Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy
Abstract Patients with cirrhosis may show minimal hepatic encephalopathy (MHE), for which rifaximin is effective. Metabolic syndrome may be associated with cognitive impairment. Our aims were to evaluate the influence of metabolic syndrome features on response to rifaximin for neurological and infla...
| Main Authors: | , , , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2022-02-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-022-06416-z |
| _version_ | 1819277692550250496 |
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| author | María-Pilar Ballester Juan-José Gallego Alessandra Fiorillo Franc Casanova-Ferrer Carla Giménez-Garzó Desamparados Escudero-García Joan Tosca María-Pilar Ríos Cristina Montón Lucía Durbán José Ballester Salvador Benlloch Amparo Urios Teresa San-Miguel Elena Kosenko Miguel-Ángel Serra Vicente Felipo Carmina Montoliu |
| author_facet | María-Pilar Ballester Juan-José Gallego Alessandra Fiorillo Franc Casanova-Ferrer Carla Giménez-Garzó Desamparados Escudero-García Joan Tosca María-Pilar Ríos Cristina Montón Lucía Durbán José Ballester Salvador Benlloch Amparo Urios Teresa San-Miguel Elena Kosenko Miguel-Ángel Serra Vicente Felipo Carmina Montoliu |
| author_sort | María-Pilar Ballester |
| collection | DOAJ |
| description | Abstract Patients with cirrhosis may show minimal hepatic encephalopathy (MHE), for which rifaximin is effective. Metabolic syndrome may be associated with cognitive impairment. Our aims were to evaluate the influence of metabolic syndrome features on response to rifaximin for neurological and inflammatory alterations in MHE. A prospective cohort study was conducted in 63 cirrhotic patients and 30 controls from two tertiary centres recruited between 2015 and 2019. Metabolic syndrome was defined according to the Adult Treatment Panel-III. Patients were classified into 31 without and 32 with MHE according to the Psychometric Hepatic Encephalopathy Score (PHES). All participants performed specific psychometric tests, and inflammatory parameters were studied. Patients with MHE received rifaximin (400 mg/8 h). Response was evaluated by PHES at 3 and 6 months. Response according to metabolic syndrome manifestations was compared. The response rate was 66%. Older age (p = 0.012) and all metabolic syndrome diseases (p < 0.05) were associated with non-response, plus an increase in risk as the number of manifestations rose (p < 0.001). Patients with metabolic manifestations exhibited worse processing speed (p = 0.011), working memory (p = 0.005), visual coordination (p = 0.013) and lower proportion of activated CD4+ lymphocytes (p = 0.039) at baseline, as well as worse concentration (p = 0.030), bimanual coordination (p = 0.004) and higher levels of intermediate monocytes (p = 0.026), CX3CL1 (p < 0.05), IL-17 (p = 0.022), AHR (p = 0.010) and IgG (p < 0.05) at 3 and/or 6 months of rifaximin. Patients with clinical signs of metabolic syndrome have poor response to rifaximin for MHE, with a higher proportion of neurological alterations associated with a pro-inflammatory environment. |
| first_indexed | 2024-12-24T00:00:09Z |
| format | Article |
| id | doaj.art-26b279801bda4b5d964748861a0986cf |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-12-24T00:00:09Z |
| publishDate | 2022-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-26b279801bda4b5d964748861a0986cf2022-12-21T17:25:09ZengNature PortfolioScientific Reports2045-23222022-02-0112111210.1038/s41598-022-06416-zMetabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathyMaría-Pilar Ballester0Juan-José Gallego1Alessandra Fiorillo2Franc Casanova-Ferrer3Carla Giménez-Garzó4Desamparados Escudero-García5Joan Tosca6María-Pilar Ríos7Cristina Montón8Lucía Durbán9José Ballester10Salvador Benlloch11Amparo Urios12Teresa San-Miguel13Elena Kosenko14Miguel-Ángel Serra15Vicente Felipo16Carmina Montoliu17Servicio de Medicina Digestiva, Hospital Clínico Universitario de ValenciaFundación