Deep stool microbiome analysis in cirrhosis reveals an association between short-chain fatty acids and hepatic encephalopathy

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...

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Autores principales:	Patricia P. Bloom, Jesús M. Luévano, Jr., Kelsey J. Miller, Raymond T. Chung
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Cirrhosis Microbiome Encephalopathy Short-chain fatty acids Ammonia Specialties of internal medicine RC581-951
Acceso en línea:	https://doaj.org/article/4630b5c3799a4dec8200a8e84dbd0e1c
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spelling	oai:doaj.org-article:4630b5c3799a4dec8200a8e84dbd0e1c2021-11-18T04:45:59ZDeep stool microbiome analysis in cirrhosis reveals an association between short-chain fatty acids and hepatic encephalopathy1665-268110.1016/j.aohep.2021.100333https://doaj.org/article/4630b5c3799a4dec8200a8e84dbd0e1c2021-11-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S1665268121000326https://doaj.org/toc/1665-2681Introduction 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 and methods: 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 (SD = 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 μmol/g ± 214 vs. 327 ± 234, P = 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.Patricia P. BloomJesús M. Luévano, Jr.Kelsey J. MillerRaymond T. ChungElsevierarticleCirrhosisMicrobiomeEncephalopathyShort-chain fatty acidsAmmoniaSpecialties of internal medicineRC581-951ENAnnals of Hepatology, Vol 25, Iss , Pp 100333- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Cirrhosis Microbiome Encephalopathy Short-chain fatty acids Ammonia Specialties of internal medicine RC581-951
spellingShingle	Cirrhosis Microbiome Encephalopathy Short-chain fatty acids Ammonia Specialties of internal medicine RC581-951 Patricia P. Bloom Jesús M. Luévano, Jr. Kelsey J. Miller Raymond T. Chung Deep stool microbiome analysis in cirrhosis reveals an association between short-chain fatty acids and hepatic encephalopathy
description	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 and methods: 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 (SD = 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 μmol/g ± 214 vs. 327 ± 234, P = 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.
format	article
author	Patricia P. Bloom Jesús M. Luévano, Jr. Kelsey J. Miller Raymond T. Chung
author_facet	Patricia P. Bloom Jesús M. Luévano, Jr. Kelsey J. Miller Raymond T. Chung
author_sort	Patricia P. Bloom
title	Deep stool microbiome analysis in cirrhosis reveals an association between short-chain fatty acids and hepatic encephalopathy
title_short	Deep stool microbiome analysis in cirrhosis reveals an association between short-chain fatty acids and hepatic encephalopathy
title_full	Deep stool microbiome analysis in cirrhosis reveals an association between short-chain fatty acids and hepatic encephalopathy
title_fullStr	Deep stool microbiome analysis in cirrhosis reveals an association between short-chain fatty acids and hepatic encephalopathy
title_full_unstemmed	Deep stool microbiome analysis in cirrhosis reveals an association between short-chain fatty acids and hepatic encephalopathy
title_sort	deep stool microbiome analysis in cirrhosis reveals an association between short-chain fatty acids and hepatic encephalopathy
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/4630b5c3799a4dec8200a8e84dbd0e1c
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Deep stool microbiome analysis in cirrhosis reveals an association between short-chain fatty acids and hepatic encephalopathy

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