Comprensión de la etiología de la enfermedad de los cálculos biliares humanos mediante el análisis microbiológico de pacientes de Colombia y la extracción de datos globales en silicio.

Lograr una mejor comprensión de la etiología de la enfermedad de cálculos biliares mediante la caracterización del microbioma de pacientes con colelitiasis de Colombia y análisis in silico de datos de estudios publicados en todo el mundo.

1. Enumerar los productos que se esperan del proyecto en términos de artículos científicos, libros o capítulos de libro, ponencias, desarrollo de metodologías, desarrollo de software, artefactos o dispositivos, diseños, tesis, invenciones, procesos, otros (especificar cuáles).

2. As mentioned above, gallstones can induce cholecystitis, cholangitis and acute pancreatitis, and promote biliary cancer [Jungst et al., 2006]. Because there are currently no effective preventative or nonsurgical treatments, surgical intervention to remove gallstones and the gallbladder is necessary in symptomatic and even recommended in some asymptomatic patients [Patiño and Quintero, 1998].
3. We also said that, histologically, cholelithiasis is always present with some degree of chronic gallbladder
4. inflammation. Certainly, “gallstones course with diverse histopathological changes in gallbladder mucosa ”
5. [Barcia, 2003], namely acute inflammation, chronic inflammation, glandular hyperplasia, granulomatous inflammation, cholesterolosis, dysplasia, and even cancer. Is inflammation always present because of the gallstone formation itself, or does inflammation precede gallstone formation?
6. In consequence, if inflammation precedes gallstone formation, could it be evidence that this originates in a microbiological source? If so, we may conclude that inflammation is important for calculi formation but it is necessary to identify the types of microorganisms involved in calculi formation that have not been defined until now. Indeed, if microbes are the primary cause of cholelithiasis, perhaps we are treating the consequences of gallbladder disease but not its etiological factors, which may well be microbiological and preventable, if intestinal microbiome is present in the etiology of calculi formation in the gallbladder and in other lithiasical liver diseases associated with inflammation, such as choledocholithiasis, hepatolithiasis, Primary Sclerosing Cholangitis (PSC), pancreatitis and even cancer, among other non lithiasic liver diseases such as Primary Biliary Cirrhosis (PBC).
7. Verdier et al. [Verdier et al., 2015] and others have described which microorganisms have been proposed as etiologic agents in biliary inflammatory diseases and discuss the general role of the biliary and intestinal microbiota. We intend to probe, in our environments and with our genetic characteristics, if this is also true and what source of microbiota is involved in our patients to participate with such information in a worldwide scientific community investigating a new way to understand very old disease prevalent in a large population of individuals and communities.
8. Knowing the importance of microbiota in the etiology of gallstones may well create a new knowledge to understand the way to prevent gallstone disease and contribute to implementing the concept of predictive and personalized medicine.

Productos de formación esperados
In this project it is clear that there will be participation of a postdoctoral fellow, surgical residents and medical students, who will be involved in the use and development of new way to approach complex and common diseases such as gallstones in an integrative manner of understanding science, putting clinicians and surgeons to work together with basic science personnel. This is relevant as a collaborative exercise in a world that needs such an integration in the best interest of the patients and society.
Estrategia de divulgación de resultados y de apropiación de los conocimientos generados
Results will be communicated to the clinical and scientific community via oral presentations in conferences and/or congresses, via at least three publications in indexed scientific journals, and also by sharing those results with the worldwide microbiome project.
Impacto Esperados:

Developing and application of translational research Integration of sciences (basic and clinical)
Collaborative work between two main schools (Natural Sciences and Mathematics, Medicine and Health
Sciences) of the Universidad del Rosario, and between the Universidad del Rosario and the Hospital Universitario Mayor-Méderi.