Jiang QR, Zeng DW. Gut microbiota shifts in hepatitis B-related portal hypertension after transjugular intrahepatic portosystemic shunt: Mechanistic and clinical implications. World J Gastroenterol 2025; 31(3): 100752 [DOI: 10.3748/wjg.v31.i3.100752]
Corresponding Author of This Article
Da-Wu Zeng, MD, Chief Doctor, Department of Infectious Diseases, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Fuzhou 350004, Fujian Province, China. zengdw1980@fjmu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jan 21, 2025; 31(3): 100752 Published online Jan 21, 2025. doi: 10.3748/wjg.v31.i3.100752
Gut microbiota shifts in hepatitis B-related portal hypertension after transjugular intrahepatic portosystemic shunt: Mechanistic and clinical implications
Qi-Rong Jiang, Da-Wu Zeng
Qi-Rong Jiang, Department of Hepatology, Hepatology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou 350005, Fujian Province, China
Da-Wu Zeng, Department of Infectious Diseases, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350004, Fujian Province, China
Author contributions: Jiang QR was responsible for writing of original draft; Zeng DW was responsible for conceptualization, writing of review and editing.
Supported by Clinical Research Center for Hepatopathy and Intestinal Diseases of Fujian Province, No. 2023GBYJ-YL-1.
Conflict-of-interest statement: Both authors have no financial relationships to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Da-Wu Zeng, MD, Chief Doctor, Department of Infectious Diseases, The First Affiliated Hospital of Fujian Medical University, No. 20 Chazhong Road, Fuzhou 350004, Fujian Province, China. zengdw1980@fjmu.edu.cn
Received: August 26, 2024 Revised: November 7, 2024 Accepted: November 28, 2024 Published online: January 21, 2025 Processing time: 116 Days and 19.9 Hours
Abstract
In this article, we provide commentary on the recent article by Zhao et al. We focus on the shifts in the gut microbiota of patients with hepatitis B virus (HBV)-associated cirrhosis/portal hypertension (PH) following transjugular intrahepatic portosystemic shunt (TIPS) and the implications for understanding the mechanisms, diagnosis, and treatment. By comparing the gut microbiota composition and dynamic changes before and after TIPS in patients with and without hepatic encephalopathy, the authors found an increase in non-probiotic bacteria in those who developed hepatic encephalopathy post-TIPS, with Morganella species present only in the hepatic encephalopathy group. The gut microbiota changes post-TIPS among patients without the occurrence of hepatic encephalopathy suggest potential therapeutic benefits through prophylactic microbiome therapies. Furthermore, the specific gut microbiota alterations may hold promise to predict the risk of hepatic encephalopathy in individuals undergoing TIPS for HBV-related PH. Despite these promising findings, future studies are needed to address limitations, including a small sample size, a relatively short evaluation period for gut microbiota alterations, the absence of data on dynamic alterations in gut microbiota post-TIPS and their correlation with blood ammonia levels, and the lack of validation in animal models. In conclusion, Zhao et al's study has shed new light on the link of gut microbiota with post-TIPS hepatic encephalopathy, potentially through the intricate gut-liver axis, and has important clinical implications for improving the management of patients with HBV-related PH.
Core Tip: Shifts in gut microbiome composition are closely related to hepatic encephalopathy, yet there is limited research on changes before and after transjugular intrahepatic portosystemic shunt (TIPS) in hepatitis B virus-related portal hypertension patients. The findings by Zhao et al highlight the potential involvement of the bacterial genus Morganella in post-TIPS hepatic encephalopathy. Meanwhile, they also emphasize the importance of the elevation of probiotics in post-TIPS patients without hepatic encephalopathy. Future studies with a larger sample size and a longer evaluation period are needed to address dynamic gut microbiota changes post-TIPS, their correlation with blood ammonia levels, and clinical outcomes.
