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Interaction of bacterial metagenome and virome in patients with cirrhosis and hepatic encephalopathy
- Source :
- Gut. 70:1162-1173
- Publication Year :
- 2020
- Publisher :
- BMJ, 2020.
-
Abstract
- ObjectiveAltered bacterial composition is associated with disease progression in cirrhosis but the role of virome, especially phages, is unclear.DesignCross-sectional and pre/post rifaximin cohorts were enrolled. Cross-sectional: controls and cirrhotic outpatients (compensated, on lactulose (Cirr-L), on rifaximin (Cirr-LR)) were included and followed for 90-day hospitalisations. Pre/post: compensated cirrhotics underwent stool collection pre/post 8 weeks of rifaximin. Stool metagenomics for bacteria and phages and their correlation networks were analysed in controls versus cirrhosis, within cirrhotics, hospitalised/not and pre/post rifaximin.ResultsCross-sectional: 40 controls and 163 cirrhotics (63 compensated, 43 Cirr-L, 57 Cirr-LR) were enrolled. Cirr-L/LR groups were similar on model for end-stage liver disease (MELD) score but Cirr-L developed greater hospitalisations versus Cirr-LR (56% vs 30%, p=0.008). Bacterial alpha/beta diversity worsened from controls through Cirr-LR. While phage alpha diversity was similar, beta diversity was different between groups. Autochthonous bacteria linked negatively, pathobionts linked positively with MELD but only modest phage-MELD correlations were seen. Phage–bacterial correlation network complexity was highest in controls, lowest in Cirr-L and increased in Cirr-LR. Microviridae and Faecalibacterium phages were linked with autochthonous bacteria in Cirr-LR, but not Cirr-L hospitalised patients had greater pathobionts, lower commensal bacteria and phages focused on Streptococcus, Lactococcus and Myoviridae. Pre/post: No changes in alpha/beta diversity of phages or bacteria were seen postrifaximin. Phage–bacterial linkages centred around urease-producing Streptococcus species collapsed postrifaximin.ConclusionUnlike bacteria, faecal phages are sparsely linked with cirrhosis characteristics and 90-day outcomes. Phage and bacterial linkages centred on urease-producing, ammonia-generating Streptococcus species were affected by disease progression and rifaximin therapy and were altered in patients who experienced 90-day hospitalisations.
- Subjects :
- Liver Cirrhosis
Male
medicine.medical_specialty
Cirrhosis
Firmicutes
medicine.disease_cause
Gastroenterology
Rifaximin
End Stage Liver Disease
Feces
Lactulose
Liver disease
chemistry.chemical_compound
Gastrointestinal Agents
Internal medicine
Lactococcus
Microviridae
medicine
Humans
Human virome
Hepatic encephalopathy
Faecalibacterium
Aged
biology
Virome
Streptococcus
business.industry
Patient Acuity
Middle Aged
medicine.disease
biology.organism_classification
Anti-Bacterial Agents
Hospitalization
Cross-Sectional Studies
chemistry
Hepatic Encephalopathy
Myoviridae
Disease Progression
Metagenome
Microbial Interactions
Female
Metagenomics
business
Bacteria
medicine.drug
Subjects
Details
- ISSN :
- 14683288 and 00175749
- Volume :
- 70
- Database :
- OpenAIRE
- Journal :
- Gut
- Accession number :
- edsair.doi.dedup.....229c268f2136b6baa8b3ffe6821dce9d