Changes in gut microbiota after transjugular intrahepatic portosystemic shunt in cirrhotic patients with mild hepatic encephalopathy in different prognosis groups

Menghao LI; Kai LI; Shihao TANG; Zhengyu WANG; Wengang GUO; Zhanxin YIN; Guohong HAN

doi:10.3969/j.issn.1001-5256.2021.02.016

Volume 37 Issue 2

Mar. 2021

Turn off MathJax

Article Contents

Article Navigation > Journal of Clinical Hepatology > 2021 > 37(2): 326-330

PDF( 2149 KB)

Changes in gut microbiota after transjugular intrahepatic portosystemic shunt in cirrhotic patients with mild hepatic encephalopathy in different prognosis groups

DOI: 10.3969/j.issn.1001-5256.2021.02.016

Department of Liver Disease and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Air Force Medical University, Xi'an 710032, China

Received Date: 2020-09-13
Accepted Date: 2020-09-30
Published Date: 2021-02-20

Abstract

Abstract

Objective To investigate the changes in gut microbiota after transjugular intrahepatic portosystemic shunt (TIPS) in cirrhotic patients with mild hepatic encephalopathy (MHE) in different prognosis groups. Methods A total of 28 MHE cirrhotic patients who were hospitalized and underwent TIPS in Xijing Hospital of Digestive Diseases from July 2016 to July 2017 were enrolled. Fecal samples and related clinical data were collected on days 1-3 before surgery and at 1 month after surgery. According to the prognosis after surgery, the patients were divided into none-hepatic encephalopathy (HE) group with 8 patients, MHE group with 12 patients, and overt hepatic encephalopathy (OHE) group with 8 patients. Fecal samples were analyzed by 16S rRNA sequencing to obtain the relative abundance of gut microbiota, and SPSS and R packages were used to analyze the biodiversity, postoperative changes, and differences in such changes of gut microbiota at the genus level between groups. The chi-square test was used for comparison of categorical data between groups; the Kruskal-Wallis H test was used for comparison of continuous data between three groups; the Bonferroni method was used for multiple comparisons of multiple samples; the Wilcoxon signed-rank test was used for comparison before and after surgery within each group. For microbiome beta-diversity analyses, a principal coordinate analysis (PCoA) was performed based on Bray-Curtis distance matrix, and the Adonis method (PerMANOVA) was used for comparison between groups. Results PCoA based on Bray-Curtis distance matrix showed that only the MHE group had a significant change in beta diversity after surgery (F=2.71, P=0.049). After surgery, the non-HE group had significant increases in the abundance of the native flora Dialister, Coprococcus, Ruminococcaceae_uncultured, Flavonifractor, and Clostridium_sensu_stricto_1 (Z=2.521, 2.1, 2.1, 2.1, and 1.96, all P < 0.05); the MHE group had significant reductions in the abundance of the harmful flora Granulicatella(Z=2.521, P=0.012), Enterococcus(Z=2.51, P=0.012), Streptococcus(Z=2.432, P=0.015), and Rothia(Z=2.001, P=0.045) and significant increases in the abundance of Veillonella(Z=2.353, P=0.019) and Megasphaera(Z=1.955, P=0.05); the OHE group only had a significant increase in the abundance of Veillonella after surgery (Z=2.38, P=0.017). There was a significant difference in the change in gut microbiota (postoperative abundance/preoperative abundance) between the non-HE group, the MHE group, and the OHE group [2.00 (1.11-91.61) vs 1.21 (0.26-6.79) vs 0.09 (0.01-0.92), χ²=6.249, P=0.043]. Conclusion There is a significant difference in the change in gut microbiota after TIPS between patients with different prognoses, and the increase in the abundance of native flora may have a certain influence on the remission of MHE.
- Liver Cirrhosis,
- Hepatic Encephalopathy,
- Portasystemic Shunt, Transjugular Intrahepatic,
- Gastrointestinal Microbiome

FullText(HTML)

References(23)

