Secondary Sclerosing Cholangitis in Critically Ill Patients Alters the Gut–Liver Axis: A Case Control Study
Secondary sclerosing cholangitis in critically ill patients (SC-CIP) occurs after long-term intensive care treatment. This study aimed to assess the gut–liver axis in SC-CIP. Stool microbiome composition, gut permeability, bacterial translocation and serum bile acid profiles of 18 SC-CIP patients co...
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2020-09-01
|
| Series: | Nutrients |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2072-6643/12/9/2728 |
| _version_ | 1797554415903703040 |
|---|---|
| author | Andreas Blesl Christoph Jüngst Frank Lammert Günter Fauler Florian Rainer Bettina Leber Nicole Feldbacher Silvia Stromberger Renate Wildburger Walter Spindelböck Peter Fickert Angela Horvath Vanessa Stadlbauer |
| author_facet | Andreas Blesl Christoph Jüngst Frank Lammert Günter Fauler Florian Rainer Bettina Leber Nicole Feldbacher Silvia Stromberger Renate Wildburger Walter Spindelböck Peter Fickert Angela Horvath Vanessa Stadlbauer |
| author_sort | Andreas Blesl |
| collection | DOAJ |
| description | Secondary sclerosing cholangitis in critically ill patients (SC-CIP) occurs after long-term intensive care treatment. This study aimed to assess the gut–liver axis in SC-CIP. Stool microbiome composition, gut permeability, bacterial translocation and serum bile acid profiles of 18 SC-CIP patients compared to 11 patients after critical illness without liver disease (CIP controls), 21 patients with cirrhosis and 21 healthy controls were studied. 16S rDNA was isolated from stool and sequenced using the Illumina technique. Diamine oxidase, zonulin, soluble CD14 (sCD14) and lipopolysaccharide binding protein were measured in serum and calprotectin in stool. Serum bile acids were analyzed by high-performance liquid chromatography-mass spectrometry (HPLC-MS). Reduced microbiome alpha diversity and altered beta diversity were seen in SC-CIP, CIP controls and cirrhosis compared to healthy controls. SC-CIP patients showed a shift towards pathogenic taxa and an oralization. SC-CIP, CIP controls and cirrhotic patients presented with impaired gut permeability, and biomarkers of bacterial translocation were increased in SC-CIP and cirrhosis. Total serum bile acids were elevated in SC-CIP and cirrhosis and the bile acid profile was altered in SC-CIP, CIP controls and cirrhosis. In conclusions, observed alterations of the gut–liver axis in SC-CIP cannot solely be attributed to liver disease, but may also be secondary to long-term intensive care treatment. |
| first_indexed | 2024-03-10T16:31:44Z |
| format | Article |
| id | doaj.art-3c0e8ade0dfd4615986bc8d8c95bf3f0 |
| institution | Directory Open Access Journal |
| issn | 2072-6643 |
| language | English |
| last_indexed | 2024-03-10T16:31:44Z |
| publishDate | 2020-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Nutrients |
| spelling | doaj.art-3c0e8ade0dfd4615986bc8d8c95bf3f02023-11-20T12:48:13ZengMDPI AGNutrients2072-66432020-09-01129272810.3390/nu12092728Secondary Sclerosing Cholangitis in Critically Ill Patients Alters the Gut–Liver Axis: A Case Control StudyAndreas Blesl0Christoph Jüngst1Frank Lammert2Günter Fauler3Florian Rainer4Bettina Leber5Nicole Feldbacher6Silvia Stromberger7Renate Wildburger8Walter Spindelböck9Peter Fickert10Angela Horvath11Vanessa Stadlbauer12Division for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, AustriaDivision for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Zürich, 8032 Zürich, SwitzerlandDepartment of Medicine II, Saarland University Medical Center, Saarland University, 66421 Homburg, GermanyInstitute for Medical and Chemical Laboratory Diagnosis, Medical University of Graz, 8036 Graz, AustriaDivision for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, AustriaDepartment of Surgery, Division of Transplantation Surgery, Medical University of Graz, 8036 Graz, AustriaDivision for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, AustriaAUVA Rehabilitation Clinic Tobelbad, 8144 Tobelbad, AustriaAUVA Rehabilitation Clinic Tobelbad, 8144 Tobelbad, AustriaDivision for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, AustriaDivision for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, AustriaDivision for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, AustriaDivision for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, AustriaSecondary sclerosing cholangitis in critically ill patients (SC-CIP) occurs after long-term intensive care treatment. This study aimed to assess the gut–liver axis in SC-CIP. Stool microbiome composition, gut permeability, bacterial translocation and serum bile acid profiles of 18 SC-CIP patients compared to 11 patients after critical illness without liver disease (CIP controls), 21 patients with cirrhosis and 21 healthy controls were studied. 