Department of Gastroenterology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
Research Center of Digestive Disease, Central South University, Changsha, Hunan, China.
Front Cell Infect Microbiol. 2023 Jul 7;13:1218552. doi: 10.3389/fcimb.2023.1218552. eCollection 2023.
Liver cirrhosis is the end stage of various chronic liver diseases (CLDs). The gut microbiota can impact the liver environment and trigger chronic liver inflammation through the gut-liver axis. Alteration of the gut microbiota has become an effective strategy in the biological treatment of cirrhosis.
Twenty-eight patients with liver cirrhosis and 16 healthy individuals were included, and fresh stool samples were collected. We analyzed changes in the gut microbiota between groups by 16S rRNA sequencing and evaluated the association between microbiota alterations and hepatic function. Additionally, 102 cirrhotic patients were retrospectively enrolled and divided into a probiotic group (n=44) and a nonprobiotic group (n=58) in addition to standard treatment for cirrhosis. Patients were monitored for hematological parameters and hepatic function during the six-month follow-up.
The gut microbiota profile of patients with cirrhosis was greatly different from that of healthy individuals, presenting with significantly reduced α diversity and decreased abundance of representative SCFA-producing bacteria including , and . The pathogenic bacteria , , and were greatly enriched in cirrhotic patients. Additionally, patients with decompensated cirrhosis (DCPC) had a significantly reduced abundance of compared to compensated cirrhosis (CPC), which is also a SCFA-producing bacteria, and the lower to ratio and enhanced MDR values were also shown in DCPC patients compared to CPC patients. In addition, the abundance of was negatively related to hepatic function in cirrhotic patients, including the levels of ALT, AST, and DBIL. From the retrospective study, we found that biochemical improvements in alanine transaminase (ALT) and total bilirubin (TBIL) were obtained in DCPC patients who received oral probiotic therapy compared with the nonprobiotic group.
Severe microbial dysbiosis existed in patients with liver cirrhosis, especially patients who reached the decompensatory stage. SCFA-producing bacteria were significantly reduced in cirrhosis. Altered gut microbiota cause changes in functional modules, which may contribute to cirrhosis progression and are associated with clinical prognosis. Adjuvant probiotic supplementation to enhance SCFA-producing bacteria can be a prospective therapy for patients with cirrhosis.
肝硬化是各种慢性肝病（CLD）的终末期。肠道微生物群可以通过肠-肝轴影响肝脏环境并引发慢性肝脏炎症。改变肠道微生物群已成为肝硬化生物治疗的有效策略。
纳入 28 例肝硬化患者和 16 例健康对照者，采集新鲜粪便标本。通过 16S rRNA 测序分析两组间肠道微生物群变化，并评估菌群改变与肝功能的关系。此外，回顾性纳入 102 例肝硬化患者，除肝硬化标准治疗外，分为益生菌组（n=44）和非益生菌组（n=58）。在 6 个月的随访中监测患者的血液学参数和肝功能。
肝硬化患者的肠道微生物群谱与健康对照者有很大差异，表现为α多样性显著降低，代表性 SCFA 产生菌，如 、 、 丰度降低。致病菌 、 、 在肝硬化患者中大量富集。此外，与代偿性肝硬化（CPC）相比，失代偿性肝硬化（DCPC）患者的 丰度显著降低，也是一种 SCFA 产生菌，并且 DCPC 患者的 与 比值较低，MDR 值也较高。此外，肝硬化患者中 的丰度与肝功能呈负相关，包括 ALT、AST 和 DBIL 水平。从回顾性研究中，我们发现与非益生菌组相比，口服益生菌治疗的 DCPC 患者的丙氨酸转氨酶（ALT）和总胆红素（TBIL）生化指标得到改善。
肝硬化患者存在严重的微生物失调，尤其是达到失代偿期的患者。肝硬化患者中 SCFA 产生菌显著减少。改变的肠道微生物群引起功能模块的变化，可能导致肝硬化进展，并与临床预后相关。辅助益生菌补充以增强 SCFA 产生菌可能是肝硬化患者的一种有前景的治疗方法。
