RT Journal Article
SR Electronic
T1 Longitudinal transkingdom gut microbial approach towards decompensation in outpatients with cirrhosis
JF Gut
JO Gut
FD BMJ Publishing Group Ltd and British Society of Gastroenterology
SP gutjnl-2022-328403
DO 10.1136/gutjnl-2022-328403
A1 Jasmohan S Bajaj
A1 Marcela Peña-Rodriguez
A1 Alex La Reau
A1 Wendy Phillips
A1 Michael Fuchs
A1 Brian C Davis
A1 Richard K Sterling
A1 Masoumeh Sikaroodi
A1 Andrew Fagan
A1 Amirhossein Shamsaddini
A1 Zachariah Henseler
A1 Tonya Ward
A1 Puneet Puri
A1 Hannah Lee
A1 Patrick M Gillevet
YR 2022
UL http://gut.bmj.com/content/early/2022/11/07/gutjnl-2022-328403.abstract
AB Objective First decompensation development is a critical milestone that needs to be predicted. Transkingdom gut microbial interactions, including archaeal methanogens, may be important targets and predictors but a longitudinal approach is needed.Design Cirrhosis outpatients who provided stool twice were included. Group 1: compensated, group 2: 1 decompensation (decomp), group 3: >1 decompensationwere followed and divided into those who remained stable or decompensated. Bacteria, viral and archaeal presence, α/β diversity and taxa changes over time adjusted for clinical variables were analysed. Correlation networks between kingdoms were analysed.Results 157 outpatients (72 group 1, 33 group 2 and 52 group 3) were followed and 28%–47% developed outcomes. Baseline between those who remained stable/developed outcome: While no α/β diversity differences were seen, commensals were lower and pathobionts were higher in those who decompensated. After decompensation: those experiencing their first decompensation showed greater decrease in α/β-diversity, bacterial change (↑Lactobacillus spp, Streptococcus parasanguinis and ↓ beneficial Lachnospiraceae and Eubacterium hallii) and viral change (↑Siphoviridae, ↓ Myoviridae) versus those with further decompensation. Archaea: 19% had Methanobacter brevii, which was similar between/within groups. Correlation networks: Baseline archaeal-viral-bacterial networks were denser and more homogeneous in those who decompensated versus the rest. Archaea-bacterial correlations collapsed post first decompensation. Lactobacillus phage Lc Nu and C2-like viruses were negatively linked with beneficial bacteria.Conclusion In this longitudinal study of cirrhosis outpatients, the greatest transkingdom gut microbial changes were seen in those reaching the first decompensation, compared with subsequent decompensating events. A transkingdom approach may refine prediction and provide therapeutic targets to prevent cirrhosis progression.No data are available. Metadata are not available due to IRB restrictions.