Fecal fatty acid-linked bile acid profiles in pediatric patients with ulcerative colitis

Objective: Effect of gut dysbiosis on fatty acid (FA) linked 3 beta-hydroxy-bile acid esters (FA-isoBAs) formation is currently unknown. This study aimed to investigate the profile of FA-isoBAs in fecal samples from pediatric patients with ulcerative colitis (UC). Methods: Fecal samples were collected from seven pediatric patients diagnosed with UC and seven age-matched healthy controls. Liquid chromatography-tandem mass spectrometry (LC/MS) method was set up for quantifications of thirteen different FA-isoBAs, including three new FA-isoBAs which had never been characterized. Method validation tests were performed with optimization of sample preparation. Statistical analyses were conducted to compare FA-isoBA concentrations between UC patients and healthy controls. Results: The LC/MS method had sufficient linearity (r > 0.998), with the low detection limit (0.03-2.82 nmol/g stool), and limits of quantification (0.10-9.40 nmol/g stool) for all FA-isoBAs. The total FA-isoBAs concentration in UC patients was significantly lower than healthy controls, regardless of the degree of the disease severity. The UC subjects had markedly increased primary bile acid (BA) levels with decreased secondary BAs. Propionic acid-linked isoBA and stearic acid-linked 12-oxo-isolithocholic acid were newly identified from healthy subjects but they were not present in UC subjects. In agreement with the previous report, composition of long-chain (C16-C18) FA-linked BAs dominated over short-chain FA-linked BAs both in healthy and disease subjects. Conclusion: The present study reported the fecal FA-isoBA profiles in pediatric UC patients for the first time. The results open the door to the new field that investigates the role of these microbial-driven BAs in gastrointestinal health.