{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T20:44:17Z","timestamp":1789159457163,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2021,3,9]],"date-time":"2021-03-09T00:00:00Z","timestamp":1615248000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000243","name":"W. Garfield Weston Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000243","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Diseases","doi-asserted-by":"publisher","award":["K23 AI 124464"],"award-info":[{"award-number":["K23 AI 124464"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Transplantation"],"published-print":{"date-parts":[[2021,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Post\u2010transplant diarrhea is a common complication after solid organ transplantation and is frequently attributed to the widely prescribed immunosuppressant mycophenolate mofetil (MMF). Given recent work identifying the relationship between MMF toxicity and gut bacterial \u03b2\u2010glucuronidase activity, we evaluated the relationship between gut microbiota composition, fecal \u03b2\u2010glucuronidase activity, and post\u2010transplant diarrhea. We recruited 97 kidney transplant recipients and profiled the gut microbiota in 273 fecal specimens using 16S rRNA gene sequencing. We further characterized fecal \u03b2\u2010glucuronidase activity in a subset of this cohort. Kidney transplant recipients with post\u2010transplant diarrhea had decreased gut microbial diversity and decreased relative gut abundances of 12 genera when compared to those without post\u2010transplant diarrhea (adjusted\n                    <jats:italic>p<\/jats:italic>\n                    value\u00a0&lt;\u00a0.15, Wilcoxon rank sum test). Among the kidney transplant recipients with post\u2010transplant diarrhea, those with higher fecal \u03b2\u2010glucuronidase activity had a more prolonged course of diarrhea (\u22657\u00a0days) compared to patients with lower fecal \u03b2\u2010glucuronidase activity (91% vs 40%,\n                    <jats:italic>p<\/jats:italic>\n                    \u00a0=\u00a0.02, Fisher's exact test). Our data reveal post\u2010transplant diarrhea as a complex phenomenon with decreased gut microbial diversity and commensal gut organisms. This study further links commensal bacterial metabolism with an important clinical outcome measure, suggesting fecal \u03b2\u2010glucuronidase activity could be a novel biomarker for gastrointestinal\u2010related MMF toxicity.\n                  <\/jats:p>","DOI":"10.1111\/ctr.14260","type":"journal-article","created":{"date-parts":[[2021,2,20]],"date-time":"2021-02-20T18:16:04Z","timestamp":1613844964000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":34,"title":["Gut microbiota profiles and fecal beta\u2010glucuronidase activity in kidney transplant recipients with and without post\u2010transplant diarrhea"],"prefix":"10.1111","volume":"35","author":[{"given":"Lisa T.","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Medicine Division of Nephrology and Hypertension Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lars F.","family":"Westblade","sequence":"additional","affiliation":[{"name":"Department of Pathology and Laboratory Medicine Weill Cornell Medicine New York NY USA"},{"name":"Department of Medicine Division of Infectious Diseases Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatima","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Biochemistry and Molecular Biology Alberta Children\u2019s Hospital Research Institute, Cumming School of Medicine, University of Calgary Calgary AB Canada"},{"name":"Department of Cardiac Sciences Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary Calgary AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael R.","family":"Taylor","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Biochemistry and Molecular Biology Alberta Children\u2019s Hospital Research Institute, Cumming School of Medicine, University of Calgary Calgary AB Canada"},{"name":"Department of Cardiac Sciences Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary Calgary AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alice","family":"Chung","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Nephrology and Hypertension Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Satlin","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Magruder","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Nephrology and Hypertension Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel","family":"Edusei","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Nephrology and Hypertension Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shady","family":"Albakry","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Nephrology and Hypertension Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brittany","family":"Botticelli","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Nephrology and Hypertension Weill Cornell Medicine New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Robertson","sequence":"additional","affiliation":[{"name":"New York Presbyterian Hospital \u2010 Weill Cornell Medical Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tricia","family":"Alston","sequence":"additional","affiliation":[{"name":"New York Presbyterian Hospital \u2010 Weill Cornell Medical Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7973-1521","authenticated-orcid":false,"given":"Darshana M.","family":"Dadhania","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Nephrology and Hypertension Weill Cornell Medicine New York NY USA"},{"name":"Department of Transplantation Medicine NewYork\u2010Presbyterian Hospital \u2013 Weill Cornell Medical Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1076-7953","authenticated-orcid":false,"given":"Michelle","family":"Lubetzky","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Nephrology and Hypertension Weill Cornell Medicine New York NY USA"},{"name":"Department of Transplantation Medicine NewYork\u2010Presbyterian Hospital \u2013 Weill Cornell Medical Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon A.","family":"Hirota","sequence":"additional","affiliation":[{"name":"Department of Physiology and Pharmacology Snyder Institute for Chronic Diseases, Cumming School of Medicine, University of Calgary Calgary AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven C.","family":"Greenway","sequence":"additional","affiliation":[{"name":"Departments of Pediatrics and Biochemistry and Molecular Biology Alberta Children\u2019s Hospital Research Institute, Cumming School of Medicine, University of Calgary Calgary AB Canada"},{"name":"Department of Cardiac Sciences Libin Cardiovascular Institute, Cumming School of Medicine, University of Calgary Calgary AB Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9612-5742","authenticated-orcid":false,"given":"John R.","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Nephrology and Hypertension Weill Cornell Medicine New York NY USA"},{"name":"Department of Transplantation Medicine NewYork\u2010Presbyterian Hospital \u2013 Weill Cornell Medical Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,3,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/ctr.13550"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/00007890-199908150-00011"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000251923.14697.f5"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2007.11.013"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfy386"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/MNH.0000000000000368"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.tp.0000225760.09969.1f"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.14974"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.2147\/TRRM.S143063"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1126\/sciadv.aax2358"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.R116.767434"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2017.00438"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.healun.2018.05.002"},{"key":"e_1_2_9_15_1","volume-title":"The 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