Clinical outcomes and gut microbiota analysis of severe alcohol-associated hepatitis patients undergoing healthy donor fecal transplant or pentoxifylline therapy:single-center experience from Kerala  

作　　者：Cyriac Abby Philips Rizwan Ahamed Sasidharan Rajesh Shobhit Singh Ajit Tharakan Jinsha K.Abduljaleel Philip Augustine 

机构地区：[1]Clinical and Translational Hepatology,The Liver Institute,Center of Excellence in GI Sciences,Rajagiri Hospital,Chunangamvely,Aluva,Ernakulam,Kerala,India [2]Monarch Liver Laboratory,The Liver Institute,Center of Excellence in GI Sciences,Rajagiri Hospital,Chunangamvely,Aluva,Ernakulam,Kerala,India [3]Department of Gastroenterology and Advanced GI Endoscopy,Center of Excellence in GI Sciences,Rajagiri Hospital,Chunangamvely,Aluva,Ernakulam,Kerala,India [4]Diagnostic and Interventional Radiology,Center of Excellence in GI Sciences,Rajagiri Hospital,Chunangamvely,Aluva,Ernakulam,Kerala,India

出　　处：《Gastroenterology Report》2022年第1期566-574,共9页胃肠病学报道（英文）

摘　　要：Background Severe alcohol-associated hepatitis(SAH)patients with infections have a high short-term mortality rate.Gut microbiota dysbiosis plays an important role in the pathogenesis of SAH.Preliminary studies have demonstrated long-term benefits with healthy donor fecal microbiota transplantation(FMT).Data on FMT compared with pentoxifylline for SAH and relevant gut microbial changes are lacking in literature.Methods From January 2019 to February 2021,retrospective analysis of a single hospital’s records revealed 47 SAH patients undergoing FMT(100mL/day via nasoduodenal tube for 7days)and 25matched patients receiving pentoxifylline(400mg/8 h for 28days).The primary end point was a 6-month survival rate.Secondary end points included incidence of ascites,hepatic encephalopathy,infections,acute kidney injury,and gutmicrobiota changes between post-therapy groups.Biomarker discovery and network analysis were also performed to identify significant taxa of gutmicrobiota in post-treatment groups in retrospectively stored stool samples.Results All were males.The 6-month survival rate was higher in the patients undergoing FMT than in patients receiving pentoxifylline(83.0%vs 56.0%,P=0.012).At the end of 6-month follow-up,the incidences of clinically significant ascites(56.0%vs 25.5%,P=0.011),hepatic encephalopathy(40.0%vs 10.6%,P=0.003),and critical infections(52.0%vs 14.9%,P<0.001)in patients administered pentoxifylline were significantly higher than those in patients treated with FMT.At 3 months,biomarker analysis revealed a significant abundance of Bifidobacterium and Eggerthella in the FMT group and the pentoxifylline group,respectively.At 6 months,Bifidobacterium in the FMT group and pathogenic Aerococcaceae in the pentoxifylline group were notable.Network analysis showed beneficial taxa(Bifidobacterium)as a central influencer in those undergoing FMT at 6 months.Conclusions Healthy donor FMT improved survival rate and reduced liver-related complications compared with pentoxifylline.These clinical benefits were asso

关 键 词：fecal microbiota stool transplant alcoholic hepatitis liver transplant DYSBIOSIS 

分 类 号：R575.1[医药卫生—消化系统]