The Apparent Asymmetrical Relationship Between Small Bowel Bacterial Overgrowth, Endotoxemia, and Liver Steatosis and Fibrosis in Cirrhotic and Non-Cirrhotic Patients: A Single-Center Pilot Study
IntroductionGut microbiota are a complex ecosystem harboring our intestine. They maintain human body equilibrium, while their derangement, namely, “dysbiosis“, has been associated with several gastrointestinal diseases, such as liver steatosis (NAFLD) and liver cirrhosis. Small intestinal bacterial...
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Frontiers Media S.A.
2022-04-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2022.872428/full |
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| author | E. Scarpellini E. Scarpellini L. Abenavoli V. Cassano E. Rinninella E. Rinninella M. Sorge F. Capretti C. Rasetti G. Svegliati Baroni F. Luzza P. Santori A. Sciacqua |
| author_facet | E. Scarpellini E. Scarpellini L. Abenavoli V. Cassano E. Rinninella E. Rinninella M. Sorge F. Capretti C. Rasetti G. Svegliati Baroni F. Luzza P. Santori A. Sciacqua |
| author_sort | E. Scarpellini |
| collection | DOAJ |
| description | IntroductionGut microbiota are a complex ecosystem harboring our intestine. They maintain human body equilibrium, while their derangement, namely, “dysbiosis“, has been associated with several gastrointestinal diseases, such as liver steatosis (NAFLD) and liver cirrhosis. Small intestinal bacterial overgrowth (SIBO) is an example of dysbiosis of the upper gastrointestinal (GI) tract.AimThe aim of this study is to evaluate the relationship between SIBO and levels of endotoxemia and grade of liver steatosis (LS) and liver fibrosis (LF) in hepatologic patients.Materials and MethodsConsecutive outpatients referred to our hepatology clinic were tested for SIBO by the lactulose breath test (LBT) and peripheral blood levels of endotoxemia; LS grading and LF were assessed by abdominal ultrasound and transient elastography, respectively.ResultsFifty-two consecutive patients (17 with alcohol abuse (4.5 ± 0.8 alcohol units per day), 4 with HCV and 2 with HBV infection, 24 of metabolic origin, 2 of autoimmune origin, and 3 with cholangiopathies; mean age 54.7 ± 8.3 years, 31 F, BMI 24.1 ± 1.1 Kg/m2) and 14 healthy volunteers (HV) (mean age 50.1 ± 4.3 years, 9 F, BMI 23.3 ± 1.1 Kg/m2) were enrolled. SIBO prevalence was significantly higher in cirrhotic (LC) vs. non-cirrhotic (LNC) patients and vs. HV (all, p < 0.05), with a significant positive trend according to Child-Pugh status (all, p < 0.05). SIBO prevalence was not correlated with LS stages (all, p = NS). Consensually, endotoxin levels were significantly higher in LC vs. LNC and vs. HV (all, p < 0.05) and significantly correlated with LF in patients with LC, according to Child-Pugh status (all, p < 0.05).ConclusionThis study shows that SIBO prevalence and relative endotoxin blood levels seem to be significantly associated with the grade of LF vs. LS in LC. SIBO is also present under pre-cirrhotic conditions, but its prevalence seems to correlate with liver disease irreversible derangement. |
| first_indexed | 2024-12-12T21:28:40Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-12-12T21:28:40Z |
| publishDate | 2022-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Medicine |
| spelling | doaj.art-d8573597d5b047288cc51010796b08932022-12-22T00:11:23ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2022-04-01910.3389/fmed.2022.872428872428The Apparent Asymmetrical Relationship Between Small Bowel Bacterial Overgrowth, Endotoxemia, and Liver Steatosis and Fibrosis in Cirrhotic and Non-Cirrhotic Patients: A Single-Center Pilot StudyE. Scarpellini0E. Scarpellini1L. Abenavoli2V. Cassano3E. Rinninella4E. Rinninella5M. Sorge6F. Capretti7C. Rasetti8G. Svegliati Baroni9F. Luzza10P. Santori11A. Sciacqua12Hepatology and Internal Medicine Unit, “Madonna del Soccorso” General Hospital, San Benedetto del Tronto, ItalyT.A.R.G.I.D., Gasthuisberg University Hospital, KULeuven, Lueven, BelgiumDepartment of Health Sciences, University “Magna Græcia”, Catanzaro, ItalyDepartment of Medical and Surgical Sciences, University “Magna Græcia”, Catanzaro, ItalyClinical Nutrition Unit, Department of Medical and Surgical Sciences, Fondazione Policlinico A. Gemelli IRCCS, Rome, ItalyDepartment of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, ItalyGastroenterology and Endoscopy Unit “Madonna del Soccorso” General Hospital, San Benedetto del Tronto, ItalyGastroenterology and Endoscopy Unit “Madonna del Soccorso” General Hospital, San Benedetto del Tronto, ItalyHepatology