• Seong Ji Choi, Yeseul Kim, Jehyun Jeon, Ho Jin Gwak, Mimi Kim, Kyojin Kang, Yohan Kim, Jaemin Jeong, Yun Kyung Jung, Kyeong Geun Lee, Ho Soon Choi, Dong Hwan Jung, Sung Gyu Lee, Yangsoon Lee, Su Jin Shin, Kiseok Jang, Mina Rho, and Dongho Choi.
• Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
• J. Korean Med. Sci. 2021 Jul 19; 36 (28): e189.

BackgroundCholecystitis is an important risk factor for gallbladder cancer, but the bile microbiome and its association with gallbladder disease has not been investigated fully. We aimed to analyze the bile microbiome in normal conditions, chronic cholecystitis, and gallbladder cancer, and to identify candidate bacteria that play an important role in gallbladder carcinogenesis.MethodsWe performed metagenome sequencing on bile samples of 10 healthy individuals, 10 patients with chronic cholecystitis, and 5 patients with gallbladder cancer, and compared the clinical, radiological, and pathological characteristics of the participants.ResultsNo significant bacterial signal was identified in the normal bile. The predominant dysbiotic bacteria in both chronic cholecystitis and gallbladder cancer were those belonging to the Enterobacteriaceae family. Klebsiella increased significantly in the order of normal, chronic cholecystitis, and gallbladder cancer. Patients with chronic cholecystitis and dysbiotic microbiome patterns had larger gallstones and showed marked epithelial atypia, which are considered as precancerous conditions.ConclusionWe investigated the bile microbiome in normal, chronic cholecystitis, and gallbladder cancer. We suggest possible roles of Enterobacteriaceae, including Klebsiella, in gallbladder carcinogenesis. Our findings reveal a possible link between a dysbiotic bile microbiome and the development of chronic calculous cholecystitis and gallbladder cancer.© 2021 The Korean Academy of Medical Sciences.

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