Hong-Wei Zhao, Jin-Long Zhang, Fu-Quan Liu, Zhen-Dong Yue, Lei Wang, Yu Zhang, Cheng-Bin Dong, Zhen-Chang Wang
{"title":"乙型肝炎病毒相关门静脉高压症患者经颈静脉肝内门体系统分流术后肠道微生物组的变化。","authors":"Hong-Wei Zhao, Jin-Long Zhang, Fu-Quan Liu, Zhen-Dong Yue, Lei Wang, Yu Zhang, Cheng-Bin Dong, Zhen-Chang Wang","doi":"10.3748/wjg.v30.i31.3668","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Gut microbiota (GM) affects the progression and response to treatment in liver diseases. The GM composition is diverse and associated with different etiologies of liver diseases. Notably, alterations in GM alterations are observed in patients with portal hypertension (PH) secondary to cirrhosis, with hepatitis B virus (HBV) infection being a major cause of cirrhosis in China. Thus, understanding the role of GM alterations in patients with HBV infection-related PH is essential.</p><p><strong>Aim: </strong>To evaluate GM alterations in patients with HBV-related PH after transjugular intrahepatic portosystemic shunt (TIPS) placement.</p><p><strong>Methods: </strong>This was a prospective, observational clinical study. There were 30 patients (with a 100% technical success rate) recruited in the present study. Patients with esophagogastric variceal bleeding due to HBV infection-associated PH who underwent TIPS were enrolled. Stool samples were obtained before and one month after TIPS treatment, and GM was analyzed using 16S ribosomal RNA amplicon sequencing.</p><p><strong>Results: </strong>One month after TIPS placement, 8 patients developed hepatic encephalopathy (HE) and were assigned to the HE group; the other 22 patients were assigned to the non-HE group. There was no substantial disparity in the abundance of GM at the phylum level between the two groups, regardless of TIPS treatment (all, <i>P</i> > 0.05). However, following TIPS placement, the following results were observed: (1) The abundance of <i>Haemophilus</i> and <i>Eggerthella</i> increased, whereas that of <i>Anaerostipes</i>, <i>Dialister</i>, <i>Butyricicoccus</i>, and <i>Oscillospira</i> declined in the HE group; (2) The richness of <i>Eggerthella</i>, <i>Streptococcus</i>, and <i>Bilophila</i> increased, whereas that of <i>Roseburia</i> and <i>Ruminococcus</i> decreased in the non-HE group; and (3) Members from the pathogenic genus <i>Morganella</i> appeared in the HE group but not in the non-HE group.</p><p><strong>Conclusion: </strong>Intestinal microbiota-related synergism may predict the risk of HE following TIPS placement in patients with HBV-related PH. Prophylactic microbiome therapies may be useful for preventing and treating HE after TIPS placement.</p>","PeriodicalId":23778,"journal":{"name":"World Journal of Gastroenterology","volume":null,"pages":null},"PeriodicalIF":4.3000,"publicationDate":"2024-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11346157/pdf/","citationCount":"0","resultStr":"{\"title\":\"Alterations in the gut microbiome after transjugular intrahepatic portosystemic shunt in patients with hepatitis B virus-related portal hypertension.\",\"authors\":\"Hong-Wei Zhao, Jin-Long Zhang, Fu-Quan Liu, Zhen-Dong Yue, Lei Wang, Yu Zhang, Cheng-Bin Dong, Zhen-Chang Wang\",\"doi\":\"10.3748/wjg.v30.i31.3668\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Gut microbiota (GM) affects the progression and response to treatment in liver diseases. The GM composition is diverse and associated with different etiologies of liver diseases. Notably, alterations in GM alterations are observed in patients with portal hypertension (PH) secondary to cirrhosis, with hepatitis B virus (HBV) infection being a major cause of cirrhosis in China. Thus, understanding the role of GM alterations in patients with HBV infection-related PH is essential.</p><p><strong>Aim: </strong>To evaluate GM alterations in patients with HBV-related PH after transjugular intrahepatic portosystemic shunt (TIPS) placement.</p><p><strong>Methods: </strong>This was a prospective, observational clinical study. There were 30 patients (with a 100% technical success rate) recruited in the present study. Patients with esophagogastric variceal bleeding due to HBV infection-associated PH who underwent TIPS were enrolled. Stool samples were obtained before and one month after TIPS treatment, and GM was analyzed using 16S ribosomal RNA amplicon sequencing.