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Letter
Circulating microbiome in blood of different circulatory compartments
  1. Robert Schierwagen1,
  2. Camila Alvarez-Silva2,
  3. Mette Simone Aae Madsen2,
  4. Carl Christian Kolbe3,
  5. Carsten Meyer4,
  6. Daniel Thomas4,
  7. Frank Erhard Uschner1,
  8. Fernando Magdaleno1,
  9. Christian Jansen1,
  10. Alessandra Pohlmann1,
  11. Michael Praktiknjo1,
  12. Gunnar T Hischebeth5,6,
  13. Ernst Molitor5,6,
  14. Eicke Latz3,7,8,
  15. Benjamin Lelouvier9,
  16. Jonel Trebicka1,10,11,12,
  17. Manimozhiyan Arumugam2
  1. 1Department of Internal Medicine I, University of Bonn, Bonn, Germany
  2. 2The Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
  3. 3Institute of Innate Immunity, University of Bonn, Bonn, Germany
  4. 4Department of Radiology, University of Bonn, Bonn, Germany
  5. 5Institute of Medical Microbiology, Immunology and Parasitology, University of Bonn, Bonn, Germany
  6. 6Partner site Cologne-Bonn, German Center of Infection Research (DZIF), Bonn, Germany
  7. 7Division of Infectious Diseases and Immunology, University of Massachusetts Medical School, Worcester, Massachusetts, USA
  8. 8Centre for Inflammation Research, Norwegian University of Science and Technology, Trondheim, Norway
  9. 9Vaiomer, Labège, France
  10. 10European Foundation for the Study of Chronic Liver Failure, Barcelona, Spain
  11. 11Institute for Bioengineering of Catalonia, Barcelona, Spain
  12. 12Department of Medical Gastroenterology and Hepatology, Odense University Hospital, Odense, Denmark
  1. Correspondence to Dr Jonel Trebicka, Department of Internal Medicine I, University of Bonn, Bonn 53127, Germany; jonel.trebicka{at}efclif.com

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We read with interest the recent review by Tilg et al,1 which summarised the role of microbiota in liver diseases and pointed out that a causal link with systemic inflammation has still not been established. This letter fills in this gap and provides an analysis of the circulating microbiota in portal vein as the link between gut and liver. The access to portal circulation is possible during the implantation of a transjugular intrahepatic portosystemic shunt (TIPS). Therefore, we characterised the circulating microbiome in portal vein (first venous outflow in gut–liver axis), liver outflow, central venous blood and peripheral venous blood from seven patients with decompensated liver cirrhosis receiving TIPS for either variceal bleeding (n=3) or refractory ascites (n=4) (mean Model for End-stage Liver Disease (MELD) 8.4 (range 6–13), Child-Pugh-Score (CHILD) A: n=4, CHILD B: n=3) (figure 1A). We performed 16S ribosomal RNA (rRNA) gene sequencing of buffy coat samples and identified 65 genera belonging to four phyla (predominantly Proteobacteria) in this cohort (online supplementary figure 1 and figure 1B …

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