Exploratory Research on the Relationship between Human Gut Microbiota and Portal Hypertension

Abstract

Objective The relationship between gut microbiota and portal hypertension remains unclear. We investigated the characteristics of the gut microbiota in portal hypertension patients with esophago-gastric varices and liver cirrhosis. Methods Thirty-six patients (12 patients with portal hypertension, 12 healthy controls, and 12 non-cirrhosis patients) were enrolled in this university hospital study. Intestinal bacteria and statistical analyses were performed up to the genus level using the terminal restriction fragment length polymorphism method targeting 16S ribosomal RNA genes, with diversified regions characterizing each bacterium. Results Levels of Lactobacillales were significantly higher (p=0.045) and those of Clostridium cluster IV significantly lower (p=0.014) in patients with portal hypertension than in other patients. This Clostridium cluster contains many butanoic acid-producing strains, including Ruminococcace and Faecalibacterium prausnitzii. Clostridium cluster IX levels were also significantly lower (p=0.045) in portal hypertension patients than in other patients. There are many strains of Clostridium that produce propionic acid, and the effects on the host and the function of these bacterial species in the human intestine remain unknown. Regarding the Bifidobacterium genus, which is supposed to decrease as a result of cirrhosis, no significant decrease was observed in this study. Conclusion In the present study, we provided information on the characteristics of the gut microbiota of portal hypertension patients with esophago-gastric varices due to liver cirrhosis. In the future, we aim to develop probiotic treatments following further analyses that include the species level, such as the intestinal flora analysis method and next-generation sequencers.

Profile of Gut Bacteria in Hypertensive Patients Based on Terminal Restriction Fragment Length Polymorphism Analysis

“…Our results showed that the Prevotella and Bacteroides groups had a low abundance in hypertensive patients. Such phenomenon has also been reported in portal hypertension patients in japan (Yokoyama et al 2020), level 3 hypertensive patients (Mushtaq et al (2019) and on pulmonary hypertension patients (Kim et al 2020). The low abundance of Prevotella group on hypertensive patients was also confirmed in the previous study (Dan et al 2019).…”

“…Unique composition of gut microbiota in each sample can be influenced by various things, such as food, intestinal mucosa, drug consumption/abuse, the immune system, and the microbiota itself (Maiuolo et al 2022). Yokoyama et al (2020) have report that blood pressure will be lower in those who consume vegetarian foods than omnivorous foods. Nakayama et al (2015) report that the microbiota profiles of children up to old age in Indonesia are similar and have Prevotella enterotype.…”

“…Several factors can change gut microbiota, including the type of food, lifestyle, medicine, environment and geography (Gupta et al 2017). In Japan, Yokoyama et al (2020) explored the gut microbiota in 12 portal hypertensive patients using the T-RFLP method. They showed an increase in the Lactobacillales and Prevotella groups, while the Bacteroides group was high in normal.…”

Role of Gut Microbiota in Pulmonary Arterial Hypertension

“…Apart from idiopathic PAH (IPAH), PAH is always associated with other conditions, including infectious disorders [such as human immunodeficiency virus (HIV) (Vujkovic-Cvijin and Somsouk, 2019) and schistosomiasis infection (Jenkins et al, 2018;Floudas et al, 2019;Hu et al, 2020)], portal hypertension (Yokoyama et al, 2020), and connective tissue diseases [systemic lupus erythematosus (SLE) (Luo et al, 2018), multiple sclerosis (Chen et al, 2016), and rheumatoid arthritis (RA) (Lerner and Matthias, 2015;Manasson et al, 2018)], and these primary diseases are usually accompanied with gut dysbiosis. The potential association between the primary disease and gut dysbiosis in PAH needs to be investigated.…”

The Effect of Whole-Grain Diet on the Gut Microbiota of the Elderly Individuals

“…Studies have shown that gut microbiota is related to the occurrence and development of various diseases ( 6 , 7 ). Recently, large-scale observational epidemiological studies and animal studies have suggested that microbial disorder and hypertension might be causally related ( 8 , 9 ). There may be some connection between Firmicutes/Bacteroidetes ratio and blood pressure ( 10 ).…”