Potential role of intestinal microflora in disease progression among patients with different stages of Hepatitis B

Abstract

Background Increasing evidence demonstrate that the gut microbiota is involved in the pathogenesis of liver diseases, and faecal microbiota transplantation is considered to be a promising new treatment option. However, there are no reports on the intestinal flora of asymptomatic HBV carriers using next-generation sequencing. This study intends to investigate the potential role of the intestinal microflora in predicting the progression of Hepatitis B patients in different non-cancerous stages. Results A total of 266 patients with different stages of Hepatitis B and 31 healthy controls were included in this study. Some of the subjects (217 cases) underwent 16S rRNA gene sequencing. Compared with the control group (CK), the α diversity of patients in Group A (HBV carrier) slightly increased, while that of patients in the other three groups decreased. Each group of patients, especially those in Group C (cirrhosis) and Group D (acute-on-chronic liver failure), could be separated from the CK using weighted UniFrac PCoA and ANOSIM. LEfSe revealed that 40 taxa belonging to three phyla had an LDA larger than 4. In addition to the comparison between Group B (chronic Hepatitis B) and Group C, the specific flora and potential taxonomic function were also identified. Different microbial communities were found to be highly correlated with clinical indicators and the Child-Pugh scores. Changes in the microbial community were highly related to the alternations of host metabolism, which in turn, was related to the development of Hepatitis B. Our analysis identified a total of 47 strains with potential biomarker functions at all levels except for the phylum level. Conclusions Faecal microbiota transplantation of some potential beneficial bacteria can change with the occurrence of disease, and HBV carriers might be the most suitable donors.

Microbiota and viral hepatitis: State of the art of a complex matter

“…HBV carriers might be suitable donors for FMT as their GM composition seems to be more appropriate compared to the healthy population. The results of Yang et al [ 108 ] confirmed that HBV carriers have altered GM although they are asymptomatic. The high treatment FMT potential from HBV carriers comes from the evidence that they are able to keep a long-life balance with the virus without developing clinical symptoms.…”

“…Different therapeutic approaches have been proposed to improve the health of patients with chronic viral hepatitis through the manipulation of GM composition, the modulation of immune signaling, and the production of metabolites[ 88 , 108 ]. It was found that some bacteria of the intestinal microbiota disappeared in patients who received antibiotics within 3 mo[ 109 ].…”

“…It is speculated that region and eating habits might affect the flora of HBV positive patients[ 109 ]. Fecal microbiota transplantation (FMT) is considered a promising new treatment option for HBV and HCV infection, due to its ability to restore GM dysbiosis[ 108 ].…”

“…The results of Doskali et al [ 113 ] suggested that a healthy GM increases the cytotoxic effects of NK cells against viral infected cells; thus, inhibiting HCV replication. Finally, Yang et al [ 108 ] confirmed that some probiotics, such as lactic acid bacteria, may have a negative impact on disease progression. The results of Yang et al [ 108 ] indicated that the intake of Lactobacillus should be cautious as these bacteria are negatively associated with environmental adaptation, energy metabolism, and the immune system and may have an influence on the progression of HBV infection[ 70 , 108 ].…”

Fecal Microbiota Transplantation in Patients with HBV Infection or Other Chronic Liver Diseases: Update on Current Knowledge and Future Perspectives

“…Indeed, if minimal alterations of the gut microbiota are reported in patients with chronic HBV infection, the worsening of liver disease is associated with the decrease in beneficial species, such as Roseburia and Ruminococcus, and the increase in other potentially pathogenic species, such as Escherichia, Shigella, Klebsiella, Enterococcus and Veillonella. In patients affected by HBV-related acute on chronic liver failure, Enterococcus, Klebsiella, Lactobacillus, Veillonella, and Escherichia-Shigella become dominant [33].…”