References

[1]	European Association for the Study of the Liver. EASL clinical practice guidelines for the management of patients with decompensated cirrhosis[J]. J Hepatol, 2018, 69(2): 406-460. DOI: 10.1016/j.jhep.2018.03.024
[2]	ZHANG JC, WANG YG, LIN F, et al. Recent advances on the pathogenesis of hepatic encephalopathy[J/CD]. Chin J Liver Dis (Electronic Version), 2019, 11(1): 6-11. (in Chinese) 张军昌, 王永刚, 林芳, 等. 肝性脑病发病机制新进展[J/CD]. 中国肝脏病杂志(电子版), 2019, 11(1): 6-11.
[3]	RIDOLA L, CARDINALE V, RIGGIO O. The burden of minimal hepatic encephalopathy: From diagnosis to therapeutic strategies[J]. Ann Gastroenterol, 2018, 31(2): 151-164.
[4]	WANG JY, ZHANG NP, CHI BR, et al. Prevalence of minimal hepatic encephalopathy and quality of life evaluations in hospitalized cirrhotic patients in China[J]. World J Gastroenterol, 2013, 19(30): 4984-4991. DOI: 10.3748/wjg.v19.i30.4984
[5]	QIN N, YANG F, LI A, et al. Alterations of the human gut microbiome in liver cirrhosis[J]. Nature, 2014, 513(7516): 59-64. DOI: 10.1038/nature13568
[6]	TANG SH, CHEN H, HAN GH. Association between gut microbiota and hepatic encephalopathy in patients with liver cirrhosis[J]. J Clin Hepatol, 2019, 35(5): 1109-1113. (in Chinese) DOI: 10.3969/j.issn.1001-5256.2019.05.041 汤世豪, 陈辉, 韩国宏. 肠道菌群与肝硬化肝性脑病的关系[J]. 临床肝胆病杂志, 2019, 35(5): 1109-1113. DOI: 10.3969/j.issn.1001-5256.2019.05.041
[7]	LU BJ, ZHAO YH, AN YT, et al. Research advances in gut microbiota in liver cirrhosis and related complications[J]. J Clin Hepatol, 2018, 34(11): 2433-2437. (in Chinese) DOI: 10.3969/j.issn.1001-5256.2018.11.037 鲁冰洁, 赵亚红, 安泳潼, 等. 肠道微生物在肝硬化及相关并发症中的研究进展[J]. 临床肝胆病杂志, 2018, 34(11): 2433-2437. DOI: 10.3969/j.issn.1001-5256.2018.11.037
[8]	BAJAJ JS, HEUMAN DM, HYLEMON PB, et al. Altered profile of human gut microbiome is associated with cirrhosis and its complications[J]. J Hepatol, 2014, 60(5): 940-947. DOI: 10.1016/j.jhep.2013.12.019
[9]	BAJAJ JS. The role of microbiota in hepatic encephalopathy[J]. Gut Microbes, 2014, 5(3): 397-403. DOI: 10.4161/gmic.28684
[10]	Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the management of hepatic encephalopathy in cirrhosis[J]. J Clin Hepatol, 2018, 34(10): 2076-2089. (in Chinese) DOI: 10.3969/j.issn.1001-5256.2018.10.007 中华医学会肝病分学会. 肝硬化肝性脑病诊疗指南[J]. 临床肝胆病杂志, 2018, 34(10): 2076-2089. DOI: 10.3969/j.issn.1001-5256.2018.10.007
[11]	FERENCI P. Hepatic encephalopathy-Definition, nomenclature, diagnosis, and quantification: Final report of the Working Party at the 11th World Congresses of Gastroenterology, Vienna, 1998[J]. Hepatology, 2002, 35(3): 716-721. DOI: 10.1053/jhep.2002.31250
[12]	ZOETENDAL EG, BEN-AMOR K, HARMSEN HJ, et al. Quantification of uncultured Ruminococcus obeum-like bacteria in human fecal samples by fluorescent in situ hybridization and flow cytometry using 16S rRNA-targeted probes[J]. Appl Environ Microbiol, 2002, 68(9): 4225-4232. DOI: 10.1128/AEM.68.9.4225-4232.2002
[13]	DABARD J, BRIDONNEAU C, PHILLIPE C, et al. Ruminococcin A, a new lantibiotic produced by a Ruminococcus gnavus strain isolated from human feces[J]. Appl Environ Microbiol, 2001, 67(9): 4111-4118. DOI: 10.1128/AEM.67.9.4111-4118.2001
