The role of gut microbiota in clinical complications, disease severity, and treatment response in severe alcoholic hepatitis

Philips, Cyriac Abby; Augustine, Philip; Ganesan, Karthik; Ranade, Shatakshi; Chopra, Varun; Patil, Kunal; Shende, Sonie; Ahamed, Rizwan; Kumbar, Sandeep; Rajesh, Sasidharan; George, Tom; Mohanan, Meera; Mohan, Narain; Phadke, Nikhil; Rani, Mridula; Narayanan, Arjun; Jagan, Suchetha Moothat

doi:10.1007/s12664-021-01157-9

Cited by 13 publications

(11 citation statements)

References 39 publications

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“…Mutual interactions between Enterococcus cecorum, Acinetobacter schindleri, and Mitsuokella species correlated with kidney injury at admission. Upregulations of the phenylpropanoid biosynthesis pathway (associated with innate immunity) and the glycerophospholipid metabolism pathway (associated with cellular integrity) were observed in subjects without infections and in deceased subjects, respectively (35).…”

Section: Alcohol-associated Cirrhosis and Sahmentioning

confidence: 99%

Gut Microbiome and Alcohol-associated Liver Disease

Philips

Schnabl

Bajaj

2022

Journal of Clinical and Experimental Hepatology

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Alcohol-associated Cirrhosis and Sahmentioning

confidence: 99%

Gut Microbiome and Alcohol-associated Liver Disease

Philips

Schnabl

Bajaj

2022

Journal of Clinical and Experimental Hepatology

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“…Pediococcus was significantly more common in patients who died during follow-up after failing to respond to corticosteroid treatment. 30 31 Researchers assessed the intestinal virome and fungal communities (mycobiome) in patients with severe ALD in addition to the bacterial population. Patients who drank heavily had alcohol use disorder, developed progressive liver disease, and had significantly higher levels of Malassezia .…”

Section: Role Of Gut Microbiota In Liver Diseasementioning

confidence: 99%

Review: Microbial Therapeutics for Liver Disease

Philips,

Augustine

2023

Journal of Gastrointestinal Infections

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The human gut contains many microorganisms, including bacteria, fungi, viruses, and archaea. Patients with liver disorders have altered intestinal flora and disrupted gut barriers. The role of the gut microbiota in the pathophysiology of many liver disorders is apparent from preclinical models and clinical studies. High-quality studies showed that people with acute or chronic liver disorders of various etiologies, such as non–alcohol- and alcohol-related liver disease, chronic hepatitis virus infection, chronic cholestatic liver disease, and liver cirrhosis and related complications, have less diverse gut flora and associated perturbed microbial functional metabolism. In this review, we discuss unique therapeutic strategies for various liver diseases that involve manipulating the gut microbiota using various methods. We provide a summary of the most recent information on untargeted methods for treating liver illnesses, such as probiotics, prebiotics, and postbiotics, fecal microbiota transplantation, and precision microbiome-centered treatments (e.g., engineered microbes). Recent research suggests that altering the gut microbiota in various ways might slow the onset of liver disease and lessen the associated clinical complications. Growing evidence suggests that antimicrobial therapy with rifaximin can beneficially alter the gut microbiome to reduce hepatic encephalopathy, portal hypertension, and systemic inflammation in decompensated cirrhosis. At the same time, a healthy donor stool transplant improves transplant-free survival in severe alcohol-associated hepatitis, prevents hepatic encephalopathy, and reduces incident and intercurrent infections and multidrug resistance in decompensated cirrhosis.

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“…Specific microbiota and their interactions show promising results as an adjuvant treatment but not as individual therapy. 19…”

Section: Microbiota-based Precision Medicine In Aldmentioning

confidence: 99%

Expert consensus on the diagnosis and management of alcoholic liver disease

Solanki¹

2022

Int J Sci Rep

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<p>Alcoholic liver disease (ALD) is a spectrum of liver injuries caused due to harmful use of alcohol. It is the primary cause of liver disease and is responsible for around 4% of mortality worldwide. ALD progresses from fatty liver to alcoholic hepatitis depending upon risk factors, such as continued alcohol consumption or comorbid liver diseases. Screening and diagnosis are suggested for patients with histological symptoms and in high-risk populations. Management of ALD includes strategies such as abstinence from alcohol consumption, nutrition therapy, pharmacological therapy, and liver transplantation, with alcohol abstinence being the most beneficial to reverse fatty liver conditions. Various novel treatment approaches having distinct mechanisms of action are also developed besides conventional corticosteroid therapy, which include microbiota-based precision medicine, monoclonal antibody therapy, hepatocyte regeneration therapy, epigenetic modulators, liver degeneration boosters, and targeting the gut-liver axis. Ursodeoxycholic acid (UDCA) has shown to benefit ALD patients with cholestasis by exerting biochemical improvements; hence, it can be considered as an adjunct therapy. National and regional advisory board meetings were conducted to discuss the current diagnostic and management techniques, including existing and novel pharmacological treatments available for ALD along with current clinical practices in India.</p>

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The role of gut microbiota in clinical complications, disease severity, and treatment response in severe alcoholic hepatitis

Cited by 13 publications

References 39 publications

Gut Microbiome and Alcohol-associated Liver Disease

Gut Microbiome and Alcohol-associated Liver Disease

Review: Microbial Therapeutics for Liver Disease

Expert consensus on the diagnosis and management of alcoholic liver disease

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