Gut microbiota shifts in hepatitis B-related portal hypertension after transjugular intrahepatic portosystemic shunt:Mechanistic and clinical implications  

作　　者：Qi-Rong Jiang Da-Wu Zeng 

机构地区：[1]Department of Hepatology,Hepatology Research Institute,The First Affiliated Hospital,Fujian Medical University,Fuzhou 350005,Fujian Province,China [2]Department of Infectious Diseases,The First Affiliated Hospital of Fujian Medical University,Fuzhou 350004,Fujian Province,China

出　　处：《World Journal of Gastroenterology》2025年第3期134-137,共4页世界胃肠病学杂志（英文）

基　　金：Supported by Clinical Research Center for Hepatopathy and Intestinal Diseases of Fujian Province,No.2023GBYJ-YL-1.

摘　　要：In this article,we provide commentary on the recent article by Zhao et al.We focus on the shifts in the gut microbiota of patients with hepatitis B virus(HBV)-associated cirrhosis/portal hypertension(PH)following transjugular intrahepatic portosystemic shunt(TIPS)and the implications for understanding the mechanisms,diagnosis,and treatment.By comparing the gut microbiota composition and dynamic changes before and after TIPS in patients with and without hepatic encephalopathy,the authors found an increase in non-probiotic bacteria in those who developed hepatic encephalopathy post-TIPS,with Morganella species present only in the hepatic encephalopathy group.The gut microbiota changes post-TIPS among patients without the occurrence of hepatic encephalopathy suggest potential therapeutic benefits through prophylactic microbiome therapies.Furthermore,the specific gut microbiota alterations may hold promise to predict the risk of hepatic encephalopathy in individuals undergoing TIPS for HBVrelated PH.Despite these promising findings,future studies are needed to address limitations,including a small sample size,a relatively short evaluation period for gut microbiota alterations,the absence of data on dynamic alterations in gut microbiota post-TIPS and their correlation with blood ammonia levels,and the lack of validation in animal models.In conclusion,Zhao et al's study has shed new light on the link of gut microbiota with post-TIPS hepatic encephalopathy,potentially through the intricate gut-liver axis,and has important clinical implications for improving the management of patients with HBV-related PH.

关 键 词：Hepatitis B virus CIRRHOSIS Portal hypertension Hepatic encephalopathy Transjugular intrahepatic portosystemic shunt Gut microbiota 

分 类 号：R512.62[医药卫生—内科学] R575.2[医药卫生—临床医学]