Duodenal microbiota may play a role in liver cirrhosis

SAN DIEGO — Variation in duodenal microbiota was more pronounced in individuals with liver cirrhosis than in healthy controls, suggesting that these microbiota may be involved in cirrhosis, according to a presenter at DDW 2016.

“[W]e observed differences in fecal and duodenal composition between cirrhotics and controls, but not in sigmoid microbiota,” Daisy Jonkers, MD, of the department of internal medicine and the School for Nutrition, Toxicology and Metabolism at Maastricht University Medical Center in the Netherlands, said in her presentation. “The alterations were more pronounced with advanced liver cirrhosis.”

Daisy Jonkers

Jonkers and colleagues aimed to assess differences in the fecal and mucosa-associated microbiota in a cohort of patients with liver cirrhosis vs. healthy controls; while taking into account disease-related factors.

They used the 16S-23S interspacer region-based profiling method (IS-pro, IS Diagnostics) to assess intestinal microbiota. “It is highly variable at the sequence level and used for typing of bacteria at the strain level,” Jonkers said. “It is readily applicable in clinical practice for on-demand analyses.”

The study included 27 healthy controls, 26 patients with compensated cirrhosis and 16 patients with decompensated cirrhosis. The researchers took fecal samples, duodenal biopsies and sigmoid biopsies.

The researchers investigated firmicutes and bacteroidetes of liver microbiota in the study populations.

Results from the fecal samples demonstrated higher median richness and diversity in firmicutes in cirrhotics compared with controls, according to Jonkers. Lower median richness for bacteroidetes was observed in cirrhotics compared with controls. “We observed large variation in fecal samples in compensated patients vs. controls,” she said.

The researchers also observed distinct clusters of fecal samples based on disease severity as measured by Child Pugh score, but not as a function of demographics, disease etiology or medication use, according to the findings. “There was a significant impact on health status,” Jonkers said.

Duodenal biopsy results indicated an increase in median richness for firmicutes in compensated cirrhotics vs. controls. “The variation within the cirrhotic group was lower than in the controls,” Jonkers said.

However, the researchers observed no significant differences in the microbiota of cirrhotics and controls as assessed by sigmoid biopsy.

Jonkers added that the findings support the potential of IS-pro as a disease progression marker in clinical practice. “Duodenal microbiota might be involved in liver cirrhosis,” she said. – by Rob Volansky

Reference

Tedjo D, et al. Abstract #1098. Presented at: Digestive Disease Week; May 21-24, 2016; San Diego.

Disclosures: Jonkers reports no relevant financial disclosures.