Chronic opioid use is associated with altered gut microbiota and predicts readmissions in patients with cirrhosis

Summary Background Opioid use is epidemic in cirrhosis, which could precipitate hepatic encephalopathy (HE) potentially through gut dysbiosis and inflammation. Aim To define the effect of opioids on readmissions and on gut microbiota composition and functionality. Methods Cohort 1 had 200 cirrhotic...

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Bibliographic Details
Published in:Alimentary pharmacology & therapeutics 2017-01, Vol.45 (2), p.319-331
Main Authors: Acharya, C., Betrapally, N. S., Gillevet, P. M., Sterling, R. K., Akbarali, H., White, M. B., Ganapathy, D., Fagan, A., Sikaroodi, M., Bajaj, J. S.
Format: Article
Language:English
Subjects:
Abundance
Amino acids
Analgesics, Opioid - therapeutic use
Cirrhosis
Dysbacteriosis
Dysbiosis - drug therapy
Dysbiosis - microbiology
Endotoxemia
Endotoxemia - drug therapy
Endotoxemia - microbiology
Epidemics
Feces - microbiology
Female
Gastrointestinal Microbiome - drug effects
Hepatic encephalopathy
Hepatic Encephalopathy - drug therapy
Hepatic Encephalopathy - microbiology
Humans
Interleukin 17
Interleukin 6
Intestinal microflora
Liver
Liver cirrhosis
Liver Cirrhosis - drug therapy
Liver Cirrhosis - microbiology
Liver diseases
Male
Middle Aged
Narcotics
Opioids
Patient Discharge - statistics & numerical data
Patient Readmission - statistics & numerical data
Relative abundance
Taxa
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Summary:Summary Background Opioid use is epidemic in cirrhosis, which could precipitate hepatic encephalopathy (HE) potentially through gut dysbiosis and inflammation. Aim To define the effect of opioids on readmissions and on gut microbiota composition and functionality. Methods Cohort 1 had 200 cirrhotic in‐patients (with/without opioid use) followed prospectively through the index hospitalisation and 6 months post discharge. Readmissions (HE‐related/unrelated) were compared between patients discharged on opioids compared to the rest, including using a multi‐variable analysis. Cohort 2 consisted of 72 cirrhotics on chronic opioids who were age/model for end‐stage liver disease (MELD) and prior HE‐balanced with 72 cirrhotics not on opioids. Stool microbiota composition (multi‐tagged sequencing), predicted functionality (PiCRUST), endotoxemia and systemic inflammation (IL‐6, IL‐17) were compared. Results Cohort 1: Chronic opioid use was statistically similar between those admitted with/without HE, and was judged to be an HE precipitant in
ISSN:0269-2813
1365-2036
DOI:10.1111/apt.13858