Microbiome as a potential diagnostic and predictive biomarker in severe alcoholic hepatitis

Abstract

SummaryBackgroundSevere alcoholic hepatitis (AH) is the most aggressive form of alcohol‐related liver disease with high mortality. The microbiome is an emerging therapeutic target in alcohol‐related liver disease.AimsTo investigate the microbiome composition in patients with severe AH, and to determine microbiome recovery after rifaximin treatment in gut bacteria and bacteria derived‐extracellular vesicles.MethodsWe enrolled 24 patients with severe AH and 24 healthy controls. Additional faecal samples were collected after 4 weeks in 8 patients with severe AH who completed rifaximin treatment. Treatment response was defined based on Lille score model after 7 days of treatment. Metagenomic profiling was performed using 16S ribosomal RNA amplicon sequencing.ResultsFaecal microbiomes of patients with severe AH had lower alpha diversity and higher beta diversity than those of healthy controls in both gut bacteria and extracellular vesicles. Bacilli, Lactobacillales and Veillonella were significantly increased in the gut bacteria of patients with severe AH, and Veillonella, Veillonella parvula group and Lactobacillales were significantly increased in the extracellular vesicles of patients with severe AH. Eubacterium_g23, Oscillibacter and Clostridiales decreased in the gut bacteria of patients with severe AH, and Eubacterium_g23, Oscillibacter and Christensenellaceae decreased in the extracellular vesicles of patients with severe AH. After rifaximin treatment, 17 taxa in the gut bacteria and 23 taxa in extracellular vesicles were significantly restored in patients with severe AH. In common, Veillonella and Veillonella parvula group increased in patients with severe AH and decreased after rifaximin treatment, and Prevotella and Prevotellaceae decreased in patients with severe AH and increased after rifaximin treatment. Treatment non‐responders showed a significantly lower abundance of Prevotella at baseline than did treatment responders.ConclusionDysbiosis was confirmed in severe AH but was alleviated by rifaximin treatment. Taxa associated with severe AH can be candidate biomarkers or therapeutic targets.

Metagenomic 16S rRNA analysis and predictive functional profiling revealed intrinsic organohalides respiration and bioremediation potential in mangrove sediment

“…different functional profiles on a cutoff value of P < 0.05 [ 39 ]. Heatmaps visualizing functional biomarker distribution were generated with the SRplot online tool ( https://www.bioinformatics.com.cn/en ).…”

Integrated microbiome and metabolome analysis reveals the interaction between intestinal flora and serum metabolites as potential biomarkers in hepatocellular carcinoma patients

“…Veillonella was found to be associated with autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), HBV infection, and alcoholic hepatitis, among other liver diseases that are highly correlated with liver function indicators and liver inflammation, according to previous research ( Wei et al., 2020 ; Kim et al., 2021 ). Veillonella was also found to be positively related to AFP, a clinical indicator of HCC ( Zhang et al., 2019 ).…”

Fungal signature differentiates alcohol-associated liver disease from nonalcoholic fatty liver disease

“… 9 , 39 On the other hand, common fecal signatures of alcohol-associated hepatitis include increased Bacilli, Lactobacillales, Veillonella , and decreased Bacteroides , Akkermansia , Eubacterium , Oscillibacter and Clostridiales compared with healthy controls. 40 , 41 Patients with alcohol use disorder also have decreased Akkermansia compared with controls but increased Bacteroides . 42 Enterococcus faecalis and presence of its secreted protein cytolysin predict disease severity and mortality in alcohol-associated hepatitis.…”