and Internal Medicine Unit, “Madonna del Soccorso” General Hospital, San Benedetto del Tronto, ItalyGastroenterology Clinic, “Riuniti University Hospital”, Polytechnics University of Marche, Ancona, ItalyDepartment of Health Sciences, University “Magna Græcia”, Catanzaro, ItalyHepatology and Internal Medicine Unit, “Madonna del Soccorso” General Hospital, San Benedetto del Tronto, ItalyDepartment of Medical and Surgical Sciences, University “Magna Græcia”, Catanzaro, ItalyIntroductionGut microbiota are a complex ecosystem harboring our intestine. They maintain human body equilibrium, while their derangement, namely, “dysbiosis“, has been associated with several gastrointestinal diseases, such as liver steatosis (NAFLD) and liver cirrhosis. Small intestinal bacterial overgrowth (SIBO) is an example of dysbiosis of the upper gastrointestinal (GI) tract.AimThe aim of this study is to evaluate the relationship between SIBO and levels of endotoxemia and grade of liver steatosis (LS) and liver fibrosis (LF) in hepatologic patients.Materials and MethodsConsecutive outpatients referred to our hepatology clinic were tested for SIBO by the lactulose breath test (LBT) and peripheral blood levels of endotoxemia; LS grading and LF were assessed by abdominal ultrasound and transient elastography, respectively.ResultsFifty-two consecutive patients (17 with alcohol abuse (4.5 ± 0.8 alcohol units per day), 4 with HCV and 2 with HBV infection, 24 of metabolic origin, 2 of autoimmune origin, and 3 with cholangiopathies; mean age 54.7 ± 8.3 years, 31 F, BMI 24.1 ± 1.1 Kg/m2) and 14 healthy volunteers (HV) (mean age 50.1 ± 4.3 years, 9 F, BMI 23.3 ± 1.1 Kg/m2) were enrolled. SIBO prevalence was significantly higher in cirrhotic (LC) vs. non-cirrhotic (LNC) patients and vs. HV (all, p < 0.05), with a significant positive trend according to Child-Pugh status (all, p < 0.05). SIBO prevalence was not correlated with LS stages (all, p = NS). Consensually, endotoxin levels were significantly higher in LC vs. LNC and vs. HV (all, p < 0.05) and significantly correlated with LF in patients with LC, according to Child-Pugh status (all, p < 0.05).ConclusionThis study shows that SIBO prevalence and relative endotoxin blood levels seem to be significantly associated with the grade of LF vs. LS in LC. SIBO is also present under pre-cirrhotic conditions, but its prevalence seems to correlate with liver disease irreversible derangement.https://www.frontiersin.org/articles/10.3389/fmed.2022.872428/fullgut microbiotadysbiosissmall intestinal bacterial overgrowthliver steatosisfibrosis |
| spellingShingle | E. Scarpellini E. Scarpellini L. Abenavoli V. Cassano E. Rinninella E. Rinninella M. Sorge F. Capretti C. Rasetti G. Svegliati Baroni F. Luzza P. Santori A. Sciacqua The Apparent Asymmetrical Relationship Between Small Bowel Bacterial Overgrowth, Endotoxemia, and Liver Steatosis and Fibrosis in Cirrhotic and Non-Cirrhotic Patients: A Single-Center Pilot Study Frontiers in Medicine gut microbiota dysbiosis small intestinal bacterial overgrowth liver steatosis fibrosis |
| title | The Apparent Asymmetrical Relationship Between Small Bowel Bacterial Overgrowth, Endotoxemia, and Liver Steatosis and Fibrosis in Cirrhotic and Non-Cirrhotic Patients: A Single-Center Pilot Study |
| title_full | The Apparent Asymmetrical Relationship Between Small Bowel Bacterial Overgrowth, Endotoxemia, and Liver Steatosis and Fibrosis in Cirrhotic and Non-Cirrhotic Patients: A Single-Center Pilot Study |
| title_fullStr | The Apparent Asymmetrical Relationship Between Small Bowel Bacterial Overgrowth, Endotoxemia, and Liver Steatosis and Fibrosis in Cirrhotic and Non-Cirrhotic Patients: A Single-Center Pilot Study |
| title_full_unstemmed | The Apparent Asymmetrical Relationship Between Small Bowel Bacterial Overgrowth, Endotoxemia, and Liver Steatosis and Fibrosis in Cirrhotic and Non-Cirrhotic Patients: A Single-Center Pilot Study |
| title_short | The Apparent Asymmetrical Relationship Between Small Bowel Bacterial Overgrowth, Endotoxemia, and Liver Steatosis and Fibrosis in Cirrhotic and Non-Cirrhotic Patients: A Single-Center Pilot Study |
| title_sort | apparent asymmetrical relationship between small bowel bacterial overgrowth endotoxemia and liver steatosis and fibrosis in cirrhotic and non cirrhotic patients a single center pilot study |
| topic | gut microbiota dysbiosis small intestinal bacterial overgrowth liver steatosis fibrosis |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2022.872428/full |
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