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Influence of hepatitis C virus eradication with direct‐acting antivirals on the gut microbiota in patients with cirrhosis

Summary Background The cure of hepatitis C virus (HCV) infection may contribute to the reduction of liver fibrosis progression and potentially influence the gut‐liver axis. Aim To investigate the influence of HCV infection eradication with direct‐acting antivirals (DAAs) on the gut microbiota compos...

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Published in:Alimentary pharmacology & therapeutics 2018-12, Vol.48 (11-12), p.1301-1311
Main Authors: Ponziani, Francesca Romana, Putignani, Lorenza, Paroni Sterbini, Francesco, Petito, Valentina, Picca, Anna, Del Chierico, Federica, Reddel, Sofia, Calvani, Riccardo, Marzetti, Emanuele, Sanguinetti, Maurizio, Gasbarrini, Antonio, Pompili, Maurizio
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cited_by cdi_FETCH-LOGICAL-c3884-ea17d4e65895c27c86737db17693e6293d857fa6096677476b3c59f141ed14873
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container_issue 11-12
container_start_page 1301
container_title Alimentary pharmacology & therapeutics
container_volume 48
creator Ponziani, Francesca Romana
Putignani, Lorenza
Paroni Sterbini, Francesco
Petito, Valentina
Picca, Anna
Del Chierico, Federica
Reddel, Sofia
Calvani, Riccardo
Marzetti, Emanuele
Sanguinetti, Maurizio
Gasbarrini, Antonio
Pompili, Maurizio
description Summary Background The cure of hepatitis C virus (HCV) infection may contribute to the reduction of liver fibrosis progression and potentially influence the gut‐liver axis. Aim To investigate the influence of HCV infection eradication with direct‐acting antivirals (DAAs) on the gut microbiota composition as well as on intestinal and systemic inflammatory parameters in patients with cirrhosis. Methods Consecutive patients with HCV‐related cirrhosis receiving DAA treatment were included. The gut microbiota composition, intestinal permeability, and inflammation were assessed before treatment and after 1 year. Clinical outcomes such as episodes of decompensation and markers of liver fibrosis were evaluated over a 2‐year follow‐up period. Results The gut microbiota alpha diversity in cirrhotic patients, which was lower than that in healthy subjects, was significantly improved by the cure of HCV infection and a shift in the overall gut microbiota composition was observed compared to baseline. The abundance of potentially pathogenic bacteria (Enterobacteriaceae, Enterococcus, and Staphylococcus) was decreased after treatment. The gut microbiota composition was associated with the inflammatory profile and markers of liver fibrosis. Although a significant reduction in the serum levels of cytokines and chemokines was observed post‐DAA treatment, measures of intestinal permeability and inflammation remained unchanged. Conclusions Cure of HCV infection with DAAs in patients with cirrhosis is associated with a modification of the gut microbiota, which correlates with fibrosis and inflammation but does not improve intestinal barrier function.
doi_str_mv 10.1111/apt.15004
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Aim To investigate the influence of HCV infection eradication with direct‐acting antivirals (DAAs) on the gut microbiota composition as well as on intestinal and systemic inflammatory parameters in patients with cirrhosis. Methods Consecutive patients with HCV‐related cirrhosis receiving DAA treatment were included. The gut microbiota composition, intestinal permeability, and inflammation were assessed before treatment and after 1 year. Clinical outcomes such as episodes of decompensation and markers of liver fibrosis were evaluated over a 2‐year follow‐up period. Results The gut microbiota alpha diversity in cirrhotic patients, which was lower than that in healthy subjects, was significantly improved by the cure of HCV infection and a shift in the overall gut microbiota composition was observed compared to baseline. The abundance of potentially pathogenic bacteria (Enterobacteriaceae, Enterococcus, and Staphylococcus) was decreased after treatment. The gut microbiota composition was associated with the inflammatory profile and markers of liver fibrosis. Although a significant reduction in the serum levels of cytokines and chemokines was observed post‐DAA treatment, measures of intestinal permeability and inflammation remained unchanged. Conclusions Cure of HCV infection with DAAs in patients with cirrhosis is associated with a modification of the gut microbiota, which correlates with fibrosis and inflammation but does not improve intestinal barrier function.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/apt.15004</identifier><identifier>PMID: 30345704</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Antiviral agents ; Chemokines ; Cirrhosis ; Cytokines ; Digestive system ; Fibrosis ; Gastrointestinal tract ; Hepatitis ; Hepatitis C ; Infections ; Inflammation ; Intestinal microflora ; Intestine ; Liver ; Liver cirrhosis ; Microbiota ; Patients ; Permeability ; Serum levels ; Viruses</subject><ispartof>Alimentary pharmacology &amp; therapeutics, 2018-12, Vol.48 (11-12), p.1301-1311</ispartof><rights>2018 John Wiley &amp; Sons Ltd</rights><rights>2018 John Wiley &amp; Sons Ltd.