Deep stool microbiome analysis in cirrhosis reveals an association between short-chain fatty acids and hepatic encephalopathy.
Ann Hepatol
; 25: 100333, 2021.
Article
em En
| MEDLINE
| ID: mdl-33621653
ABSTRACT
INTRODUCTION AND OBJECTIVES:
Hepatic encephalopathy (HE) is a complication of cirrhosis linked to the microbiome. We aimed to characterize the fecal microbiome of patients with prior and future overt HE, and explore the relationship between fecal species, short-chain fatty acids (SCFAs) and ammonia on HE pathogenesis. MATERIALS ANDMETHODS:
Consecutive inpatients and outpatients with cirrhosis were recruited. A single stool sample was collected and underwent shallow shotgun sequencing, and SCFA and ammonia quantification. Patients were followed until the end of the study period. Prior and new overt HE was diagnosed by the treating hepatologist.RESULTS:
Forty-nine patients with cirrhosis, mean MELD-Na 20 (SDâ¯=â¯9) and 33 (67%) with a history of OHE provided a stool sample. Over a median 85 days of follow up (interquartile range 34-181 days), 16 developed an OHE episode. Eight fecal bacterial species were associated with a history of OHE, and no species predicted future OHE. Bacterial species positively associated with SCFA content were inversely related to cirrhosis disease severity. Patients with a history of OHE had lower concentrations of 6 fecal SCFAs. Fecal ammonia concentrations were similar between those with and without a history of OHE (273⯵mol/g ± 214 vs. 327⯱â¯234, Pâ¯=â¯0.43).CONCLUSIONS:
We found 8 fecal species and 6 SCFAs linked to OHE. Many of the species inversely linked to OHE also have an association with SCFA production. Further work is needed to detail this relationship and to develop targeted interventions to treat HE.Palavras-chave
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Base de dados:
MEDLINE
Assunto principal:
Encefalopatia Hepática
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Ácidos Graxos Voláteis
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Fezes
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Microbiota
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Cirrose Hepática
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Risk_factors_studies
Limite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article