and propionate deficiency, enhanced proteolytic metabolism, and reduced functional activity of the obligate anaerobic gut microbiota.
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List of references
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