</rights><rights>Copyright © 2018 John Wiley &amp; Sons Ltd</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3884-ea17d4e65895c27c86737db17693e6293d857fa6096677476b3c59f141ed14873</citedby><cites>FETCH-LOGICAL-c3884-ea17d4e65895c27c86737db17693e6293d857fa6096677476b3c59f141ed14873</cites><orcidid>0000-0002-5924-6238</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30345704$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ponziani, Francesca Romana</creatorcontrib><creatorcontrib>Putignani, Lorenza</creatorcontrib><creatorcontrib>Paroni Sterbini, Francesco</creatorcontrib><creatorcontrib>Petito, Valentina</creatorcontrib><creatorcontrib>Picca, Anna</creatorcontrib><creatorcontrib>Del Chierico, Federica</creatorcontrib><creatorcontrib>Reddel, Sofia</creatorcontrib><creatorcontrib>Calvani, Riccardo</creatorcontrib><creatorcontrib>Marzetti, Emanuele</creatorcontrib><creatorcontrib>Sanguinetti, Maurizio</creatorcontrib><creatorcontrib>Gasbarrini, Antonio</creatorcontrib><creatorcontrib>Pompili, Maurizio</creatorcontrib><title>Influence of hepatitis C virus eradication with direct‐acting antivirals on the gut microbiota in patients with cirrhosis</title><title>Alimentary pharmacology &amp; therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary Background The cure of hepatitis C virus (HCV) infection may contribute to the reduction of liver fibrosis progression and potentially influence the gut‐liver axis. Aim To investigate the influence of HCV infection eradication with direct‐acting antivirals (DAAs) on the gut microbiota composition as well as on intestinal and systemic inflammatory parameters in patients with cirrhosis. Methods Consecutive patients with HCV‐related cirrhosis receiving DAA treatment were included. The gut microbiota composition, intestinal permeability, and inflammation were assessed before treatment and after 1 year. Clinical outcomes such as episodes of decompensation and markers of liver fibrosis were evaluated over a 2‐year follow‐up period. Results The gut microbiota alpha diversity in cirrhotic patients, which was lower than that in healthy subjects, was significantly improved by the cure of HCV infection and a shift in the overall gut microbiota composition was observed compared to baseline. The abundance of potentially pathogenic bacteria (Enterobacteriaceae, Enterococcus, and Staphylococcus) was decreased after treatment. The gut microbiota composition was associated with the inflammatory profile and markers of liver fibrosis. Although a significant reduction in the serum levels of cytokines and chemokines was observed post‐DAA treatment, measures of intestinal permeability and inflammation remained unchanged. Conclusions Cure of HCV infection with DAAs in patients with cirrhosis is associated with a modification of the gut microbiota, which correlates with fibrosis and inflammation but does not improve intestinal barrier function.</description><subject>Antiviral agents</subject><subject>Chemokines</subject><subject>Cirrhosis</subject><subject>Cytokines</subject><subject>Digestive system</subject><subject>Fibrosis</subject><subject>Gastrointestinal tract</subject><subject>Hepatitis</subject><subject>Hepatitis C</subject><subject>Infections</subject><subject>Inflammation</subject><subject>Intestinal microflora</subject><subject>Intestine</subject><subject>Liver</subject><subject>Liver cirrhosis</subject><subject>Microbiota</subject><subject>Patients</subject><subject>Permeability</subject><subject>Serum levels</subject><subject>Viruses</subject><issn>0269-2813</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><recordid>eNp10U9LHDEYBvAgFnerHvwCJeBFD7Mmk79zXBZrBaEe9DxkM--4WWYz2ySjiBc_Qj-jn8Rsx_ZQMJdA-OXJGx6ETiiZ0bwuzDbNqCCE76EpZVIUJWFyH01JKaui1JRN0NcY14QQqUh5gCaMMC4U4VP0cu3bbgBvAfctXsHWJJdcxAv86MIQMQTTOJsPe4-fXFrhxgWw6e31t7HJ-QdsfHKZmi7iTNIK8MOQ8MbZ0C9dnwx2Hu9Cwac4JlgXwqqPLh6hL22-B8cf-yG6_355t_hR3Py8ul7MbwrLtOYFGKoaDlLoSthSWS0VU82SKlkxkGXFGi1UaySppFSKK7lkVlQt5RQayrVih-hszN2G_tcAMdUbFy10nfHQD7EuKauEzm_RTE__o-t-CD5Pt1O6YoxrkdX5qPInYwzQ1tvgNiY815TUu0bq3Ej9p5Fsv30kDssNNP_k3woyuBjBk-vg-fOken57N0a-A81Jlg0</recordid><startdate>201812</startdate><enddate>201812</enddate><creator>Ponziani, Francesca Romana</creator><creator>Putignani, Lorenza</creator><creator>Paroni Sterbini, Francesco</creator><creator>Petito, Valentina</creator><creator>Picca, Anna</creator><creator>Del Chierico, Federica</creator><creator>Reddel, Sofia</creator><creator>Calvani, Riccardo</creator><creator>Marzetti, Emanuele</creator><creator>Sanguinetti, Maurizio</creator><creator>Gasbarrini, Antonio</creator><creator>Pompili, Maurizio</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>M7N</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5924-6238</orcidid></search><sort><creationdate>201812</creationdate><title>Influence