Longitudinal transkingdom gut microbial approach towards decompensation in outpatients with cirrhosis
© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ..
OBJECTIVE: First decompensation development is a critical milestone that needs to be predicted. Transkingdom gut microbial interactions, including archaeal methanogens, may be important targets and predictors but a longitudinal approach is needed.
DESIGN: Cirrhosis outpatients who provided stool twice were included. Group 1: compensated, group 2: 1 decompensation (decomp), group 3: >1 decompensationwere followed and divided into those who remained stable or decompensated. Bacteria, viral and archaeal presence, α/β diversity and taxa changes over time adjusted for clinical variables were analysed. Correlation networks between kingdoms were analysed.
RESULTS: 157 outpatients (72 group 1, 33 group 2 and 52 group 3) were followed and 28%-47% developed outcomes. Baseline between those who remained stable/developed outcome: While no α/β diversity differences were seen, commensals were lower and pathobionts were higher in those who decompensated. After decompensation: those experiencing their first decompensation showed greater decrease in α/β-diversity, bacterial change (↑Lactobacillus spp, Streptococcus parasanguinis and ↓ beneficial Lachnospiraceae and Eubacterium hallii) and viral change (↑Siphoviridae, ↓ Myoviridae) versus those with further decompensation. Archaea: 19% had Methanobacter brevii, which was similar between/within groups. Correlation networks: Baseline archaeal-viral-bacterial networks were denser and more homogeneous in those who decompensated versus the rest. Archaea-bacterial correlations collapsed post first decompensation. Lactobacillus phage Lc Nu and C2-like viruses were negatively linked with beneficial bacteria.
CONCLUSION: In this longitudinal study of cirrhosis outpatients, the greatest transkingdom gut microbial changes were seen in those reaching the first decompensation, compared with subsequent decompensating events. A transkingdom approach may refine prediction and provide therapeutic targets to prevent cirrhosis progression.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:72 |
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| Enthalten in: |
Gut - 72(2023), 4 vom: 01. Apr., Seite 759-771 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bajaj, Jasmohan S [VerfasserIn] |
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| Links: |
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| Themen: |
ASCITES |
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| Anmerkungen: |
Date Completed 09.03.2023 Date Revised 02.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1136/gutjnl-2022-328403 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 100 | 1 | |a Bajaj, Jasmohan S |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Longitudinal transkingdom gut microbial approach towards decompensation in outpatients with cirrhosis |
| 264 | 1 | |c 2023 | |
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| 500 | |a Date Revised 02.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ. | ||
| 520 | |a OBJECTIVE: First decompensation development is a critical milestone that needs to be predicted. Transkingdom gut microbial interactions, including archaeal methanogens, may be important targets and predictors but a longitudinal approach is needed | ||
| 520 | |a DESIGN: Cirrhosis outpatients who provided stool twice were included. Group 1: compensated, group 2: 1 decompensation (decomp), group 3: >1 decompensationwere followed and divided into those who remained stable or decompensated. Bacteria, viral and archaeal presence, α/β diversity and taxa changes over time adjusted for clinical variables were analysed. Correlation networks between kingdoms were analysed | ||
| 520 | |a RESULTS: 157 outpatients (72 group 1, 33 group 2 and 52 group 3) were followed and 28%-47% developed outcomes. Baseline between those who remained stable/developed outcome: While no α/β diversity differences were seen, commensals were lower and pathobionts were higher in those who decompensated. After decompensation: those experiencing their first decompensation showed greater decrease in α/β-diversity, bacterial change (↑Lactobacillus spp, Streptococcus parasanguinis and ↓ beneficial Lachnospiraceae and Eubacterium hallii) and viral change (↑Siphoviridae, ↓ Myoviridae) versus those with further decompensation. Archaea: 19% had Methanobacter brevii, which was similar between/within groups. Correlation networks: Baseline archaeal-viral-bacterial networks were denser and more homogeneous in those who decompensated versus the rest. Archaea-bacterial correlations collapsed post first decompensation. Lactobacillus phage Lc Nu and C2-like viruses were negatively linked with beneficial bacteria | ||
| 520 | |a CONCLUSION: In this longitudinal study of cirrhosis outpatients, the greatest transkingdom gut microbial changes were seen in those reaching the first decompensation, compared with subsequent decompensating events. A transkingdom approach may refine prediction and provide therapeutic targets to prevent cirrhosis progression | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a Research Support, U.S. Gov't, Non-P.H.S. | |
| 650 | 4 | |a ASCITES | |
| 650 | 4 | |a CIRRHOSIS | |
| 650 | 4 | |a ENTERIC BACTERIAL MICROFLORA | |
| 650 | 4 | |a HEPATIC ENCEPHALOPATHY | |
| 700 | 1 | |a Peña-Rodriguez, Marcela |e verfasserin |4 aut | |
| 700 | 1 | |a La Reau, Alex |e verfasserin |4 aut | |
| 700 | 1 | |a Phillips, Wendy |e verfasserin |4 aut | |
| 700 | 1 | |a Fuchs, Michael |e verfasserin |4 aut | |
| 700 | 1 | |a Davis, Brian C |e verfasserin |4 aut | |
| 700 | 1 | |a Sterling, Richard K |e verfasserin |4 aut | |
| 700 | 1 | |a Sikaroodi, Masoumeh |e verfasserin |4 aut | |
| 700 | 1 | |a Fagan, Andrew |e verfasserin |4 aut | |
| 700 | 1 | |a Shamsaddini, Amirhossein |e verfasserin |4 aut | |
| 700 | 1 | |a Henseler, Zachariah |e verfasserin |4 aut | |
| 700 | 1 | |a Ward, Tonya |e verfasserin |4 aut | |
| 700 | 1 | |a Puri, Puneet |e verfasserin |4 aut | |
| 700 | 1 | |a Lee, Hannah |e verfasserin |4 aut | |
| 700 | 1 | |a Gillevet, Patrick M |e verfasserin |4 aut | |
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