Maslennikov R, Ivashkin V, Efremova I, Alieva A, Kashuh E, Tsvetaeva E, Poluektova E, Shirokova E, Ivashkin K. Gut dysbiosis is associated with poorer long-term prognosis in cirrhosis. World J Hepatol 2021; 13(5): 557-570 [PMID: 34131470 DOI: 10.4254/wjh.v13.i5.557]
Corresponding Author of This Article
Roman Maslennikov, MD, PhD, Professor, Department of Internal Medicine, Gastroenterology and Hepatology, Sechenov University, Pogodinskaya Street, 1, bld. 1, Moscow 119435, Russia. mmmm00@yandex.ru
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Control Study
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 Hepatol. May 27, 2021; 13(5): 557-570 Published online May 27, 2021. doi: 10.4254/wjh.v13.i5.557
Gut dysbiosis is associated with poorer long-term prognosis in cirrhosis
Roman Maslennikov, Vladimir Ivashkin, Irina Efremova, Aliya Alieva, Ekaterina Kashuh, Ekaterina Tsvetaeva, Elena Poluektova, Elena Shirokova, Konstantin Ivashkin
Roman Maslennikov, Vladimir Ivashkin, Irina Efremova, Aliya Alieva, Ekaterina Kashuh, Ekaterina Tsvetaeva, Elena Poluektova, Elena Shirokova, Konstantin Ivashkin, Department of Internal Medicine, Gastroenterology and Hepatology, Sechenov University, Moscow 119435, Russia
Roman Maslennikov, The Interregional Public Organization “Scientific Community for the Promotion of the Clinical Study of the Human Microbiome”, Moscow 119435, Russia
Author contributions: Maslennikov R is the guarantor and finished draft writing; Ivashkin V thought the research idea; Ivashkin V and Maslennikov R made the study design; all authors finished research and data analysis; all authors finished draft editing.
Supported byBiocodex Microbiota Foundation - National Research Grant Russia 2019.
Institutional review board statement: The present study was approved by the Ethics Committee of Sechenov University in accordance with the Declaration of Helsinki (№03-16).
Conflict-of-interest statement: No other conflicts of interest.
Data sharing statement: Dataset available from the corresponding author at maslennikov_r_v@staff.sechenov.ru
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Roman Maslennikov, MD, PhD, Professor, Department of Internal Medicine, Gastroenterology and Hepatology, Sechenov University, Pogodinskaya Street, 1, bld. 1, Moscow 119435, Russia. mmmm00@yandex.ru
Received: January 16, 2021 Peer-review started: January 16, 2021 First decision: February 24, 2021 Revised: February 28, 2021 Accepted: April 22, 2021 Article in press: April 22, 2021 Published online: May 27, 2021 Processing time: 123 Days and 20 Hours
ARTICLE HIGHLIGHTS
Research background
Gut dysbiosis is common in cirrhosis.
Research motivation
The aim is to study the influence of gut dysbiosis on prognosis in cirrhosis.
Research objectives
The objectives include the development and test of a modified dysbiosis ratio (MDR) to distinguish between patients with cirrhosis and healthy controls, patients with compensated and decompensated cirrhosis, deceased and surviving patients.
Research methods
The case-control study included 48 in-patients with cirrhosis and 21 healthy controls. Stool microbiome was assessed using 16S ribosomal ribonucleic acid gene sequencing. We used MDR: [Bacilli (%) + Proteobacteria (%)]/[Clostridia (%) + bacteroidetes (%)]. Patients with MDR more its median made up the group with severe dysbiosis, others did the group with non-severe dysbiosis. The follow-up period was 4 years.
Research results
The mortality rate of patients with severe dysbiosis was significantly higher than that of patients with non-severe dysbiosis. The presence of severe dysbiosis was independent risk factors for death. The deceased patients had a higher MDR value than the survivors. MDR was higher in patients with cirrhosis than in health controls and in patients with decompensated cirrhosis than in patients with compensated cirrhosis.
Research conclusions
Gut dysbiosis is associated with a poorer long-term prognosis in cirrhosis.
Research perspectives
A larger study involving non-included patient populations should be provided to confirm the findings. New studies are needed to evaluate how various methods (e.g., probiotics, prebiotics, antibiotics, and fecal transplantation) can correct dysbiosis by analyzing the MDR and how this correction can improve the prognosis of patients with cirrhosis.
