Cirrhosis of the liver is related to changes in the composition of the gut microbiome

Cirrhosis of the liver is related to changes in the composition of the gut microbiome.  Gastroenterology: The relationship between the change of intestinal microbiota in cirrhosis and chronic acute liver failure and its prognosis.

Cirrhosis of the liver is related to changes in the composition of the gut microbiome. However, chronic acute liver failure (ACLF) is the most serious clinical stage of liver cirrhosis, and there are few studies on the changes of intestinal microbiome in chronic acute liver failure through quantitative metagenomics.

This study investigated the gut microbiome of patients with liver cirrhosis, which covers the entire disease range (compensated phase, acute liver failure without chronic onset, and acute decompensated phase with ACLF). The study also included a group of healthy subjects as controls.

Prospective collection of stool samples from 182 patients with liver cirrhosis. Use an ion proton sequencer to construct and sequence DNA libraries, and group microbial genes into groups called metagenomics.

The results showed that compared with healthy subjects, liver cirrhosis was associated with a significant decrease in gene and metagenomic richness. This decrease in richness is related to the disease stage, especially in ACLF patients, and persists after adjustment of antibiotic treatment. ACLF is related to the significant increase of Enterococcus and Peptostreptococcus and the decrease of certain inherent bacteria. Changes in the intestinal microbiome are related to MELD score, Child classification and organ failure, and are related to some complications, especially hepatic encephalopathy and infection.

Interestingly, the gut microbiome can be used as a good stable predictor for the 3-month survival period. Functional analysis showed that patients with liver cirrhosis have abundant pathways related to ethanol production, gamma-aminobutyric acid metabolism and endotoxin biosynthesis.

Studies have shown that significant changes in the intestinal microbiome are a major feature of liver cirrhosis and appear in parallel with the stage of ACLF disease. Changes in the intestinal microbiome are related to the complications of liver cirrhosis and its survival rate, and may lead to disease progression and poor prognosis. These results should be further confirmed in future studies.

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