Intestinal Microbiota Was Assessed in Cirrhotic Patients with Hepatitis B Virus Infection

Abstract

To unravel the profile of intestinal microecological parameters in Chinese patients with asymptomatic carriage of hepatitis B virus (HBV), chronic hepatitis B, decompensated HBV cirrhosis, and health controls and to establish their correlation with liver disease progression, we performed quantitative PCR and immunological techniques to investigate fecal parameters, including population of fecal predominant bacteria and the abundance of some virulence genes derived from Escherichia coli, Bacteroides fragilis, Clostridium difficile, and Clostridium perfringens in fecal crude DNA and some immunological parameters in extracts of all fecal samples. Data analysis indicated that 16S rRNA gene copy numbers for Faecalibacterium prausnitzii, Enterococcus faecalis, Enterobacteriaceae, bifidobacteria, and lactic acid bacteria (Lactobacillus, Pediococcus, Leuconostoc, and Weissella) showed marked variation in the intestine of HBV cirrhotic patients. The Bifidobacteria/Enterobacteriaceae (B/E) ratio, which may indicate microbial colonization resistance of the bowel, was decreased significantly in turn from 1.15 ± 0.11 in healthy controls, 0.99 ± 0.09 in asymptomatic carriers, and 0.76 ± 0.08 in patients with chronic hepatitis B to 0.64 ± 0.09 in patients with decompensated HBV cirrhosis (for all, P < 0.01). This suggests that B/E ratio is useful for following the level of intestinal microecological disorder in the course of liver disease progression. The data for virulence gene abundance suggested increased diversity of virulence factors during liver disease progression. Fecal secretory IgA and tumor necrosis factor-α in decompensated HBV cirrhotic patients were present at higher levels than in other groups, which indicates that a complicated autoregulatory system tries to achieve a new intestinal microecological balance.

Comparison of the Gut Microbe Profiles and Numbers Between Patients with Liver Cirrhosis and Healthy Individuals

“…While the B/E ratio from this study was lower in patients with liver cirrhosis than that in the healthy group, suggesting that the intestinal colonization resistance was reduced in cirrhotic patients. Similar results were reported by other author [24].…”

“…In this study, real-time PCR was utilized to obtain a quantitative estimation of the Enterobacteriaceae, Enterococcus, and Bifidobacterium genus in the two groups. The results revealed that Enterobacteriaceae and Enterococcus increased dramatically in the cirrhotic group, which corresponded with some current reports on liver damage [22,24]. This investigation on alternation may shed some light on the pathological mechanism of liver cirrhosis.…”

“…This may indicate that the inadequate Bifidobacterium in gut microbiota might be a risk factor for the development of cirrhosis but not the decisive factor. The Bifidobacterium/Enterobacteriaceae (B/E) ratio usually reflects the ability of the bowel to counteract pathogen colonization [17,34], which is called colonization resistance [24]. While the B/E ratio from this study was lower in patients with liver cirrhosis than that in the healthy group, suggesting that the intestinal colonization resistance was reduced in cirrhotic patients.…”

Effect by Intestinal Microbiom on the Progression of Viral Hepatitis

“…Дегидроксилирование желчных кислот [33,56] [43,59,61,63]. Несмотря на то, что печень не находится в непосредственном контакте с живыми мик-роорганизмами, населяющими желудочно-кишечный тракт, безоговорочным является тот факт, что любые нарушения микробиоце-ноза кишечника оказывают неизбежно отри-цательное влияние на патофизиологическое и морфофункциональное состояние печени вследствие воздействия микробных патоген-ассоциированных молекулярных паттернов (PAMPs) -эндотоксинов (липополисахаридов), бактериальных метаболитов, а также бактери-альной ДНК и компонентов клеточной стенки [48].…”

Probiotics and Liver Disease

“…12 Another report indicated a progressive decrease in the ratio of Bifidobacterium to Enterobacteriaceae accompanying progression of liver disease in a range of subjects, from healthy controls to subjects with decompensated hepatitis B virus cirrhosis to asymptomatic carriers and subjects with chronic hepatitis B. 13 This indicates that changes in gut microbiota seem to mirror changes in severity of disease. The TLR 4/lipopolysaccharide interaction may be the link modulating this relationship; the role of this interaction in fibrogenesis is increasingly recognized.…”