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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). Blood microbiome phylum compositions identified in our …
30 RS and CA-S share first authorship.
JT and AM share last authorship.
Contributors Conceptualisation: RS, CA-S, JT and MA; methodology: RS, CA-S, GTH, EM, JT and MA; formal analysis: RS, CA-S, JT and MA; investigation, RS, CA-S, MSAM, CCK, CM, DT, FEU, FM, CJ, AP, MP and GTH; resources: CCK, CM, DT, FEU, FM, CJ, AP, MP, GTH and EL; data curation: BL; writing – original draft: RS, CA-S, EM, EL, BL, JT and MA; visualisation: RS, CA-S, JT and MA; supervision: JT and MA.
Funding The authors were supported by grants from the Deutsche Forschungsgemeinschaft (SFB TRR57), Cellex Foundation, Novo Nordisk Foundation (NNF10CC1016515 and NNF16CC0020896) and European Union’s Horizon 2020 research and innovation program (No 668031).
Disclaimer The funders had no influence on study design, data collection and analysis, decision to publish or preparation of the manuscript.
Patient consent Obtained.
Ethics approval The ethics committee of the University Clinic Bonn in agreement with the Declaration of Helsinki permitted the study (No. 295/16).
Provenance and peer review Not commissioned; internally peer reviewed.
Author note RS and CA-S share first authorship. JT and MA share last authorship.
Correction notice This article has been corrected since it published Online First. The first authorship statement has been added and funding statement updated.