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Comprehensive Analysis of Serum and Fecal Bile Acid Profiles and Interaction with Gut Microbiota in Primary Biliary Cholangitis
Abstract
Accumulation of bile acids (BAs) contributes significantly to the pathogenesis of primary biliary cholangitis (PBC). Here, we sought to systematically characterize the serum and fecal BA profiles and the linkage between BAs and gut microbiota in PBC. The serum and fecal BAs were compared between 65 UDCA treatment-naive PBC and 109 healthy controls using UPLC-MS in cross-sectional study. In a prospective study, a subgroup of patients was enrolled for BA and microbiota analysis before and after UDCA therapy. BA compositions in serum and feces significantly differed between treatment-naive PBC and controls. Particularly, PBC was associated with decreased conversions of conjugated to unconjugated, and primary to secondary BAs, indicating impaired microbial metabolism of BAs. PBC patients at advanced stage exhibited a more abnormal BA profile compared with early-stage patients. UDCA treatment led to a decreased level of taurine-conjugated BAs, thereby reversing the conjugated/unconjugated ratio in PBC. Moreover, the level of secondary BAs such as DCA and conjugated DCA inversely correlated with PBC-enriched gut microbes (e.g., Veillonella, Klebsiella), while positively correlated with control-enriched microbes (e.g., Faecalibacterium, Oscillospira). Microbiota analysis also revealed a significant increase of taurine-metabolizing bacteria Bilophila spp. in patients after UDCA, which was strongly correlated with decreased taurine-conjugated BAs. In addition, serum FGF19 was remarkably increased in treatment-naïve PBC and decreased after UDCA. Our study established specific alterations of BA compositions in serum and feces of PBC, suggesting the potential for using BAs for diagnosis, and highlighting the possibility of modulating BA profile by altering gut microbiota. Graphical Abstract.
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“In primary biliary cholangitis, the gut microbiota alter both serum and faecal bile acid profiles with a decreased conversion of primary to secondary bile acids.36,37”
From Primary biliary cholangitis. (2024) · cites this paper as [36]
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Metadata
- Authors
- Chen, W., Wei, Y., Xiong, A., Li, Y., Guan, H., Wang, Q., Miao, Q., Bian, Z., Xiao, X., Lian, M., Zhang, J., Li, B., Cao, Q., Fan, Z., Zhang, W., Qiu, D., Fang, J., Gershwin, M. E., Yang, L., Tang, R., & Ma, X.
- Affiliations
- Shanghai Jiao Tong University (CN)
- Shanghai University of Traditional Chinese Medicine (CN)
- Nantong University (CN)
- University of California, Davis (US)
- Corresponding author
- Yang, Li
- Tang, Ruqi
- Ma, Xiong
- ORCID
- Venue
- Clinical Reviews in Allergy & Immunology
- Published
- 2019-03-21
- Volume
- 58
- Issue
- 1
- Pages
- 25-38
- ISSN
- 1080-0549 (ISSN-L)
- 1559-0267
- OpenAlex
- W2924978408
- Cited by
- 166
- References
- 52
- Citations by year
- 2026: 15 · 2025: 26 · 2024: 36 · 2023: 24 · 2022: 21 · 2021: 32 · 2020: 9 · 2019: 3
- FWCI
- 10.45
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Clinical Reviews in Allergy & Immunology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Natural Science Foundation of China (81620108002, 81771732, 81830016, 81570469, 81873561, 81573581, 81421001, 81500435)
- Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant (20161311)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Oncology › Drug Transport and Resistance Mechanisms
- Keywords
- primary biliary cirrhosis, bile acids, gut microbiota, fecal bile acids, taurine-conjugated bile acids, bile acid metabolism, FGF19, bile acid deconjugation, secondary bile acids, Bilophila, Veillonella, Klebsiella, Faecalibacterium, Oscillospira, disease severity
- MeSH terms
- Gastrointestinal Microbiome, Adult, Aged, Bile Acids and Salts, Cross-Sectional Studies, Disease Susceptibility, Feces, Female, Fibroblast Growth Factors, Humans, Liver Cirrhosis, Biliary, Liver Function Tests, Male, Middle Aged, Models, Biological, Severity of Illness Index, Biomarkers, Cluster Analysis, Case-Control Studies, Computational Biology, Metagenome, Metagenomics, Hydrophobic and Hydrophilic Interactions
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