利用粪便菌群判定是否患有酒精性肝炎
创作:Echo Quasimodo 审核:兵兵 03月28日
  • 研究纳入78名参与者,与健康人群(HC)相比,严重嗜酒者(HDC)人群体内拟杆菌门显著减少;
  • 与HDC相比,酒精性肝炎患者的瘤胃菌科、韦荣球菌科、毛螺菌科、紫单胞菌科和理研菌科发生显著改变;
  • 各组之间菌群均具有显著差异性,重度酒精性肝炎患者(SAH)体内,变形菌门显著增加;
  • 厚壁菌门的丰度从HDC、MAH(中度酒精性肝炎)到SAH依次减少;
  • 但是,菌群种类不能区分MAH和SAH;
  • 酒精性肝炎患者的粪便中产SCFA细菌和SCFA均减少。
主编推荐语
兵兵
文章以健康人群作为对比,探究了严重嗜酒者、以及中度、重度酒精性肝炎之间粪便菌群的差异。研究结果表明,上述四组之间菌群均具有显著差异性。利用严重嗜酒者和酒精性肝炎患者之间粪便菌群的差异,可以推断嗜酒者是否患有酒精性肝炎。但是,菌群差异不能量化肝炎的严重程度。
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Hepatology [IF:14.679]

Fecal microbiome distinguishes alcohol consumption from alcoholic hepatitis but does not discriminate disease severity

粪便微生物组可辨别酒精摄入和酒精性肝炎,但不能判定疾病的严重程度

10.1002/hep.31178

02-14, Article

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Background And Aims: The role of the intestinal microbiome in alcoholic hepatitis is not established. The aims of this study were to: (1) characterize the fecal microbial ecology associated with alcoholic hepatitis, (2) relate microbiome changes to disease severity and (3) infer the functional relevance of shifts in microbial ecology.
Methods: The fecal microbiome in patients with moderate or severe alcoholic hepatitis (MAH and SAH) was compared to healthy (HC) and heavy drinking controls (HDC). Microbial taxa were identified by 16S pyrosequencing. Functional metagenomics was performed using PICRUSt. Fecal short chain fatty acids (SCFA) were measured using an LC/MS platform.
Results: 78 participants (HC, n=24; HDC, n=20; MAH, n=10; SAH, n=24) were studied. Heavy drinking had a distinct signature compared to healthy controls with depletion of Bacteroidetes (46% vs 26%; p=0.01). Alcoholic hepatitis was associated with a distinct microbiome signature compared to heavy drinking controls (AUC=0.826); differential abundance of Ruminococcaceae, Veillonellaceae, Lachnospiraceae, Porphyromonadaceae, and Rikenellaceae families were the key contributors to these differences. The beta diversity was significantly different amongst the groups (PERMANOVA p < 0.001). Severe alcoholic hepatitis was associated with increased Proteobacteria (SAH 14% vs. HDC 7% and SAH vs. HC 2%, p=0.20 and 0.01 respectively). Firmicutes abundance declined from HDC to MAH to SAH (63% vs. 53% vs. 48% respectively, p=0.09 HDC vs. SAH). Microbial taxa did not distinguish between moderate and severe alcoholic hepatitis (PERMANOVA p= 0.785). SCFA producing bacteria (Lachnospiraceae and Ruminococcaceae) were decreased in alcoholic hepatitis, and a similar decrease was observed in fecal short chain fatty acids among alcoholic hepatitis patients.
Conclusions: There are distinct changes in fecal microbiome associated with development of but not severity of alcoholic hepatitis.

First Authors:
Ekaterina Smirnova

Correspondence Authors:
Ekaterina Smirnova

All Authors:
Ekaterina Smirnova,Puneet Puri,Mark D Muthiah,Kalyani Daitya,Robert Brown,Naga Chalasani,Suthat Liangpunsakul,Vijay H Shah,Kayla Gelow,Mohammed S Siddiqui,Sherry Boyett,Faridoddin Mirshahi,Masoumeh Sikaroodi,Patrick Gillevet,Arun J Sanyal

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