粪便明胶酶不能预测酒精相关性肝炎患者的死亡率。

IF 4.1 3区 生物学 Q2 CELL BIOLOGY Microbial Cell Pub Date : 2024-08-26 eCollection Date: 2024-01-01 DOI:10.15698/mic2024.08.836
Yongqiang Yang, Phillipp Hartmann, Bernd Schnabl
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引用次数: 0

摘要

酒精相关性肝病在全球范围内发病率很高,其中酒精相关性肝炎是一种严重的肝病,具有发病率高、死亡率高和经济负担重的特点。肠道细菌失调与酒精相关性肝炎的恶化有关。病原菌粪肠球菌(E. faecalis)分泌的粪便细胞溶解素与酒精相关性肝炎患者死亡率的增加有关。虽然明胶酶被认为是粪肠球菌的毒力因子,但其流行程度及其对酒精相关性肝炎患者预后的影响仍不清楚。在这项研究中,65 名酒精相关性肝炎患者中有 20 人(30.8%)的粪便中检测出明胶酶呈阳性。明胶酶阳性和明胶酶阴性患者的 30 天和 90 天死亡率无明显差异(分别为 p=0.97 和 p=0.48)。与其他已确定的肝病标志物相比,粪便明胶酶对 30 天死亡率(曲线下面积 [AUC] 0.50 vs 纤维化-4 指数 (FIB-4) 0.75)和 90 天死亡率(AUC 0.57 vs FIB-4 0.79 或 "年龄、血清胆红素、INR 和血清肌酐"(ABIC)评分 0.78)的判别能力较低。此外,根据随机森林分析,粪便明胶酶不是 30 天或 90 天死亡率的重要特征。最后,与明胶酶阴性的患者相比,明胶酶阳性的酒精相关性肝炎患者并没有表现出更严重的肝病。总之,粪便明胶酶不能预测我们队列中酒精相关性肝炎患者的死亡率或疾病严重程度。
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Fecal gelatinase does not predict mortality in patients with alcohol-associated hepatitis.

Alcohol-associated liver disease is highly prevalent worldwide, with alcohol-associated hepatitis as a severe form characterized by substantial morbidity, mortality, and economic burden. Gut bacterial dysbiosis has been linked to progression of alcohol-associated hepatitis. Fecal cytolysin secreted by the pathobiont Enterococcus faecalis (E. faecalis) is associated with increased mortality in patients with alcohol-associated hepatitis. Although gelatinase is considered a virulence factor in E. faecalis, its prevalence and impact on alcohol-associated hepatitis patient outcomes remains unclear. In this study, 20 out of 65 (30.8%) patients with alcohol-associated hepatitis tested positive for gelatinase in their stool. There were no significant differences in 30-day and 90-day mortality between gelatinase-positive and gelatinase-negative patients (p=0.97 and p=0.48, respectively). Fecal gelatinase had a low discriminative ability for 30-day mortality (area under the curve [AUC] 0.50 vs fibrosis-4 Index (FIB-4) 0.75) and 90-day mortality compared with other established liver disease markers (AUC 0.57 vs FIB-4 0.79 or 'age, serum bilirubin, INR, and serum creatinine' (ABIC) score 0.78). Furthermore, fecal gelatinase was not an important feature for 30-day or 90-day mortality per random forest analysis. Finally, gelatinase-positive patients with alcohol-associated hepatitis did not exhibit more severe liver disease compared with gelatinase-negative patients. In conclusion, fecal gelatinase does not predict mortality or disease severity in patients with alcohol-associated hepatitis from our cohort.

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来源期刊
Microbial Cell
Microbial Cell Multiple-
CiteScore
6.40
自引率
0.00%
发文量
32
审稿时长
12 weeks
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