de Investigación Hospital Clínico Universitario de Valencia-INCLIVAFundación de Investigación Hospital Clínico Universitario de Valencia-INCLIVAFundación de Investigación Hospital Clínico Universitario de Valencia-INCLIVALaboratory of Neurobiology, Centro Investigación Príncipe FelipeServicio de Medicina Digestiva, Hospital Clínico Universitario de ValenciaServicio de Medicina Digestiva, Hospital Clínico Universitario de ValenciaServicio de Medicina Digestiva, Hospital Arnau de VilanovaServicio de Medicina Digestiva, Hospital Clínico Universitario de ValenciaServicio de Medicina Digestiva, Hospital Arnau de VilanovaServicio de Medicina Digestiva, Hospital Clínico Universitario de ValenciaServicio de Medicina Digestiva, Hospital Arnau de VilanovaFundación de Investigación Hospital Clínico Universitario de Valencia-INCLIVAFundación de Investigación Hospital Clínico Universitario de Valencia-INCLIVAInstitute of Theoretical and Experimental Biophysics of Russian Academy of SciencesServicio de Medicina Digestiva, Hospital Clínico Universitario de ValenciaLaboratory of Neurobiology, Centro Investigación Príncipe FelipeFundación de Investigación Hospital Clínico Universitario de Valencia-INCLIVAAbstract Patients with cirrhosis may show minimal hepatic encephalopathy (MHE), for which rifaximin is effective. Metabolic syndrome may be associated with cognitive impairment. Our aims were to evaluate the influence of metabolic syndrome features on response to rifaximin for neurological and inflammatory alterations in MHE. A prospective cohort study was conducted in 63 cirrhotic patients and 30 controls from two tertiary centres recruited between 2015 and 2019. Metabolic syndrome was defined according to the Adult Treatment Panel-III. Patients were classified into 31 without and 32 with MHE according to the Psychometric Hepatic Encephalopathy Score (PHES). All participants performed specific psychometric tests, and inflammatory parameters were studied. Patients with MHE received rifaximin (400 mg/8 h). Response was evaluated by PHES at 3 and 6 months. Response according to metabolic syndrome manifestations was compared. The response rate was 66%. Older age (p = 0.012) and all metabolic syndrome diseases (p < 0.05) were associated with non-response, plus an increase in risk as the number of manifestations rose (p < 0.001). Patients with metabolic manifestations exhibited worse processing speed (p = 0.011), working memory (p = 0.005), visual coordination (p = 0.013) and lower proportion of activated CD4+ lymphocytes (p = 0.039) at baseline, as well as worse concentration (p = 0.030), bimanual coordination (p = 0.004) and higher levels of intermediate monocytes (p = 0.026), CX3CL1 (p < 0.05), IL-17 (p = 0.022), AHR (p = 0.010) and IgG (p < 0.05) at 3 and/or 6 months of rifaximin. Patients with clinical signs of metabolic syndrome have poor response to rifaximin for MHE, with a higher proportion of neurological alterations associated with a pro-inflammatory environment.https://doi.org/10.1038/s41598-022-06416-z |
| spellingShingle | María-Pilar Ballester Juan-José Gallego Alessandra Fiorillo Franc Casanova-Ferrer Carla Giménez-Garzó Desamparados Escudero-García Joan Tosca María-Pilar Ríos Cristina Montón Lucía Durbán José Ballester Salvador Benlloch Amparo Urios Teresa San-Miguel Elena Kosenko Miguel-Ángel Serra Vicente Felipo Carmina Montoliu Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy Scientific Reports |
| title | Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy |
| title_full | Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy |
| title_fullStr | Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy |
| title_full_unstemmed | Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy |
| title_short | Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy |
| title_sort | metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy |
| url | https://doi.org/10.1038/s41598-022-06416-z |
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