Xu XT, Jiang MJ, Fu YL, Xie F, Li JJ, Meng QH. Gut microbiome composition in patients with liver cirrhosis with and without hepatic encephalopathy: A systematic review and meta-analysis. World J Hepatol 2025; 17(1): 100377 [DOI: 10.4254/wjh.v17.i1.100377]
Corresponding Author of This Article
Qing-Hua Meng, PhD, Professor, Interventional Therapy Center for Oncology, Beijing YouAn Hospital, Capital Medical University, No. 8 Xitoutiao, Youanmen Wai, Fengtai District, Beijing 100069, China. meng_qh0805@ccmu.edu.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Meta-Analysis
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/
Xiao-Tong Xu, Yun-Lai Fu, Fang Xie, Beijing Institute of Hepatology, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China
Xiao-Tong Xu, Yun-Lai Fu, Jian-Jun Li, Qing-Hua Meng, Interventional Therapy Center for Oncology, Beijing YouAn Hospital, Capital Medical University, Beijing 100069, China
Min-Jie Jiang, Department of Infectious Diseases, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250000, Shandong Province, China
Co-first authors: Xiao-Tong Xu and Min-Jie Jiang.
Co-corresponding authors: Jian-Jun Li and Qing-Hua Meng.
Author contributions: Xu XT and Jiang MJ made equal contributions to the data analysis and manuscript writing as co-first authors of this manuscript; Xu XT, Jiang MJ, and Fu YL contributed to the literature database retrieval, data collection, and data extraction; Xu XT, Xie F, Li JJ, and Meng QH conceptualized the topic; Li JJ, Xie F, and Meng QH reviewed the article; Li JJ and Meng QH participated and provided valuable feedback, ensuring the quality of the article and contributing as co-corresponding authors; and all authors thoroughly reviewed and endorsed the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: Qing-Hua Meng, PhD, Professor, Interventional Therapy Center for Oncology, Beijing YouAn Hospital, Capital Medical University, No. 8 Xitoutiao, Youanmen Wai, Fengtai District, Beijing 100069, China. meng_qh0805@ccmu.edu.cn
Received: August 15, 2024 Revised: October 26, 2024 Accepted: November 19, 2024 Published online: January 27, 2025 Processing time: 144 Days and 3 Hours
Abstract
BACKGROUND
The gut microbiome is associated with hepatic encephalopathy (HE), but research results on the gut microbiome characteristics of patients with liver cirrhosis with and without HE are inconsistent.
AIM
To study the gut microbiota characteristics of patients with liver cirrhosis with and without HE.
METHODS
We searched the PubMed, Web of Science, EMBASE, and Cochrane databases using two keywords, HE, and gut microbiome. According to the inclusion and exclusion criteria, suitable literature was screened to extract data on the diversity and composition of the fecal microbiota in patients with liver cirrhosis with and without HE. The data were analyzed using RevMan and STATA.
RESULTS
Seventeen studies were included: (1) A meta-analysis of 7 studies revealed that the Shannon index in liver cirrhosis patients with HE was significantly lower than that in patients without HE [-0.20, 95% confidence interval (CI): -0.28 to -0.13, I2 = 20%]; (2) The relative abundances of Lachnospiraceae (-2.73, 95%CI: -4.58 to -0.87, I2 = 38%) and Ruminococcaceae (-2.93, 95%CI: -4.29 to -1.56, I2 = 0%) in liver cirrhosis patients with HE was significantly lower than those in patients without HE; (3) In patients with HE, Enterococcus, Proteobacteria, Enterococcaceae, and Enterobacteriaceae proportions increased, but Ruminococcaceae, Lachnospiraceae, Prevotellaceae, and Bacteroidetes proportions decreased; (4) Differences in the fecal metabolome between liver cirrhosis patients with and without HE were detected; and (5) Differential gut microbiomes may serve as diagnostic and prognostic tools.
CONCLUSION
The gut microbiomes of patients with liver cirrhosis with and without HE differ. Some gut microbiomes may distinguish liver cirrhosis patients with or without HE and determine patient prognosis.
Core Tip: The gut microbiome is associated with hepatic encephalopathy (HE), but research results on the gut microbiome characteristics of patients with liver cirrhosis with and without HE are inconsistent. We aimed to conduct a meta-analysis of the gut microbiota characteristics of patients with liver cirrhosis with and without HE, to provide a reference for the targeted regulation of the gut microbiota and reduction in HE incidence.
