Protein metabolism could be affected by the intestinal mucosal damage caused by microbial dysbiosis, diarrhea and other intestinal deseases, leading to the changes in composition of proteins in feces (
16,
21). Among them, alpha-1-antitrypsin in human milk could withstand the breakdown of digestive juices, and help the survival of other proteins especially during bacterial diarrhea (
22). Increased fecal lactoferrin can be a significant indicator for monitoring intestinal inflammation in children with non-virus diarrhea (
23). In addition, serum albumin was identified as a marker in the colorectal cancer, meanwhile, polymeric-immunoglobulin receptor could not protect rotavirus from expanding in the gut (
16,
24). Similarly, after infants suffered from RD, the relative proportions of fecal proteins with 50-55 KDa, 79-80 KDa, and 84 - 85 KDa decreased significantly (P < 0.05), meanwhile, the relative proportion of fecal proteins with 67 - 69 KDa increased significantly (P < 0.05). Given that all fecal proteins from infants in the study were derived from breast milk, it was reasonable to infer these differential proteins should correspond to polymeric immunoglobulin receptor (84 KDa), lactoferrin (80 KDa), serum albumin (69 KDa) and alpha-1-antitrypsin (53 KDa) according to the molecular weight of the proteins (
10,
22,
25,
26). However, a deeper and more comprehensive study on the relationship between differential proteins and rotavirus infection is still needed in future.
As the structural units for proteins and polypeptide, AAs were participated in synthesis of bioactive molecules which played the key role in the regulation of signaling pathways and metabolism (
27). AAs metabolism in complex gut environment provides a strategy for bacteria survival and growth with both positive and negative effects on host (
28). For example, Marchesi et al reported the AAs degradation of inflammatory bowel disease (IBD) patients were promoted due to an impairment of the metabolic activity of the gut bacteria (
29), meanwhile, De et al found a higher AAs level in the; feces of IBD patients, and considered it was because that inflammatory conditions induce large energy requirements to repair the damaged mucosa leading to enhanced protein catabolism (
30). Besides, Bjerrum et al revealed that the levels of aspartic acid and glutamate in fecal extracts from inactive Crohn’s disease (CD) patients were significantly reduced compared with those of healthy samples (
11). Our results showed that there were significant decreases in AAs levels in; feces of RD infants, including aspartic acid, threonine, serine, glutamic acid, glycinc, alanine, valine, methionine, isoleucine, leucine, phenylalanine, lysine, histidine, arginine, and proline, which suggested a reduced level of AAs in; feces linked to the diarrhea induced by rotavirus defection.
In previous studies, as the significant metabolite of intestinal microbiota, the changes in levels of SCFAs in; feces of diarrhea patients have been a focus of research (
31,
32). However, intestinal diseases can not only change the diversity of intestinal microbiota, but also cause intestinal metabolic disorders. Therefore, it is necessary to conduct a comprehensive analysis on the differences in fecal FAs profile consisting of SCFAs, MCFAs and LCFAs between RD infants and H infants.
Butyric acid was considered as one of the most important SCFAs associated with human health, and could be produced by metabolism of intestinal microorganisms; therefore, the differences in biodiversity of fecal microbiota can explain the possible reason for butyric acid alteration of patients with intestinal diseases (
33). Some researchers suggested that the lower levels of butyrate and propionate in; feces of CD and ulcerative colitis (UC) diarrhea patients should be the consequence of an inflammation-driven intestinal dysbiosis (
11). Further, De et al found the depletion of butyric acid in feces of IBD patients was linked to a shift in the composition and metabolic activity of colonic microbiota (
30). In this study, the level of butyric acid in; feces of infants decreased significantly after infection with rotavirus, which was similar to the study reported by Canani et al. who found a significant reduction in the concentration of fecal butyric acid of patients with intestinal diseases (
34). However, in our previous report, we detected formic acid, acetic acid, propionic acid and butyric acid in the feces of RD and H infants who were between 0 and 6 months old, among them, acetic acid was the dominant SCFA (
35), while, in current study, only butyric acid was detected in the feces of RD and H infants who were between 4 and 9 months old. In addition, there was no significant difference in the levels of these five SCFAs in the feces between 0-6-month-old infants with and without RD (
35), on the contrary, the level of butyric acid in RD infants was significantly reduced compared to H infants in this study. Since the infants in the two studies had the same diet, the difference in SCFAs should be due to the age, in particular, the intestinal flora of infants younger than 1 year old is a dynamic colonization, which suggests that a more detailed age division should be made in the clinical analysis of RD infants in order to implement specific treatment measures for patients of different ages.
In prior study, MCFAs were found to be significantly reduced in the; feces of patients with CD, UC and pouchitis, and were used as a class of metabolic biomarkers of disease-related changes (
36). Garner et al also found a lower prevalence of some MCFs in patients with UC than that in asymptomatic individuals (
37). Similarly, in this study, the significant decreases in relative proportions of MCFAs and LCFAs, such as C18:1N9T, C18:2N6C, C22:0, C20:3N3, C22:2, and C20:5N3 in; feces from RD infants were found in; feces of RD infants. Furthermore, the relative proportions of C8:0, C10:0, C11:0, C12:0, C13:0, C14:1, C14:0, C16:0, C17:1, C18:1N9C, and C18:3N6 were increased in the; feces from RD infants, which indicated that RD may affect the absorption of the above fatty acids. Thus, in addition to SCFAs, the metabolic profiles of MCFAs and LCFAs should also be analyzed as an important prospective longitudinal study.
In summary, we provided a comprehensive analysis to illustrate the effects of RD on protein, AAs and fat metabolism. The data of this study revealed the differences in compositions of fecal proteins, AAs and FAs (SCFAs, MCFs, and LCFs) between RD infants and H infants. These findings revealed the pathological characteristics of RD in infants, and expanded the understanding on relationship between RD and fecal metabolites profile.