Predictive and Prognostic Roles of Gut Microbial Variation in Liver Transplant

Frontiers in Medicine

article

Hon Jen Wong¹  Wen Hui Lim²  Cheng Han Ng²  Darren Jun Hao Tan²  Glenn K. Bonney²  Alfred W. C. Kow²  Daniel Q. Huang¹  Mohammad Shadab Siddiqui⁵  Mazen Noureddin⁶  Nicholas Syn³  Mark D. Muthiah¹ 

[1] Division of Gastroenterology and Hepatology, Department of Medicine, National University Health System;Yong Loo Lin School of Medicine, National University Singapore;National University Centre for Organ Transplantation, National University Health System;Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, National University Hospital Singapore;Division of Gastroenterology, Hepatology and Nutrition, Department of Internal Medicine, Virginia Commonwealth University;Cedars-Sinai Fatty Liver Program, Division of Digestive and Liver Diseases, Department of Medicine, Comprehensive Transplant Centre, Cedars-Sinai Medical Centre

关键词: liver transplantation;    gut microbiome;    immunity;    rejection;    cancer;    metabolic disease;    prevention;   

DOI  :  10.3389/fmed.2022.873523

学科分类：社会科学、人文和艺术（综合）

来源: Frontiers

【 摘 要 】

Patients undergoing liver transplant (LTX) typically confront a challenging postoperative journey. A dysbiotic gut microbiome is associated with the development of complications, including post-LTX allograft rejection, metabolic diseases and de novo or recurrent cancer. A major explanation of this are the bipartite interactions between the gut microbiota and host immunity, which modulates the alloimmune response towards the liver allograft. Furthermore, bacterial translocation from dysbiosis causes pathogenic changes in the concentrations of microbial metabolites like lipopolysaccharides, short-chain fatty acids (SCFAs) and Trimethylamine-N-Oxide, with links to cardiovascular disease development and diabetes mellitus. Gut dysbiosis also disrupts bile acid metabolism, with implications for various post-LTX metabolic diseases. Certain taxonomy of microbiota such as lactobacilli, F.prausnitzii and Bacteroides appear to be associated with these undesired outcomes. As such, an interesting but as yet unproven hypothesis exists as to whether induction of a “beneficial” composition of gut microbiota may improve prognosis in LTX patients. Additionally, there are roles of the microbiome as predictive and prognostic indicators for clinicians in improving patient care. Hence, the gut microbiome represents an exceptionally exciting avenue for developing novel prognostic, predictive and therapeutic applications.

【 授权许可】

CC BY