Santiago Alba, Sanchez Elisabet, Clark Allison, Pozuelo Marta, Calvo Miguel, Yañez Francisca, Sarrabayrouse Guillaume, Perea Lidia, Vidal Silvia, Gallardo Alberto, Guarner Carlos, Soriano German, Manichanh Chaysavanh
Department of Gastroenterology, Vall d'Hebron Research Institute, Barcelona, Spain.
Department of Gastroenterology, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
mSystems. 2019 Feb 19;4(1). doi: 10.1128/mSystems.00278-18. eCollection 2019 Jan-Feb.
Whether the interaction between the gut microbiota and the immune response influences the evolution of cirrhosis is poorly understood. We aimed to investigate modifications of the microbiome and the immune response during the progression of cirrhosis. Rats were treated with carbon tetrachloride (CCl) to induce cirrhosis. We then assessed microbiome load and composition in stool, ileocecal contents (ICCs), mesenteric lymph nodes (MLNs), blood, and ascitic fluids (AFs) at 6, 8, and 10 weeks or ascites production and measured cytokine production in MLNs and blood. The microbiome of MLN, blood, and AF showed a distinct composition compared to that of stool and ICCs. () were found associated with the appearance of a decompensated state of cirrhosis. Microbial load increased and showed a positive correlation with the relative abundance of pathobionts in the MLN of decompensated rats. Among several genera, and " Arthromitus" positively correlated with elevated levels of systemic proinflammatory cytokines. " Arthromitus," a segmented filamentous bacteria, was detected in ICC, MLN, and AF samples, suggesting a possible translocation from the gut to the AF through the lymphatic system, whereas was detected in ICC, MLN, AF, and blood, suggesting a possible translocation from the gut to the AF through the bloodstream. In the present study, we demonstrate that microbiome changes in distinct intestinal sites are associated with microbial shifts in the MLNs as well as an increase in cytokine production, providing further evidence of the role the gut-liver-immunity axis plays in the progression of cirrhosis. Cirrhosis severity in patients was previously shown to be associated with progressive changes in the fecal microbiome in a longitudinal setting. Recent evidence shows that bacterial translocation from the gut to the extraintestinal sites could play a major role in poor disease outcome and patient survival. However, the underlying mechanisms involving the microbiota in the disease progression are not well understood. Here, using an animal model of cirrhosis in a longitudinal and multibody sites setting, we showed the presence of a distinct composition of the microbiome in mesenteric lymph nodes, blood, and ascitic fluid compared to that in feces and ileocecal content, suggesting compartmentalization of the gut microbiome. We also demonstrate that microbiome changes in intestinal sites are associated with shifts in specific microbial groups in the mesenteric lymph nodes as well as an increase in systemic cytokine production, linking inflammation to decompensated cirrhosis in the gut-liver-immunity axis.
肠道微生物群与免疫反应之间的相互作用是否会影响肝硬化的进展,目前尚不清楚。我们旨在研究肝硬化进展过程中微生物组和免疫反应的变化。用四氯化碳(CCl)处理大鼠以诱导肝硬化。然后,我们在第6、8和10周评估粪便、回盲部内容物(ICC)、肠系膜淋巴结(MLN)、血液和腹水(AF)中的微生物组负荷和组成,或腹水产生情况,并测量MLN和血液中的细胞因子产生情况。与粪便和ICC相比,MLN、血液和AF的微生物组组成明显不同。发现()与肝硬化失代偿状态的出现有关。微生物负荷增加,并且与失代偿大鼠MLN中致病共生菌的相对丰度呈正相关。在几个属中,(属名未给出)和“节状丝状菌”与全身促炎细胞因子水平升高呈正相关。在ICC、MLN和AF样本中检测到“节状丝状菌”这种分段丝状细菌,表明其可能通过淋巴系统从肠道转移至AF,而(属名未给出)在ICC、MLN、AF和血液中均被检测到,表明其可能通过血液循环从肠道转移至AF。在本研究中,我们证明不同肠道部位的微生物组变化与MLN中的微生物转移以及细胞因子产生增加有关,这进一步证明了肠 - 肝 - 免疫轴在肝硬化进展中所起的作用。先前的研究表明,患者的肝硬化严重程度与纵向研究中粪便微生物组的渐进性变化有关。最近的证据表明,细菌从肠道向肠外部位的转移可能在疾病不良结局和患者生存中起主要作用。然而,微生物群在疾病进展中的潜在机制尚未完全了解。在这里,我们使用纵向和多部位的肝硬化动物模型,表明与粪便和回盲部内容物相比,肠系膜淋巴结、血液和腹水中的微生物组组成明显不同,这表明肠道微生物组存在区室化。我们还证明肠道部位的微生物组变化与肠系膜淋巴结中特定微生物群的转移以及全身细胞因子产生增加有关,将炎症与肠 - 肝 - 免疫轴中的失代偿性肝硬化联系起来。