Gut microbiome signature may help detect advanced fatty liver
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Results of a recently published study revealed preliminary evidence for a fecal-microbiome-derived metagenomic signature to detect advanced fibrosis in patients with nonalcoholic fatty liver disease.
“We found that the gut microbiomes in NAFLD are dominated by members of Firmicutes and Bacteroidetes, followed by Proteobacteria and Actinobacteria in much lower abundances,” Rohit Loomba, MD, MHSc, director of the NAFLD Research Center, UC San Diego Health, and professor of medicine at UC San Diego School of Medicine, and colleagues wrote. “However, as the disease progresses from mild/moderate NAFLD to advanced fibrosis, the Proteobacteria phylum has a statistically significant increase in abundance while the Firmicutes phylum decreases.”
The researchers enrolled 86 patients with biopsy-proven NAFLD to undergo whole-genome shotgun sequencing of DNA that was extracted from their stool samples to determine gut microbiome compositions. Mean patient age was 48 years and 48 were women. Seventy-two patients had mild-to-moderate NALFD and 14 had advanced NAFLD.
Patients with advanced fibrosis were more likely to be older, Hispanic, have diabetes, higher alanine aminotransferase and aspartate aminotransferase, higher HbA1c, more severe lobular and portal inflammation and ballooning, and lower platelet count compared with patients with mild to moderate fibrosis.
While the gut microbiomes in both groups were dominated by Firmicutes and Bacteroidetes, each were differentially abundant between the advanced fibrosis group and the mild-to-moderate group (P < .05). Firmicutes was higher in the mild to moderate group and Proteobacteria was higher in the advanced group.
The most abundant species-level organisms in the mild to moderate group were Eubacterium (median 2.5%) and Bacteroides vulgatus (median 1.7%). In the advanced group, the most abundant organisms were Bacteroides vulgatus (median 2.2%) and Escherichia coli (median 1%). Ruminococcus obeum CAG: 39, R. obeum and Eubacterium rectale were significantly lower in the advanced group compared with the mild to moderate group.
“The results suggest that microbial biomarkers can be used to diagnose metabolic and fibrotic diseases and present an adjunct tool to current invasive approaches to determine stage of liver disease,” the researchers wrote. “We believe that our study sets the stage to explore the potential role of a stool-based test to detect advanced fibrosis in the future.” – by Talitha Bennett
Disclosure s : The researchers report relevant financial disclosures.