{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T23:02:20Z","timestamp":1769554940082,"version":"3.49.0"},"reference-count":11,"publisher":"Georg Thieme Verlag KG","issue":"CP","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"crossref","award":["20K16998,21K18272,22K07241,23H02899"],"award-info":[{"award-number":["20K16998,21K18272,22K07241,23H02899"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Endosc Int Open"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Biliary stents are widely used in endoscopic retrograde cholangiopancreatography (ERCP), yet their impact on the native bile microbiome under non-infectious conditions remains unclear. We aimed to characterize stent-associated alterations in the biliary microbiome using 16S rRNA gene sequencing.<\/jats:p>\n                  <jats:p>We analyzed bile samples collected during ERCP from 35 patients without clinical or laboratory evidence of acute cholangitis. Patients were categorized into a control group (n = 25; na\u00efve papillae) and an endoscopic biliary stenting (EBS) group (n = 10; previously stented). Microbial composition was assessed using high-throughput 16S rRNA sequencing after propensity score matching to balance background characteristics.<\/jats:p>\n                  <jats:p>Beta diversity differed significantly between groups (PERMANOVA, P &lt; 0.01), despite no significant differences in alpha diversity. The EBS group demonstrated increased relative abundance of Firmicutes and Fusobacteriota, and depletion of Proteobacteria. Notably, Enterococcus was significantly enriched in the EBS group (log fold change 6.74; q &lt; 0.01), whereas Sphingomonas was reduced.<\/jats:p>\n                  <jats:p>Endoscopic biliary stenting is associated with distinct bile microbiome alterations, characterized by enrichment of Enterococcus species in clinically stable patients. These findings suggest that stents may predispose to opportunistic colonization, providing a potential mechanistic link to future cholangitis. Recognizing such preclinical dysbiosis may inform tailored antimicrobial strategies and future stent design.<\/jats:p>","DOI":"10.1055\/a-2733-3468","type":"journal-article","created":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T23:48:02Z","timestamp":1761608882000},"source":"Crossref","is-referenced-by-count":1,"special_numbering":"S","title":["Biliary stents reshape the bile microbiome in the absence of cholangitis"],"prefix":"10.1055","volume":"13","clinical-trial-number":[{"clinical-trial-number":"umin000037438","registry":"10.18810\/umin-japan"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3981-2984","authenticated-orcid":false,"given":"Atsuto","family":"Kayashima","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, National Hospital Organisation Tokyo Medical Center, Meguro, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seiichiro","family":"Fukuhara","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology, National Hospital Organisation Tokyo Medical Center, Meguro, Japan"},{"name":"Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine Graduate School of Medicine, Shinjuku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kentaro","family":"Miyamoto","sequence":"additional","affiliation":[{"name":"Research Department, R&D Division, Miyarisan Pharmaceutical Co. Ltd., Saitama, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eisuke","family":"Iwasaki","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7579-1316","authenticated-orcid":false,"given":"Motohiko","family":"Kato","sequence":"additional","affiliation":[{"name":"Center for Diagnostic and Therapeutic Endoscopy, Keio University School of Medicine Graduate School of Medicine, Shinjuku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomohisa","family":"Sujino","sequence":"additional","affiliation":[{"name":"Laboratory of Sakaguchi, Department of Multidimensional Analysis of Gastrointestinal Biology, Keio University School of Medicine Graduate School of Medicine, Shinjuku-ku, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,11,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1111\/den.12379","article-title":"TOKYO criteria 2014 for transpapillary biliary stenting","volume":"27","author":"H Isayama","year":"2015","journal-title":"Dig Endosc"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.jinf.2013.04.008","article-title":"Spectrum of pathogens in acute cholangitis in patients with and without biliary endoprosthesis","volume":"67","author":"A Weber","year":"2013","journal-title":"J Infect"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1186\/s40168-019-0712-8","article-title":"The human gallbladder microbiome is related to the physiological state and the biliary metabolic profile","volume":"7","author":"N Molinero","year":"2019","journal-title":"Microbiome"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.1055\/a-1790-1314","article-title":"Microbiology of bile aspirates obtained at ERCP in patients with suspected acute cholangitis","volume":"54","author":"MA Gromski","year":"2022","journal-title":"Endoscopy"},{"key":"ref5","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1002\/jhbp.512","article-title":"Tokyo Guidelines 2018: diagnostic criteria and severity grading of acute cholangitis (with videos)","volume":"25","author":"S Kiriyama","year":"2018","journal-title":"J Hepato-Biliary-Pancreat Sci"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"665","DOI":"10.1136\/gutjnl-2019-318416","article-title":"Alterations of the bile microbiome in primary sclerosing cholangitis","volume":"69","author":"T Liwinski","year":"2020","journal-title":"Gut"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"e0452","DOI":"10.1097\/HC9.0000000000000452","article-title":"Unique bile acid profiles in the bile ducts of patients with primary sclerosing cholangitis","volume":"8","author":"A Kayashima","year":"2024","journal-title":"Hepatol Commun"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"885","DOI":"10.1067\/mge.2002.129604","article-title":"Microbiology of bile in patients with cholangitis or cholestasis with and without plastic biliary endoprosthesis","volume":"56","author":"R Rerknimitr","year":"2002","journal-title":"Gastrointest Endosc"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"11577","DOI":"10.3390\/ijms241411577","article-title":"An Overview of the factors involved in biofilm production by the Enterococcus genus","volume":"24","author":"P \u0218chiopu","year":"2023","journal-title":"Int J Mol Sci"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"112","DOI":"10.3748\/wjg.v24.i1.112","article-title":"Characterization of biofilms in biliary stents and potential factors involved in occlusion","volume":"24","author":"C Vaishnavi","year":"2018","journal-title":"World J Gastroenterol"},{"key":"ref11","doi-asserted-by":"crossref","first-page":"16966","DOI":"10.1038\/s41598-025-00976-6","article-title":"Biliary microbiome profiling via 16 S rRNA amplicon sequencing in patients with cholangiocarcinoma, pancreatic carcinoma and choledocholithiasis","volume":"15","author":"H Mizutani","year":"2025","journal-title":"Sci Rep"}],"container-title":["Endoscopy International 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