of hepatitis C virus eradication with direct‐acting antivirals on the gut microbiota in patients with cirrhosis</title><author>Ponziani, Francesca Romana ; Putignani, Lorenza ; Paroni Sterbini, Francesco ; Petito, Valentina ; Picca, Anna ; Del Chierico, Federica ; Reddel, Sofia ; Calvani, Riccardo ; Marzetti, Emanuele ; Sanguinetti, Maurizio ; Gasbarrini, Antonio ; Pompili, Maurizio</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3884-ea17d4e65895c27c86737db17693e6293d857fa6096677476b3c59f141ed14873</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Antiviral agents</topic><topic>Chemokines</topic><topic>Cirrhosis</topic><topic>Cytokines</topic><topic>Digestive system</topic><topic>Fibrosis</topic><topic>Gastrointestinal tract</topic><topic>Hepatitis</topic><topic>Hepatitis C</topic><topic>Infections</topic><topic>Inflammation</topic><topic>Intestinal microflora</topic><topic>Intestine</topic><topic>Liver</topic><topic>Liver cirrhosis</topic><topic>Microbiota</topic><topic>Patients</topic><topic>Permeability</topic><topic>Serum levels</topic><topic>Viruses</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ponziani, Francesca Romana</creatorcontrib><creatorcontrib>Putignani, Lorenza</creatorcontrib><creatorcontrib>Paroni Sterbini, Francesco</creatorcontrib><creatorcontrib>Petito, Valentina</creatorcontrib><creatorcontrib>Picca, Anna</creatorcontrib><creatorcontrib>Del Chierico, Federica</creatorcontrib><creatorcontrib>Reddel, Sofia</creatorcontrib><creatorcontrib>Calvani, Riccardo</creatorcontrib><creatorcontrib>Marzetti, Emanuele</creatorcontrib><creatorcontrib>Sanguinetti, Maurizio</creatorcontrib><creatorcontrib>Gasbarrini, Antonio</creatorcontrib><creatorcontrib>Pompili, Maurizio</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Alimentary pharmacology &amp; therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ponziani, Francesca Romana</au><au>Putignani, Lorenza</au><au>Paroni Sterbini, Francesco</au><au>Petito, Valentina</au><au>Picca, Anna</au><au>Del Chierico, Federica</au><au>Reddel, Sofia</au><au>Calvani, Riccardo</au><au>Marzetti, Emanuele</au><au>Sanguinetti, Maurizio</au><au>Gasbarrini, Antonio</au><au>Pompili, Maurizio</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of hepatitis C virus eradication with direct‐acting antivirals on the gut microbiota in patients with cirrhosis</atitle><jtitle>Alimentary pharmacology &amp; therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2018-12</date><risdate>2018</risdate><volume>48</volume><issue>11-12</issue><spage>1301</spage><epage>1311</epage><pages>1301-1311</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><abstract>Summary Background The cure of hepatitis C virus (HCV) infection may contribute to the reduction of liver fibrosis progression and potentially influence the gut‐liver axis. Aim To investigate the influence of HCV infection eradication with direct‐acting antivirals (DAAs) on the gut microbiota composition as well as on intestinal and systemic inflammatory parameters in patients with cirrhosis. Methods Consecutive patients with HCV‐related cirrhosis receiving DAA treatment were included. The gut microbiota composition, intestinal permeability, and inflammation were assessed before treatment and after 1 year. Clinical outcomes such as episodes of decompensation and markers of liver fibrosis were evaluated over a 2‐year follow‐up period. Results The gut microbiota alpha diversity in cirrhotic patients, which was lower than that in healthy subjects, was significantly improved by the cure of HCV infection and a shift in the overall gut microbiota composition was observed compared to baseline. The abundance of potentially pathogenic bacteria (Enterobacteriaceae, Enterococcus, and Staphylococcus) was decreased after treatment. The gut microbiota composition was associated with the inflammatory profile and markers of liver fibrosis. Although a significant reduction in the serum levels of cytokines and chemokines was observed post‐DAA treatment, measures of intestinal permeability and inflammation remained unchanged. Conclusions Cure of HCV infection with DAAs in patients with cirrhosis is associated with a modification of the gut microbiota, which correlates with fibrosis and inflammation but does not improve intestinal barrier function.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30345704</pmid><doi>10.1111/apt.15004</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-5924-6238</orcidid><oa>free_for_read</oa></addata></record>
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1365-2036
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subjects Antiviral agents
Chemokines
Cirrhosis
Cytokines
Digestive system
Fibrosis
Gastrointestinal tract
Hepatitis
Hepatitis C
Infections
Inflammation
Intestinal microflora
Intestine
Liver
Liver cirrhosis
Microbiota
Patients
Permeability
Serum levels
Viruses
title Influence of hepatitis C virus eradication with direct‐acting antivirals on the gut microbiota in patients with cirrhosis
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