</p><p><strong>Results: </strong>One month after TIPS placement, 8 patients developed hepatic encephalopathy (HE) and were assigned to the HE group; the other 22 patients were assigned to the non-HE group. There was no substantial disparity in the abundance of GM at the phylum level between the two groups, regardless of TIPS treatment (all, <i>P</i> > 0.05). However, following TIPS placement, the following results were observed: (1) The abundance of <i>Haemophilus</i> and <i>Eggerthella</i> increased, whereas that of <i>Anaerostipes</i>, <i>Dialister</i>, <i>Butyricicoccus</i>, and <i>Oscillospira</i> declined in the HE group; (2) The richness of <i>Eggerthella</i>, <i>Streptococcus</i>, and <i>Bilophila</i> increased, whereas that of <i>Roseburia</i> and <i>Ruminococcus</i> decreased in the non-HE group; and (3) Members from the pathogenic genus <i>Morganella</i> appeared in the HE group but not in the non-HE group.</p><p><strong>Conclusion: </strong>Intestinal microbiota-related synergism may predict the risk of HE following TIPS placement in patients with HBV-related PH. 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引用次数: 0
摘要
背景:肠道微生物群(GM)会影响肝病的进展和对治疗的反应。肠道微生物群的组成多种多样,与肝病的不同病因有关。值得注意的是,在中国,乙型肝炎病毒(HBV)感染是肝硬化的主要病因,而肝硬化继发门静脉高压症(PH)患者的肠道微生物群发生了改变。目的:评估经颈静脉肝内门体系统分流术(TIPS)后 HBV 相关 PH 患者的基因组改变:这是一项前瞻性、观察性临床研究。本研究共招募了 30 名患者(技术成功率为 100%)。研究对象为因 HBV 感染相关 PH 引起食管胃底静脉曲张出血并接受 TIPS 的患者。在 TIPS 治疗前和治疗后一个月采集粪便样本,并使用 16S 核糖体 RNA 扩增片段测序分析 GM:结果:放置 TIPS 一个月后,8 名患者出现肝性脑病(HE),被分配到 HE 组;其他 22 名患者被分配到非 HE 组。无论 TIPS 治疗与否,两组患者的基因组学门类丰度没有实质性差异(全部,P > 0.05)。然而,放置 TIPS 后,观察到以下结果:(1)在 HE 组中,嗜血杆菌和卵菌的丰富度增加,而 Anaerostipes、Dialister、Butyricicoccus 和 Oscillospira 的丰富度下降;(2)在非 HE 组中,卵菌、链球菌和双嗜血杆菌的丰富度增加,而 Roseburia 和 Ruminococcus 的丰富度下降;以及(3)在 HE 组中出现了致病性摩根菌属的成员,而在非 HE 组中没有出现:结论:与肠道微生物群相关的协同作用可预测 HBV 相关 PH 患者置入 TIPS 后发生 HE 的风险。预防性微生物组疗法可能有助于预防和治疗 TIPS 置入后的 HE。
Alterations in the gut microbiome after transjugular intrahepatic portosystemic shunt in patients with hepatitis B virus-related portal hypertension.
Background: Gut microbiota (GM) affects the progression and response to treatment in liver diseases. The GM composition is diverse and associated with different etiologies of liver diseases. Notably, alterations in GM alterations are observed in patients with portal hypertension (PH) secondary to cirrhosis, with hepatitis B virus (HBV) infection being a major cause of cirrhosis in China. Thus, understanding the role of GM alterations in patients with HBV infection-related PH is essential.
Aim: To evaluate GM alterations in patients with HBV-related PH after transjugular intrahepatic portosystemic shunt (TIPS) placement.
Methods: This was a prospective, observational clinical study. There were 30 patients (with a 100% technical success rate) recruited in the present study. Patients with esophagogastric variceal bleeding due to HBV infection-associated PH who underwent TIPS were enrolled. Stool samples were obtained before and one month after TIPS treatment, and GM was analyzed using 16S ribosomal RNA amplicon sequencing.
Results: One month after TIPS placement, 8 patients developed hepatic encephalopathy (HE) and were assigned to the HE group; the other 22 patients were assigned to the non-HE group. There was no substantial disparity in the abundance of GM at the phylum level between the two groups, regardless of TIPS treatment (all, P > 0.05). However, following TIPS placement, the following results were observed: (1) The abundance of Haemophilus and Eggerthella increased, whereas that of Anaerostipes, Dialister, Butyricicoccus, and Oscillospira declined in the HE group; (2) The richness of Eggerthella, Streptococcus, and Bilophila increased, whereas that of Roseburia and Ruminococcus decreased in the non-HE group; and (3) Members from the pathogenic genus Morganella appeared in the HE group but not in the non-HE group.
Conclusion: Intestinal microbiota-related synergism may predict the risk of HE following TIPS placement in patients with HBV-related PH. Prophylactic microbiome therapies may be useful for preventing and treating HE after TIPS placement.
期刊介绍:
The primary aims of the WJG are to improve diagnostic, therapeutic and preventive modalities and the skills of clinicians and to guide clinical practice in gastroenterology and hepatology.