Gulyaeva Kseniya, Nadinskaia Maria, Maslennikov Roman, Aleshina Yulia, Goptar Irina, Lukashev Alexander, Poluektova Elena, Ivashkin Vladimir
Department of Internal Medicine, Gastroenterology and Hepatology, Sechenov University, Pogodinskaya str., 1, bld. 1, Moscow, 119435, Russian Federation.
Martsinovsky Institute of Medical Parasitology, Tropical and Vector Borne Diseases, Sechenov University, Moscow, Russian Federation, 19991.
Sci Rep. 2025 Mar 11;15(1):8394. doi: 10.1038/s41598-025-92618-0.
Gut dysbiosis plays an important role in cirrhosis, but the mechanism of its development was not established. The aim of the study was to test the hypothesis that portal hypertension can be the main factor in the development of gut dysbiosis in cirrhosis. This cross-sectional study included 25 patients with chronic non-cirrhotic portal hypertension due to extrahepatic portal vein obstruction after portal vein thrombosis (PVT) (NCPVT group), 29 cirrhotic patients without PVT (CirNoPVT), 15 cirrhotic patients with chronic PVT (CPVT), and 22 healthy controls. The fecal microbiota was assessed using 16S rRNA gene sequencing. The CirNoPVT and CPVT groups had largely similar differences in gut microbiota composition from the control group. Patients with NCPVT, as well as patients with cirrhosis, had a higher abundance of Streptococcus, Escherichia, Enterococcus, Enterobacteriaceae, Enterococcaceae, Streptococcaceae, Bacilli, Gammaproteobacteria, Proteobacteria, and a lower abundance of Roseburia, Faecalibacterium, Methanobrevibacter, Ruminococcaceae, Methanobacteriaceae, Clostridia, Methanobacteria, and Euryarchaeota as they were compared with healthy individuals. Patients with NCPVT had a higher abundance of Bifidobacterium, Bifidobacteriaceae, Actinobacteria, and a lower abundance of Gemmiger and Catenibacterium compared to healthy individuals, which was not observed in the cirrhosis groups. The abundance of Porphyromonadaceae with the genus Parabacteroides was reduced in both groups with PVT, but not in CirNoPVT. There were no significant differences in gut microbiota beta-diversity among the CirNoPVT, CPVT and NCPVT groups. All these groups had significant differences in beta-diversity from the control group. Portal hypertension seems be the main factor in the development of gut dysbiosis in cirrhosis.
肠道菌群失调在肝硬化中起重要作用，但其发展机制尚未明确。本研究旨在验证门静脉高压可能是肝硬化患者肠道菌群失调发展的主要因素这一假说。这项横断面研究纳入了25例因门静脉血栓形成（PVT）后肝外门静脉阻塞导致慢性非肝硬化门静脉高压的患者（非肝硬化门静脉高压组）、29例无PVT的肝硬化患者（肝硬化无PVT组）、15例慢性PVT的肝硬化患者（慢性PVT组）以及22名健康对照者。采用16S rRNA基因测序评估粪便微生物群。肝硬化无PVT组和慢性PVT组的肠道微生物群组成与对照组相比差异大致相似。与健康个体相比，非肝硬化门静脉高压患者以及肝硬化患者的链球菌属、大肠埃希菌属、肠球菌属、肠杆菌科、肠球菌科、链球菌科、芽孢杆菌属、γ-变形菌纲、变形菌门丰度较高，而罗斯氏菌属、粪杆菌属、短柄甲烷杆菌属、瘤胃球菌科、甲烷杆菌科、梭菌纲、甲烷杆菌纲和广古菌门丰度较低。与健康个体相比，非肝硬化门静脉高压患者双歧杆菌属、双歧杆菌科、放线菌门丰度较高， Gemmiger菌属和链状杆菌属丰度较低，而在肝硬化组中未观察到这种情况。两组有PVT的患者中卟啉单胞菌科及副拟杆菌属丰度均降低，但肝硬化无PVT组未出现这种情况。肝硬化无PVT组、慢性PVT组和非肝硬化门静脉高压组之间肠道微生物群的β多样性无显著差异。所有这些组与对照组相比，β多样性均有显著差异。门静脉高压似乎是肝硬化患者肠道菌群失调发展的主要因素。
