A shared mucosal gut microbiota signature in primary sclerosing cholangitis before and after liver transplantation

Abstract

Background and Aims: Several characteristic features of the fecal microbiota have been described in primary sclerosing cholangitis (PSC), whereas data on mucosal microbiota are less consistent. We aimed to use a large colonoscopy cohort to investigate key knowledge gaps, including the role of gut microbiota in PSC with inflammatory bowel disease (IBD), the effect of liver transplantation (LT), and whether recurrent PSC (rPSC) may be used to define consistent microbiota features in PSC irrespective of LT. Approach and Results:We included 84 PSC and 51 liver transplanted PSC patients (PSC-LT) and 40 healthy controls (HCs) and performed sequencing of the 16S ribosomal RNA gene (V3-V4) from ileocolonic biopsies.Intraindividual microbial diversity was reduced in both PSC and PSC-LT

Reply: The mucosal gut signature in primary sclerosing cholangitis before and after liver transplantation. Is the dysbiosis index really predictive for the recurrence of PSC?

“…We read with interest the letter from Mammadov et al [1] , commenting on our recent publication on the mucosal gut microbiome in primary sclerosing cholangitis (PSC) before and after liver transplantation and their comment that we understate the importance of the pretransplant mucosal microbiota on posttransplant liver health in PSC. [2] We acknowledge the likely important role of the pretransplant microbiome also for posttransplant health; and indeed, we believe our study corroborates this. Our finding of a shared mucosal gut microbiome before and after liver transplantation highlights the possibility that an unhealthy gut microbial ecology with disease-modifying properties present before the transplant could persist after transplantation and potentially drive the development of recurrent primary sclerosing cholangitis (rPSC).…”

Systematic review: microbial manipulation as therapy for primary sclerosing cholangitis

“…The etiopathogenic link between PSC and dysbiosis is further supported by a number of observations arising from experimental models of PSC 15 . Liver transplantation does not normalise the gastrointestinal microbiome, and some genera associated with PSC correlate with recurrent PSC after liver transplantation 16 …”

“… 15 Liver transplantation does not normalise the gastrointestinal microbiome, and some genera associated with PSC correlate with recurrent PSC after liver transplantation. 16 …”

“…15 Liver transplantation does not normalise the gastrointestinal microbiome, and some genera associated with PSC correlate with recurrent PSC after liver transplantation. 16 Emerging data demonstrate that manipulation of the gut microbiota holds promise as an effective therapeutic strategy in PSC. Oral…”

Can a mucosal microbiota signature predict disease severity, survival, and disease recurrence in PSC?

“…In the current study, Hole et al1 determined characteristic differences between mucosa-adherent microbiota of patients with PSC with/without inflammatory bowel disease (IBD), PSC patients with/without IBD following liver transplantation (PSC-LT), and healthy control subjects. Intraindividual microbial diversity was decreased in both PSC groups compared with controls.…”