Proton pump inhibitor treatment aggravates bacterial translocation in patients with advanced cirrhosis and portal hypertension
Abstract: Recent studies have linked proton pump inhibitor (PPI) treatment to increased complications of cirrhosis, such as bacterial infections and hepatic encephalopathy. However, the underlying pathophysiological mechanisms remain unclear. The present study investigated the hypothesis that PPI treatment may promote adverse effects in patients with advanced cirrhosis by affecting subclinical bacterial translocation (BT) from the gut into the portal venous bloodstream. Blood samples from the portal vein were obtained during implantation of a transjugular intrahepatic portosystemic shunt (TIPS) in a total of 80 cirrhosis patients with PPI treatment (PPI group, n = 57) and without PPI treatment (no-PPI group, n = 23). BT was identified using a 16S ribosomal RNA gene (V1V2 region) polymerase chain reaction. The microbiota composition in the portal venous blood samples was further analyzed by deep amplicon sequencing. Indeed, the prevalence of BT was significantly higher in the PPI group compared to the no-PPI group (86.0% vs 52.2%, P = 0.001). Importantly, this effect was not attributable to group differences in the severity of cirrhosis, parameters of portal hypertension, or medication. Microbiome analyses showed significantly increased alpha-diversity (Shannon) in the portal venous blood of the PPI group. Taxonomic analyses revealed significantly increased Streptococcus abundances in these patients. The present study reveals aggravated BT in patients with advanced cirrhosis and portal hypertension receiving PPI therapy. Increased BT could be an important pathomechanism contributing to the adverse effects of PPI treatment in patients with cirrhosis
- Standort
-
Deutsche Nationalbibliothek Frankfurt am Main
- Umfang
-
Online-Ressource
- Sprache
-
Englisch
- Anmerkungen
-
mBio. - 14, 5 (2023) , mbio.00492-23, ISSN: 2150-7511
- Ereignis
-
Veröffentlichung
- (wo)
-
Freiburg
- (wer)
-
Universität
- (wann)
-
2023
- Urheber
-
Sturm, Lukas
Hirose, Misa
Stolz, Laura
Schultheiß, Michael
Zoldan, Martina Katharina
Reincke, Marlene Elisabeth
Huber, Jan Patrick
Käser, Rafael Simon Peter
Böttler, Tobias
Thimme, Robert
Albert, Elisabeth
Busch, Hauke
Kuenstner, Axel
Bettinger, Dominik
- DOI
-
10.1128/mbio.00492-23
- URN
-
urn:nbn:de:bsz:25-freidok-2388518
- Rechteinformation
-
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
- Letzte Aktualisierung
-
25.03.2025, 13:46 MEZ
Datenpartner
Deutsche Nationalbibliothek. Bei Fragen zum Objekt wenden Sie sich bitte an den Datenpartner.
Beteiligte
- Sturm, Lukas
- Hirose, Misa
- Stolz, Laura
- Schultheiß, Michael
- Zoldan, Martina Katharina
- Reincke, Marlene Elisabeth
- Huber, Jan Patrick
- Käser, Rafael Simon Peter
- Böttler, Tobias
- Thimme, Robert
- Albert, Elisabeth
- Busch, Hauke
- Kuenstner, Axel
- Bettinger, Dominik
- Universität
Entstanden
- 2023