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Gut dysbiosis in acute‐on‐chronic liver failure and its predictive value for mortality
Author(s) -
Chen Yanfei,
Guo Jing,
Qian Guirong,
Fang Daiqiong,
Shi Ding,
Guo Lihua,
Li Lanjuan
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12932
Subject(s) - dysbiosis , gut flora , medicine , hepatic encephalopathy , gastroenterology , cirrhosis , feces , microbiome , liver disease , chronic liver disease , immunology , biology , microbiology and biotechnology , bioinformatics
Background Bacterial translocation from the gut plays an important role in the pathophysiology of acute‐on‐chronic liver failure ( ACLF ). However, gut dysbiosis in ACLF was not widely documented in previous studies. Aim This research characterized the fecal microbiota in patients with ACLF and analyzed the temporal stability of gut microbiota during illness. Methods Fecal microbiota of 79 ACLF patients (42 patients were followed in the next 4 weeks after the first visit for longitudinal study) and 50 healthy controls was analyzed by 16S ribosomal DNA pyrosequencing. Results There was a marked difference between the ACLF group and the control group. The overall microbial diversity and richness were significantly lower in ACLF than in controls. ACLF patients had lower abundance of B acteroidaceae , R uminococcaceae , and L anchnospiraceae , but higher abundance of P asteurellaceae , S treptococcaceae , and E nterecoccaceae . The relative abundance of L achnospiraceae was obviously decreased in ACLF patients with hepatic encephalopathy. The gut microbiota kept relatively stable in a short term after the onset of ACLF . The use of antibiotics only showed moderate impacts on the gut microbiota. The relative abundance of P asteurellaceae and Model of End Stage Liver Disease score were independent factors predicting mortality rate. Network analysis comparison showed robust correlations between specific bacterial families ( R uminococcaceae and L achnospiraceae ) and inflammatory cytokines (interleukin [ IL ]‐6, tumor necrosis factor alpha, IL ‐2) in ACLF patients. Conclusions These data suggest gut dysbiosis in ACLF and its predictive value for mortality. The results thus open up the possibility of designing diagnostic biomarkers and targeted probiotics aimed at decreasing mortality in ACLF .