Cited by 1,099Gut microbiota and healthLiver Disease and TransplantationAbdominal vascular conditions and treatments

Altered profile of human gut microbiome is associated with cirrhosis and its complications

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Bajaj, Jasmohan S., Heuman, Douglas M., Hylemon, Phillip B., Sanyal, Arun J., White, Melanie B., Monteith, Pamela, Noble, Nicole A., Unser, Ariel B. +4 more·2014·Journal of Hepatology

Abstract

Background & aims The gut microbiome is altered in cirrhosis; however its evolution with disease progression is only partly understood. We aimed to study changes in the microbiome over cirrhosis severity, its stability over time and its longitudinal alterations with decompensation.Methods Controls and age-matched cirrhotics (compensated/decompensated/hospitalized) were included. Their stool microbiota was quantified using multi-tagged pyrosequencing. The ratio of autochthonous to non-autochthonous taxa was calculated as the cirrhosis dysbiosis ratio (CDR); a low number indicating dysbiosis. Firstly, the microbiome was compared between controls and cirrhotic sub-groups. Secondly, for stability assessment, stool collected twice within 6months in compensated outpatients was analyzed. Thirdly, changes after decompensation were assessed using (a) longitudinal comparison in patients before/after hepatic encephalopathy development (HE), (b) longitudinal cohort of hospitalized infected cirrhotics MELD-matched to uninfected cirrhotics followed for 30days.Results 244 subjects [219 cirrhotics (121 compensated outpatients, 54 decompensated outpatients, 44 inpatients) and 25 age-matched controls] were included. CDR was highest in controls (2.05) followed by compensated (0.89), decompensated (0.66), and inpatients (0.32, p<0.0001) and negatively correlated with endotoxin. Microbiota and CDR remained unchanged in stable outpatient cirrhotics (0.91 vs. 0.86, p=0.45). In patients studied before/after HE development, dysbiosis occurred post-HE (CDR: 1.2 to 0.42, p=0.03). In the longitudinal matched-cohort, microbiota were significantly different between infected/uninfected cirrhotics at baseline and a low CDR was associated with death and organ failures within 30days.Conclusions Progressive changes in the gut microbiome accompany cirrhosis and become more severe in the setting of decompensation. The cirrhosis dysbiosis ratio may be a useful quantitative index to describe microbiome alterations accompanying cirrhosis progression.

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Crossref · 10.1016/j.jhep.2013.12.019

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  • Some of the microbial changes caused by PPIs are the same as the alterations already present in patients with cirrhosis and especially in patients with decompensated cirrhosis, including the relative increase of potentially pathogenic bacteria such as Staphylococcaeae, Enterobacteriaceae and Enterococcaceae.

    “It is noteworthy that some of the microbial changes caused by PPIs are the same as the alterations already present in patients with cirrhosis and especially in patients with decompensated cirrhosis including the relative increase of potentially pathogenic bacteria such as Staphylococcaeae, Enterobacteriaceae and Enterococcaceae[93].”

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Authors
Bajaj, J. S., Heuman, D. M., Hylemon, P. B., Sanyal, A. J., White, M. B., Monteith, P., Noble, N. A., Unser, A. B., Daita, K., Fisher, A. R., Sikaroodi, M., & Gillevet, P. M.
Affiliations
  • Virginia Commonwealth University (US)
  • George Mason University (US)
Corresponding author
Bajaj, Jasmohan S.
Venue
Journal of Hepatology
Publisher
Elsevier BV
Published
2014-05
Volume
60
Issue
5
Pages
940-947
ISSN
0168-8278 (ISSN-L)
OpenAlex
W2170325206
Cited by
1,099
References
36
Citations by year
2026: 69 · 2025: 91 · 2024: 106 · 2023: 118 · 2022: 111 · 2021: 131 · 2020: 105 · 2019: 105 · 2018: 88 · 2017: 63 · 2016: 49 · 2015: 44 · 2014: 19
FWCI
16.73
Type
journal article
Language
en
Open access
Locations
  • Journal of Hepatology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
  • National Institutes of Health (UL1TR000058)
  • National Institute on Alcohol Abuse and Alcoholism (R01AA020203)
  • National Institute of Diabetes and Digestive and Kidney Diseases (R01DK087913)
  • National Center for Advancing Translational Sciences (UL1-TR00058)
  • National Center for Complementary and Integrative Health (U01AT004428)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
  • Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
Keywords
gut microbiota, liver cirrhosis, cirrhosis decompensation, hepatic encephalopathy, dysbiosis, endotoxin, microbiome stability, disease progression, mortality
MeSH terms
Digestive System, Female, Hepatic Encephalopathy, Humans, Infections, Liver Cirrhosis, Liver Cirrhosis, Alcoholic, Longitudinal Studies, Male, Middle Aged, Prospective Studies, Severity of Illness Index, Cohort Studies, Case-Control Studies, Disease Progression, End Stage Liver Disease, Microbiota, Non-alcoholic Fatty Liver Disease

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