Biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis

Abstract Proton pump inhibitors (PPI) are an invaluable therapy option for acid related diseases; however, PPI therapy is also linked to a series of side effects in cirrhosis, such as microbiome alterations, spontaneous bacterial peritonitis and hepatic encephalopathy. Decision tools to balance bene...

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Autores principales:	Angela Horvath, Florian Rainer, Mina Bashir, Bettina Leber, Bianca Schmerboeck, Ingeborg Klymiuk, Andrea Groselj-Strele, Marija Durdevic, Daniel E. Freedberg, Julian A. Abrams, Peter Fickert, Philipp Stiegler, Vanessa Stadlbauer
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2019
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/55e5d506aa1545a8ba05694f4b1cb4d1
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spelling	oai:doaj.org-article:55e5d506aa1545a8ba05694f4b1cb4d12021-12-02T15:09:37ZBiomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis10.1038/s41598-019-48352-52045-2322https://doaj.org/article/55e5d506aa1545a8ba05694f4b1cb4d12019-08-01T00:00:00Zhttps://doi.org/10.1038/s41598-019-48352-5https://doaj.org/toc/2045-2322Abstract Proton pump inhibitors (PPI) are an invaluable therapy option for acid related diseases; however, PPI therapy is also linked to a series of side effects in cirrhosis, such as microbiome alterations, spontaneous bacterial peritonitis and hepatic encephalopathy. Decision tools to balance benefits and risks of PPI therapy are largely missing. In this study, we tested gut-derived biomarkers to identify PPI-associated dysbiosis, its association with gut barrier function and liver-related mortality. In this observational study, faecal microbiome composition data obtained from 16S rDNA sequencing of 90 cirrhotic patients with and without long-term PPI use and additional potential biomarkers identified from the literature were evaluated for their predictive value regarding PPI-associated dysbiosis and liver-related three-year mortality. In addition, faecal calprotectin, faecal zonulin and serum lipopolysaccharides were assessed as markers for intestinal inflammation, gut permeability and bacterial translocation. Streptococcus salivarius, Veillonella parvula and the genus Streptococcus were significantly increased in patients with long-term PPI therapy and performed well as biomarkers for PPI-associated dysbiosis (accuracy: 74%, 72% and 74%, respectively). The abundance of Streptococcus salivarius was linked to intestinal inflammation and gut barrier dysfunction, whereas the abundance of Veillonella parvula showed associations with liver disease severity; both were independent predictors for liver-related three-year mortality. Gut-derived biomarkers of PPI-associated dysbiosis are linked to worse outcome and a potential option to evaluate the risks of adverse events during long-term PPI therapy.Angela HorvathFlorian RainerMina BashirBettina LeberBianca SchmerboeckIngeborg KlymiukAndrea Groselj-StreleMarija DurdevicDaniel E. FreedbergJulian A. AbramsPeter FickertPhilipp StieglerVanessa StadlbauerNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 9, Iss 1, Pp 1-9 (2019)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Angela Horvath Florian Rainer Mina Bashir Bettina Leber Bianca Schmerboeck Ingeborg Klymiuk Andrea Groselj-Strele Marija Durdevic Daniel E. Freedberg Julian A. Abrams Peter Fickert Philipp Stiegler Vanessa Stadlbauer Biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis
description	Abstract Proton pump inhibitors (PPI) are an invaluable therapy option for acid related diseases; however, PPI therapy is also linked to a series of side effects in cirrhosis, such as microbiome alterations, spontaneous bacterial peritonitis and hepatic encephalopathy. Decision tools to balance benefits and risks of PPI therapy are largely missing. In this study, we tested gut-derived biomarkers to identify PPI-associated dysbiosis, its association with gut barrier function and liver-related mortality. In this observational study, faecal microbiome composition data obtained from 16S rDNA sequencing of 90 cirrhotic patients with and without long-term PPI use and additional potential biomarkers identified from the literature were evaluated for their predictive value regarding PPI-associated dysbiosis and liver-related three-year mortality. In addition, faecal calprotectin, faecal zonulin and serum lipopolysaccharides were assessed as markers for intestinal inflammation, gut permeability and bacterial translocation. Streptococcus salivarius, Veillonella parvula and the genus Streptococcus were significantly increased in patients with long-term PPI therapy and performed well as biomarkers for PPI-associated dysbiosis (accuracy: 74%, 72% and 74%, respectively). The abundance of Streptococcus salivarius was linked to intestinal inflammation and gut barrier dysfunction, whereas the abundance of Veillonella parvula showed associations with liver disease severity; both were independent predictors for liver-related three-year mortality. Gut-derived biomarkers of PPI-associated dysbiosis are linked to worse outcome and a potential option to evaluate the risks of adverse events during long-term PPI therapy.
format	article
author	Angela Horvath Florian Rainer Mina Bashir Bettina Leber Bianca Schmerboeck Ingeborg Klymiuk Andrea Groselj-Strele Marija Durdevic Daniel E. Freedberg Julian A. Abrams Peter Fickert Philipp Stiegler Vanessa Stadlbauer
author_facet	Angela Horvath Florian Rainer Mina Bashir Bettina Leber Bianca Schmerboeck Ingeborg Klymiuk Andrea Groselj-Strele Marija Durdevic Daniel E. Freedberg Julian A. Abrams Peter Fickert Philipp Stiegler Vanessa Stadlbauer
author_sort	Angela Horvath
title	Biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis
title_short	Biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis
title_full	Biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis
title_fullStr	Biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis
title_full_unstemmed	Biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis
title_sort	biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis
publisher	Nature Portfolio
publishDate	2019
url	https://doaj.org/article/55e5d506aa1545a8ba05694f4b1cb4d1
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Biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis

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