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Biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis

Proton pump inhibitors (PPI) are an invaluable therapy option for acid related diseases; however, PPI therapy is also linked to a series of side effects in cirrhosis, such as microbiome alterations, spontaneous bacterial peritonitis and hepatic encephalopathy. Decision tools to balance benefits and...

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Autores principales: Horvath, Angela, Rainer, Florian, Bashir, Mina, Leber, Bettina, Schmerboeck, Bianca, Klymiuk, Ingeborg, Groselj-Strele, Andrea, Durdevic, Marija, Freedberg, Daniel E., Abrams, Julian A., Fickert, Peter, Stiegler, Philipp, Stadlbauer, Vanessa
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700098/
https://www.ncbi.nlm.nih.gov/pubmed/31427714
http://dx.doi.org/10.1038/s41598-019-48352-5
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author Horvath, Angela
Rainer, Florian
Bashir, Mina
Leber, Bettina
Schmerboeck, Bianca
Klymiuk, Ingeborg
Groselj-Strele, Andrea
Durdevic, Marija
Freedberg, Daniel E.
Abrams, Julian A.
Fickert, Peter
Stiegler, Philipp
Stadlbauer, Vanessa
author_facet Horvath, Angela
Rainer, Florian
Bashir, Mina
Leber, Bettina
Schmerboeck, Bianca
Klymiuk, Ingeborg
Groselj-Strele, Andrea
Durdevic, Marija
Freedberg, Daniel E.
Abrams, Julian A.
Fickert, Peter
Stiegler, Philipp
Stadlbauer, Vanessa
author_sort Horvath, Angela
collection PubMed
description Proton pump inhibitors (PPI) are an invaluable therapy option for acid related diseases; however, PPI therapy is also linked to a series of side effects in cirrhosis, such as microbiome alterations, spontaneous bacterial peritonitis and hepatic encephalopathy. Decision tools to balance benefits and risks of PPI therapy are largely missing. In this study, we tested gut-derived biomarkers to identify PPI-associated dysbiosis, its association with gut barrier function and liver-related mortality. In this observational study, faecal microbiome composition data obtained from 16S rDNA sequencing of 90 cirrhotic patients with and without long-term PPI use and additional potential biomarkers identified from the literature were evaluated for their predictive value regarding PPI-associated dysbiosis and liver-related three-year mortality. In addition, faecal calprotectin, faecal zonulin and serum lipopolysaccharides were assessed as markers for intestinal inflammation, gut permeability and bacterial translocation. Streptococcus salivarius, Veillonella parvula and the genus Streptococcus were significantly increased in patients with long-term PPI therapy and performed well as biomarkers for PPI-associated dysbiosis (accuracy: 74%, 72% and 74%, respectively). The abundance of Streptococcus salivarius was linked to intestinal inflammation and gut barrier dysfunction, whereas the abundance of Veillonella parvula showed associations with liver disease severity; both were independent predictors for liver-related three-year mortality. Gut-derived biomarkers of PPI-associated dysbiosis are linked to worse outcome and a potential option to evaluate the risks of adverse events during long-term PPI therapy.
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spelling pubmed-67000982019-08-21 Biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis Horvath, Angela Rainer, Florian Bashir, Mina Leber, Bettina Schmerboeck, Bianca Klymiuk, Ingeborg Groselj-Strele, Andrea Durdevic, Marija Freedberg, Daniel E. Abrams, Julian A. Fickert, Peter Stiegler, Philipp Stadlbauer, Vanessa Sci Rep Article Proton pump inhibitors (PPI) are an invaluable therapy option for acid related diseases; however, PPI therapy is also linked to a series of side effects in cirrhosis, such as microbiome alterations, spontaneous bacterial peritonitis and hepatic encephalopathy. Decision tools to balance benefits and risks of PPI therapy are largely missing. In this study, we tested gut-derived biomarkers to identify PPI-associated dysbiosis, its association with gut barrier function and liver-related mortality. In this observational study, faecal microbiome composition data obtained from 16S rDNA sequencing of 90 cirrhotic patients with and without long-term PPI use and additional potential biomarkers identified from the literature were evaluated for their predictive value regarding PPI-associated dysbiosis and liver-related three-year mortality. In addition, faecal calprotectin, faecal zonulin and serum lipopolysaccharides were assessed as markers for intestinal inflammation, gut permeability and bacterial translocation. Streptococcus salivarius, Veillonella parvula and the genus Streptococcus were significantly increased in patients with long-term PPI therapy and performed well as biomarkers for PPI-associated dysbiosis (accuracy: 74%, 72% and 74%, respectively). The abundance of Streptococcus salivarius was linked to intestinal inflammation and gut barrier dysfunction, whereas the abundance of Veillonella parvula showed associations with liver disease severity; both were independent predictors for liver-related three-year mortality. Gut-derived biomarkers of PPI-associated dysbiosis are linked to worse outcome and a potential option to evaluate the risks of adverse events during long-term PPI therapy. Nature Publishing Group UK 2019-08-19 /pmc/articles/PMC6700098/ /pubmed/31427714 http://dx.doi.org/10.1038/s41598-019-48352-5 Text en © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Horvath, Angela
Rainer, Florian
Bashir, Mina
Leber, Bettina
Schmerboeck, Bianca
Klymiuk, Ingeborg
Groselj-Strele, Andrea
Durdevic, Marija
Freedberg, Daniel E.
Abrams, Julian A.
Fickert, Peter
Stiegler, Philipp
Stadlbauer, Vanessa
Biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis
title Biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis
title_full Biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis
title_fullStr Biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis
title_full_unstemmed Biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis
title_short Biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis
title_sort biomarkers for oralization during long-term proton pump inhibitor therapy predict survival in cirrhosis
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6700098/
https://www.ncbi.nlm.nih.gov/pubmed/31427714
http://dx.doi.org/10.1038/s41598-019-48352-5
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