The impact of artificial liver support system on intestinal microbiota and serum bile acid profiles in patients with acute-on-chronic liver failure: a prospective cohort study.

IF 5.9 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Hepatology International Pub Date : 2024-10-01 Epub Date: 2024-07-20 DOI:10.1007/s12072-024-10712-3
Yuyu Zeng, Dakai Gan, Kaige Zhang, Tao Long, Yan He, Rui Zhou, Shuanglan Liu, Molong Xiong
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Abstract

Background: Acute-on-chronic liver failure (ACLF) patients exhibit an imbalance in intestinal microbiota, and bile acids (BAs) can affect the composition of intestinal microbiota. Although Artificial liver support system (ALSS) is a treatment for ACLF, the impact of ALSS on intestinal microbiota and serum BA profiles of ACLF patients remains unclear.

Methods: A prospective study was conducted, which included 51 patients diagnosed with ACLF. These patients were stratified into two groups based on the utilization of an ALSS during their treatment period: a standard medical treatment group (SMT group), comprising 19 patients, and an ALSS combined with SMT group (ALSS group), comprising 32 patients. Blood and stool samples were collected from the patients on the day of admission and 14 days after treatment. Additionally, eight healthy controls were recruited, and their stool samples were also collected. The intestinal microbiota was sequenced using the 16S rRNA sequencing technique, while the serum BA profiles were determined using ultra-performance liquid chromatography/mass spectrometry.

Results: ACLF patients exhibited imbalances in intestinal microbiota and abnormalities in BA profiles. Compared to SMT alone, the combined ALSS and SMT was more effective in regulating intestinal microbiota imbalance and increasing the concentrations of ursodeoxycholic acid and glycoursodeoxycholic acid. Correlation analysis revealed a significant correlation between intestinal microbiota and Bas. Furthermore, the preliminary correlation heatmap indicated that the Faecalibaculum, Gemmiger, and taurochenodeoxycholic acid were associated with clinical improvement.

Conclusions: Our study identified the compositional characteristics of the intestinal microbiota and serum BA in ACLF patients, emphasizing the impact of ALSS on both intestinal microbiota and serum BA profiles.

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人工肝支持系统对急性-慢性肝衰竭患者肠道微生物群和血清胆汁酸谱的影响:一项前瞻性队列研究。
背景:急性-慢性肝衰竭(ACLF)患者的肠道微生物区系失衡,而胆汁酸(BA)会影响肠道微生物区系的组成。虽然人工肝支持系统(ALSS)是治疗 ACLF 的一种方法,但 ALSS 对 ACLF 患者肠道微生物群和血清 BA 特征的影响仍不清楚:我们进行了一项前瞻性研究,纳入了 51 名确诊为 ACLF 的患者。根据这些患者在治疗期间使用 ALSS 的情况将其分为两组:标准药物治疗组(SMT 组),包括 19 名患者;ALSS 与 SMT 联合治疗组(ALSS 组),包括 32 名患者。采集了患者入院当天和治疗后 14 天的血液和粪便样本。此外,还招募了 8 名健康对照者,并采集了他们的粪便样本。使用 16S rRNA 测序技术对肠道微生物群进行测序,同时使用超高效液相色谱/质谱法测定血清 BA 图谱:结果:ACLF患者表现出肠道微生物群失衡和BA谱异常。与单独使用 SMT 相比,ALSS 和 SMT 联合疗法在调节肠道微生物群失衡、增加熊去氧胆酸和糖去氧胆酸浓度方面更为有效。相关分析表明,肠道微生物群与 Bas 之间存在明显的相关性。此外,初步相关热图显示,Faecalibaculum、Gemmiger 和 taurochenodeoxycholic acid 与临床改善相关:我们的研究确定了 ACLF 患者肠道微生物群和血清 BA 的组成特征,强调了 ALSS 对肠道微生物群和血清 BA 特征的影响。
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来源期刊
Hepatology International
Hepatology International 医学-胃肠肝病学
CiteScore
10.90
自引率
3.00%
发文量
167
审稿时长
6-12 weeks
期刊介绍: Hepatology International is the official journal of the Asian Pacific Association for the Study of the Liver (APASL). This is a peer-reviewed journal featuring articles written by clinicians, clinical researchers and basic scientists is dedicated to research and patient care issues in hepatology. This journal will focus mainly on new and emerging technologies, cutting-edge science and advances in liver and biliary disorders. Types of articles published: -Original Research Articles related to clinical care and basic research -Review Articles -Consensus guidelines for diagnosis and treatment -Clinical cases, images -Selected Author Summaries -Video Submissions
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