Presepsin as a biomarker of bacterial translocation and an indicator for the prescription of probiotics in cirrhosis  

作　　者：Irina Efremova Roman Maslennikov Elena Poluektova Oleg Medvedev Anna Kudryavtseva George Krasnov Maria Fedorova Filipp Romanikhin Maria Zharkova Oxana Zolnikova Gyunay Bagieva Vladimir Ivashkin 

机构地区：[1]Department of Internal Medicine,Gastroenterology and Hepatology,Sechenov University,Moscow 119435,Russia [2]Department of Scientific,Scientific Community for the Promotion of the Clinical Study of the Human Microbiome,Moscow 119435,Russia [3]Department of Pharmacology,Lomonosov Moscow State University,Moscow 119192,Russia [4]Department of Post-Genomic Research Laboratory,Engelhardt Institute of Molecular Biology,Russian Academy of Sciences,Moscow 119991,Russia

出　　处：《World Journal of Hepatology》2024年第5期822-831,共10页世界肝病学杂志（英文版）（电子版）

基　　金：approved by the Ethics Committee of Sechenov University and performed in accordance with the Declaration of Helsinki.

摘　　要：BACKGROUND The gut–liver axis and bacterial translocation are important in cirrhosis,but there is no available universal biomarker of cellular bacterial translocation,for which presepsin may be a candidate.AIM To evaluate the relationship of the blood presepsin levels with the state of the gut microbiota in cirrhosis in the absence of obvious infection.METHODS This study included 48 patients with Child–Pugh cirrhosis classes B and C and 15 healthy controls.The fecal microbiome was assessed using 16S rRNA gene sequencing.Plasma levels of presepsin were measured.A total of 22 patients received a probiotic(Saccharomyces boulardii)for 3 months.RESULTS Presepsin levels were higher in patients with cirrhosis than in healthy individuals[342(91-2875)vs 120(102-141)pg/mL;P=0.048].Patients with elevated presepsin levels accounted for 56.3%of all included patients.They had lower levels of serum albumin and higher levels of serum total bilirubin and overall severity of cirrhosis as assessed using the Child–Pugh scale.Patients with elevated presepsin levels had an increased abundance of the main taxa responsible for bacterial translocation,namely Bacilli and Proteobacteria(including the main class Gammaproteobacteria and the minor taxa Xanthobacteraceae and Stenotrophomonas),and a low abundance of bacteria from the family Lachnospiraceae(including the minor genus Fusicatenibacter),which produce short-chain fatty acids that have a positive effect on intestinal barrier function.The presepsin level directly correlated with the relative abundance of Bacilli,Proteobacteria,and inversely correlated with the abundance of Lachnospiraceae and Propionibacteriaceae.After 3 months of taking the probiotic,the severity of cirrhosis on the Child–Pugh scale decreased significantly only in the group with elevated presepsin levels[from 9(8-11)to 7(6-9);P=0.004],while there were no significant changes in the group with normal presepsin levels[from 8(7-8)to 7(6-8);P=0.123].A high level of presepsin before the prescription of the probioti

关 键 词：DYSBIOSIS GUT Intestinal permeability Leaky gut Gut-liver axis LIVER MICROBIOTA 

分 类 号：R735.7[医药卫生—肿瘤]