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Rifaximin Alleviates Endotoxemia with Decreased Serum Levels of Soluble CD163 and Mannose Receptor and Partial Modification of Gut Microbiota in Cirrhotic Patients

Rifaximin is a poorly absorbable antibiotic against hepatic encephalopathy (HE). This observational study aimed to elucidate the effect of rifaximin on intestinal permeability and gut microbiota in patients with decompensated cirrhosis. Thirty patients with decompensated cirrhosis were assessed by a...

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Autores principales: Kaji, Kosuke, Saikawa, Soichiro, Takaya, Hiroaki, Fujinaga, Yukihisa, Furukawa, Masanori, Kitagawa, Koh, Ozutsumi, Takahiro, Kaya, Daisuke, Tsuji, Yuki, Sawada, Yasuhiko, Kawaratani, Hideto, Moriya, Kei, Namisaki, Tadashi, Akahane, Takemi, Mitoro, Akira, Yoshiji, Hitoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7235723/
https://www.ncbi.nlm.nih.gov/pubmed/32235367
http://dx.doi.org/10.3390/antibiotics9040145
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author Kaji, Kosuke
Saikawa, Soichiro
Takaya, Hiroaki
Fujinaga, Yukihisa
Furukawa, Masanori
Kitagawa, Koh
Ozutsumi, Takahiro
Kaya, Daisuke
Tsuji, Yuki
Sawada, Yasuhiko
Kawaratani, Hideto
Moriya, Kei
Namisaki, Tadashi
Akahane, Takemi
Mitoro, Akira
Yoshiji, Hitoshi
author_facet Kaji, Kosuke
Saikawa, Soichiro
Takaya, Hiroaki
Fujinaga, Yukihisa
Furukawa, Masanori
Kitagawa, Koh
Ozutsumi, Takahiro
Kaya, Daisuke
Tsuji, Yuki
Sawada, Yasuhiko
Kawaratani, Hideto
Moriya, Kei
Namisaki, Tadashi
Akahane, Takemi
Mitoro, Akira
Yoshiji, Hitoshi
author_sort Kaji, Kosuke
collection PubMed
description Rifaximin is a poorly absorbable antibiotic against hepatic encephalopathy (HE). This observational study aimed to elucidate the effect of rifaximin on intestinal permeability and gut microbiota in patients with decompensated cirrhosis. Thirty patients with decompensated cirrhosis were assessed by ammonia level, neuropsychological testing, endotoxin activity (EA), and serum proinflammatory cytokines at baseline and after four weeks of rifaximin treatment (1200 mg/day). Intestinal permeability was indicated by serum soluble CD163 (sCD163), mannose receptor (sMR), and zonulin levels. To evaluate the gut microbiome, 16S ribosomal RNA gene sequencing was applied. Rifaximin ameliorated hyperammonemia and cognitive dysfunction, although it did not change the serum proinflammatory cytokine levels. It decreased EA levels as well as serum levels of sCD163 and sMR, but not zonulin, and both decreases in sCD163 and sMR showed positive correlations with EA decrease (ΔsCD163: Correlation coefficient (R) = 0.680, p = 0.023; ΔsMR: R = 0.613, p = 0.014, vs. ΔEA). Gut microbial analysis revealed that the richness and complexity of species were unchanged while the abundance of the Streptococcus genus was reduced after treatment with rifaximin. Collectively, rifaximin alleviated HE and endotoxemia with improved intestinal hyperpermeability in patients with decompensated cirrhosis, and this effect is partially involved in a gut microbial change.
