Altered faecal microbiota on the expression of Th cells responses in the exacerbation of patients with hepatitis E infection

Abstract

Fulminant hepatitis E may lead to acute liver failure (ALF). Perturbations of intestinal microbiota are related to severe liver disease. To study the correlations between faecal microbiota and the occurrence and exacerbation of hepatitis E virus (HEV) infection, we characterized 24 faecal samples from 12 patients with acute hepatitis E (AHE) and 12 patients with HEV-ALF using high-throughput sequencing. We found both the alpha and beta diversity indices showed no significant differences between the AHE and HEV-ALF groups. Several predominant taxa were significantly different between the AHE and HEV-ALF groups. Most notably, the HEV-ALF group had increased levels of Gammaproteobacteria, Proteobacteria, Xanthomonadceae and Stenotrophomonas, but reduced levels of Firmicutes, Streptococcus, Subdoligranulum and Lactobacillus, compared with the AHE group. The levels of Lactobacillaceae and Gammaproteobacteria could be used to distinguish patients with HEV-ALF from those with AHE. In addition, the level of Th lymphocytes was significantly lower in the HEV-ALF group than in the AHE group. The relative abundances of Lactobacillaceae and Gammaproteobacteria were positively correlated with Th lymphocytes, serum international normalized ratio (INR) and hepatic encephalopathy severity. Moreover, surviving patients had higher levels of Lactobacillus mucosae than deceased patients. Our study demonstrated that the presence of altered faecal microbiota is associated with exacerbation of HEV infection; this finding may be useful for exploring the interactions among faecal microbiota, immune responses, mechanisms of infection and progression in patients with HEV, as well as for the development of novel diagnostic and therapeutic strategies.

Uterine Injury Caused by Genotype 4 Hepatitis E Virus Infection Based on a BALB/c Mice Model

“…This outcome indicated that HEV infection promoted the expression of ERAb, CK7, VIM, and VEGF and accelerated adverse pregnancy outcomes. The inhibition of ER-α expression by HEV infection has been confirmed in pregnant women and HEV cell cultures [16,17]. In the present study, ER-α expression was significantly suppressed in the uteruses of HEV-infected pregnant mice or mice that had experienced miscarriage.…”

“…The reduction in ER-α expression inhibited the phosphorylation of S6 in the PI3K-AKT-mTOR signaling pathway and subsequently increased HEV replication [18]. Our previous studies have shown that HEV infection regulates estrogen signaling pathways by inhibiting the cAMPK-PKA-CREB and PI3K-AKT-mTOR signaling pathways [17,18]. Thus, the dysregulation of genes in the uterus may be responsible for adverse pregnancy outcomes.…”

Changes and Clinical Significance of PIVKA-II in Hepatitis E Patients

“…Hepatitis E cases were defined based on positive serum anti-HEV IgM, combined with clinical presentation of acute hepatitis (e.g., elevated liver enzymes and/or jaundice and/or non-specific symptoms, such as fatigue, itching, and nausea). The following exclusion criteria were established as previously reported ( 7 ): (1) use of antibiotics during the previous month; (2) current bacterial or fungal infections; (3) co-infection with hepatitis A virus, hepatitis B virus, or hepatitis C virus, or the presence of alcoholic fatty liver disease; (4) drug-induced liver disease; (5) autoimmune liver disease; (6) liver cancer, reproductive embryonic cancer, and/or female pregnancy; (7) co-infection with cytomegalovirus or Epstein–Barr virus; (8) presence of metabolic associated fatty liver disease; (9) approval for liver transplantation; and (10) incomplete data.…”

Oral–Gut Microbiome Axis in Gastrointestinal Disease and Cancer

“…The enteric viruses can interact with the gut microbiota in both direct and indirect manners, resulting in devastating effects on the gut microbial ecosystem [ 97 , 98 ]. HEV infection has been reported to increase the abundance of Lactobacillaceae and Gammaproteobacteria in the fecal samples of patients with acute liver failure [ 99 ]. In contrast, supplementation with the probiotic bacterium Enterococcus faecium NCIMB 10415 can effectively promote HEV removal in infected pigs [ 100 ].…”