16S rDNA was isolated from stool and sequenced using the Illumina technique. Diamine oxidase, zonulin, soluble CD14 (sCD14) and lipopolysaccharide binding protein were measured in serum and calprotectin in stool. Serum bile acids were analyzed by high-performance liquid chromatography-mass spectrometry (HPLC-MS). Reduced microbiome alpha diversity and altered beta diversity were seen in SC-CIP, CIP controls and cirrhosis compared to healthy controls. SC-CIP patients showed a shift towards pathogenic taxa and an oralization. SC-CIP, CIP controls and cirrhotic patients presented with impaired gut permeability, and biomarkers of bacterial translocation were increased in SC-CIP and cirrhosis. Total serum bile acids were elevated in SC-CIP and cirrhosis and the bile acid profile was altered in SC-CIP, CIP controls and cirrhosis. In conclusions, observed alterations of the gut–liver axis in SC-CIP cannot solely be attributed to liver disease, but may also be secondary to long-term intensive care treatment.https://www.mdpi.com/2072-6643/12/9/2728SC-CIPsecondary sclerosing cholangitiscritical illnessmicrobiomegut permeabilitybile acids |
| spellingShingle | Andreas Blesl Christoph Jüngst Frank Lammert Günter Fauler Florian Rainer Bettina Leber Nicole Feldbacher Silvia Stromberger Renate Wildburger Walter Spindelböck Peter Fickert Angela Horvath Vanessa Stadlbauer Secondary Sclerosing Cholangitis in Critically Ill Patients Alters the Gut–Liver Axis: A Case Control Study Nutrients SC-CIP secondary sclerosing cholangitis critical illness microbiome gut permeability bile acids |
| title | Secondary Sclerosing Cholangitis in Critically Ill Patients Alters the Gut–Liver Axis: A Case Control Study |
| title_full | Secondary Sclerosing Cholangitis in Critically Ill Patients Alters the Gut–Liver Axis: A Case Control Study |
| title_fullStr | Secondary Sclerosing Cholangitis in Critically Ill Patients Alters the Gut–Liver Axis: A Case Control Study |
| title_full_unstemmed | Secondary Sclerosing Cholangitis in Critically Ill Patients Alters the Gut–Liver Axis: A Case Control Study |
| title_short | Secondary Sclerosing Cholangitis in Critically Ill Patients Alters the Gut–Liver Axis: A Case Control Study |
| title_sort | secondary sclerosing cholangitis in critically ill patients alters the gut liver axis a case control study |
| topic | SC-CIP secondary sclerosing cholangitis critical illness microbiome gut permeability bile acids |
| url | https://www.mdpi.com/2072-6643/12/9/2728 |
| work_keys_str_mv | AT andreasblesl secondarysclerosingcholangitisincriticallyillpatientsaltersthegutliveraxisacasecontrolstudy AT christophjungst secondarysclerosingcholangitisincriticallyillpatientsaltersthegutliveraxisacasecontrolstudy AT franklammert secondarysclerosingcholangitisincriticallyillpatientsaltersthegutliveraxisacasecontrolstudy AT gunterfauler secondarysclerosingcholangitisincriticallyillpatientsaltersthegutliveraxisacasecontrolstudy AT florianrainer secondarysclerosingcholangitisincriticallyillpatientsaltersthegutliveraxisacasecontrolstudy AT bettinaleber secondarysclerosingcholangitisincriticallyillpatientsaltersthegutliveraxisacasecontrolstudy AT nicolefeldbacher secondarysclerosingcholangitisincriticallyillpatientsaltersthegutliveraxisacasecontrolstudy AT silviastromberger secondarysclerosingcholangitisincriticallyillpatientsaltersthegutliveraxisacasecontrolstudy AT renatewildburger secondarysclerosingcholangitisincriticallyillpatientsaltersthegutliveraxisacasecontrolstudy AT walterspindelbock secondarysclerosingcholangitisincriticallyillpatientsaltersthegutliveraxisacasecontrolstudy AT peterfickert secondarysclerosingcholangitisincriticallyillpatientsaltersthegutliveraxisacasecontrolstudy AT angelahorvath secondarysclerosingcholangitisincriticallyillpatientsaltersthegutliveraxisacasecontrolstudy AT vanessastadlbauer secondarysclerosingcholangitisincriticallyillpatientsaltersthegutliveraxisacasecontrolstudy |