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spelling pubmed-72357232020-05-22 Rifaximin Alleviates Endotoxemia with Decreased Serum Levels of Soluble CD163 and Mannose Receptor and Partial Modification of Gut Microbiota in Cirrhotic Patients Kaji, Kosuke Saikawa, Soichiro Takaya, Hiroaki Fujinaga, Yukihisa Furukawa, Masanori Kitagawa, Koh Ozutsumi, Takahiro Kaya, Daisuke Tsuji, Yuki Sawada, Yasuhiko Kawaratani, Hideto Moriya, Kei Namisaki, Tadashi Akahane, Takemi Mitoro, Akira Yoshiji, Hitoshi Antibiotics (Basel) Article Rifaximin is a poorly absorbable antibiotic against hepatic encephalopathy (HE). This observational study aimed to elucidate the effect of rifaximin on intestinal permeability and gut microbiota in patients with decompensated cirrhosis. Thirty patients with decompensated cirrhosis were assessed by ammonia level, neuropsychological testing, endotoxin activity (EA), and serum proinflammatory cytokines at baseline and after four weeks of rifaximin treatment (1200 mg/day). Intestinal permeability was indicated by serum soluble CD163 (sCD163), mannose receptor (sMR), and zonulin levels. To evaluate the gut microbiome, 16S ribosomal RNA gene sequencing was applied. Rifaximin ameliorated hyperammonemia and cognitive dysfunction, although it did not change the serum proinflammatory cytokine levels. It decreased EA levels as well as serum levels of sCD163 and sMR, but not zonulin, and both decreases in sCD163 and sMR showed positive correlations with EA decrease (ΔsCD163: Correlation coefficient (R) = 0.680, p = 0.023; ΔsMR: R = 0.613, p = 0.014, vs. ΔEA). Gut microbial analysis revealed that the richness and complexity of species were unchanged while the abundance of the Streptococcus genus was reduced after treatment with rifaximin. Collectively, rifaximin alleviated HE and endotoxemia with improved intestinal hyperpermeability in patients with decompensated cirrhosis, and this effect is partially involved in a gut microbial change. MDPI 2020-03-29 /pmc/articles/PMC7235723/ /pubmed/32235367 http://dx.doi.org/10.3390/antibiotics9040145 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kaji, Kosuke
Saikawa, Soichiro
Takaya, Hiroaki
Fujinaga, Yukihisa
Furukawa, Masanori
Kitagawa, Koh
Ozutsumi, Takahiro
Kaya, Daisuke
Tsuji, Yuki
Sawada, Yasuhiko
Kawaratani, Hideto
Moriya, Kei
Namisaki, Tadashi
Akahane, Takemi
Mitoro, Akira
Yoshiji, Hitoshi
Rifaximin Alleviates Endotoxemia with Decreased Serum Levels of Soluble CD163 and Mannose Receptor and Partial Modification of Gut Microbiota in Cirrhotic Patients
title Rifaximin Alleviates Endotoxemia with Decreased Serum Levels of Soluble CD163 and Mannose Receptor and Partial Modification of Gut Microbiota in Cirrhotic Patients
title_full Rifaximin Alleviates Endotoxemia with Decreased Serum Levels of Soluble CD163 and Mannose Receptor and Partial Modification of Gut Microbiota in Cirrhotic Patients
title_fullStr Rifaximin Alleviates Endotoxemia with Decreased Serum Levels of Soluble CD163 and Mannose Receptor and Partial Modification of Gut Microbiota in Cirrhotic Patients
title_full_unstemmed Rifaximin Alleviates Endotoxemia with Decreased Serum Levels of Soluble CD163 and Mannose Receptor and Partial Modification of Gut Microbiota in Cirrhotic Patients
title_short Rifaximin Alleviates Endotoxemia with Decreased Serum Levels of Soluble CD163 and Mannose Receptor and Partial Modification of Gut Microbiota in Cirrhotic Patients
title_sort rifaximin alleviates endotoxemia with decreased serum levels of soluble cd163 and mannose receptor and partial modification of gut microbiota in cirrhotic patients
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7235723/
https://www.ncbi.nlm.nih.gov/pubmed/32235367
http://dx.doi.org/10.3390/antibiotics9040145
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