[14]	DUNCAN SH, LOUIS P, FLINT HJ. Cultivable bacterial diversity from the human colon[J]. Lett Appl Microbiol, 2007, 44(4): 343-350. DOI: 10.1111/j.1472-765X.2007.02129.x
[15]	WONG JM, de SOUZA R, KENDALL CW, et al. Colonic health: Fermentation and short chain fatty acids[J]. J Clin Gastroenterol, 2006, 40(3): 235-243. DOI: 10.1097/00004836-200603000-00015
[16]	NAVA GM, STAPPENBECK TS. Diversity of the autochthonous colonic microbiota[J]. Gut Microbes, 2011, 2(2): 99-104. DOI: 10.4161/gmic.2.2.15416
[17]	SOKOL H, PIGNEUR B, WATTERLOT L, et al. Faecalibacterium prausnitzii is an anti-inflammatory commensal bacterium identified by gut microbiota analysis of Crohn disease patients[J]. Proc Natl Acad Sci U S A, 2008, 105(43): 16731-16736. DOI: 10.1073/pnas.0804812105
[18]	SOKOL H, LAY C, SEKSIK P, et al. Analysis of bacterial bowel communities of IBD patients: What has it revealed?[J]. Inflamm Bowel Dis, 2008, 14(6): 858-867. DOI: 10.1002/ibd.20392
[19]	BAJAJ JS, BETRAPALLY NS, HYLEMON PB, et al. Salivary microbiota reflects changes in gut microbiota in cirrhosis with hepatic encephalopathy[J]. Hepatology, 2015, 62(4): 1260-1271. DOI: 10.1002/hep.27819
[20]	BAJAJ JS, RIDLON JM, HYLEMON PB, et al. Linkage of gut microbiome with cognition in hepatic encephalopathy[J]. Am J Physiol Gastrointest Liver Physiol, 2012, 302(1): g168-g175. DOI: 10.1152/ajpgi.00190.2011
[21]	de CRUZ P, KANG S, WAGNER J, et al. Association between specific mucosa-associated microbiota in Crohn's disease at the time of resection and subsequent disease recurrence: A pilot study[J]. J Gastroenterol Hepatol, 2015, 30(2): 268-278. DOI: 10.1111/jgh.12694
[22]	BONGAERTS GP, SCHREURS BW, LUNEL FV, et al. Was isolation of Veillonella from spinal osteomyelitis possible due to poor tissue perfusion?[J]. Med Hypotheses, 2004, 63(4): 659-661. DOI: 10.1016/j.mehy.2004.02.052
[23]	ROVERY C, ETIENNE A, FOUCAULT C, et al. Veillonella montpellierensis endocarditis[J]. Emerg Infect Dis, 2005, 11(7): 1112-1114. DOI: 10.3201/eid1107.041361

Relative Articles

Supplements(0)

Cited By

Proportional views

Proportional views

通讯作者: 陈斌, bchen63@163.com

1.
沈阳化工大学材料科学与工程学院沈阳 110142

Figures(3) / Tables(2)

Get Citation

PDF

XML

Article Metrics

Article views (612) PDF downloads(54)

Changes in gut microbiota after transjugular intrahepatic portosystemic shunt in cirrhotic patients with mild hepatic encephalopathy in different prognosis groups

DOI: 10.3969/j.issn.1001-5256.2021.02.016

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

Changes in gut microbiota after transjugular intrahepatic portosystemic shunt in cirrhotic patients with mild hepatic encephalopathy in different prognosis groups

DOI: 10.3969/j.issn.1001-5256.2021.02.016

Abstract

References

Proportional views

Catalog

通讯作者: 陈斌, bchen63@163.com

Article Metrics

Proportional views

Related

About Journal

Submission Guideline

Journal Online

Hepatobiliary College

Guidelines

Export File

Citation

Format

Content