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Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy
Patients with cirrhosis may show minimal hepatic encephalopathy (MHE), for which rifaximin is effective. Metabolic syndrome may be associated with cognitive impairment. Our aims were to evaluate the influence of metabolic syndrome features on response to rifaximin for neurological and inflammatory a...
Autores principales: | , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group UK
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8844048/ https://www.ncbi.nlm.nih.gov/pubmed/35165326 http://dx.doi.org/10.1038/s41598-022-06416-z |
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author | Ballester, María-Pilar Gallego, Juan-José Fiorillo, Alessandra Casanova-Ferrer, Franc Giménez-Garzó, Carla Escudero-García, Desamparados Tosca, Joan Ríos, María-Pilar Montón, Cristina Durbán, Lucía Ballester, José Benlloch, Salvador Urios, Amparo San-Miguel, Teresa Kosenko, Elena Serra, Miguel-Ángel Felipo, Vicente Montoliu, Carmina |
author_facet | Ballester, María-Pilar Gallego, Juan-José Fiorillo, Alessandra Casanova-Ferrer, Franc Giménez-Garzó, Carla Escudero-García, Desamparados Tosca, Joan Ríos, María-Pilar Montón, Cristina Durbán, Lucía Ballester, José Benlloch, Salvador Urios, Amparo San-Miguel, Teresa Kosenko, Elena Serra, Miguel-Ángel Felipo, Vicente Montoliu, Carmina |
author_sort | Ballester, María-Pilar |
collection | PubMed |
description | Patients with cirrhosis may show minimal hepatic encephalopathy (MHE), for which rifaximin is effective. Metabolic syndrome may be associated with cognitive impairment. Our aims were to evaluate the influence of metabolic syndrome features on response to rifaximin for neurological and inflammatory alterations in MHE. A prospective cohort study was conducted in 63 cirrhotic patients and 30 controls from two tertiary centres recruited between 2015 and 2019. Metabolic syndrome was defined according to the Adult Treatment Panel-III. Patients were classified into 31 without and 32 with MHE according to the Psychometric Hepatic Encephalopathy Score (PHES). All participants performed specific psychometric tests, and inflammatory parameters were studied. Patients with MHE received rifaximin (400 mg/8 h). Response was evaluated by PHES at 3 and 6 months. Response according to metabolic syndrome manifestations was compared. The response rate was 66%. Older age (p = 0.012) and all metabolic syndrome diseases (p < 0.05) were associated with non-response, plus an increase in risk as the number of manifestations rose (p < 0.001). Patients with metabolic manifestations exhibited worse processing speed (p = 0.011), working memory (p = 0.005), visual coordination (p = 0.013) and lower proportion of activated CD4(+) lymphocytes (p = 0.039) at baseline, as well as worse concentration (p = 0.030), bimanual coordination (p = 0.004) and higher levels of intermediate monocytes (p = 0.026), CX3CL1 (p < 0.05), IL-17 (p = 0.022), AHR (p = 0.010) and IgG (p < 0.05) at 3 and/or 6 months of rifaximin. Patients with clinical signs of metabolic syndrome have poor response to rifaximin for MHE, with a higher proportion of neurological alterations associated with a pro-inflammatory environment. |
format | Online Article Text |
id | pubmed-8844048 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-88440482022-02-16 Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy Ballester, María-Pilar Gallego, Juan-José Fiorillo, Alessandra Casanova-Ferrer, Franc Giménez-Garzó, Carla Escudero-García, Desamparados Tosca, Joan Ríos, María-Pilar Montón, Cristina Durbán, Lucía Ballester, José Benlloch, Salvador Urios, Amparo San-Miguel, Teresa Kosenko, Elena Serra, Miguel-Ángel Felipo, Vicente Montoliu, Carmina Sci Rep Article Patients with cirrhosis may show minimal hepatic encephalopathy (MHE), for which rifaximin is effective. Metabolic syndrome may be associated with cognitive impairment. Our aims were to evaluate the influence of metabolic syndrome features on response to rifaximin for neurological and inflammatory alterations in MHE. A prospective cohort study was conducted in 63 cirrhotic patients and 30 controls from two tertiary centres recruited between 2015 and 2019. Metabolic syndrome was defined according to the Adult Treatment Panel-III. Patients were classified into 31 without and 32 with MHE according to the Psychometric Hepatic Encephalopathy Score (PHES). All participants performed specific psychometric tests, and inflammatory parameters were studied. Patients with MHE received rifaximin (400 mg/8 h). Response was evaluated by PHES at 3 and 6 months. Response according to metabolic syndrome manifestations was compared. The response rate was 66%. Older age (p = 0.012) and all metabolic syndrome diseases (p < 0.05) were associated with non-response, plus an increase in risk as the number of manifestations rose (p < 0.001). Patients with metabolic manifestations exhibited worse processing speed (p = 0.011), working memory (p = 0.005), visual coordination (p = 0.013) and lower proportion of activated CD4(+) lymphocytes (p = 0.039) at baseline, as well as worse concentration (p = 0.030), bimanual coordination (p = 0.004) and higher levels of intermediate monocytes (p = 0.026), CX3CL1 (p < 0.05), IL-17 (p = 0.022), AHR (p = 0.010) and IgG (p < 0.05) at 3 and/or 6 months of rifaximin. Patients with clinical signs of metabolic syndrome have poor response to rifaximin for MHE, with a higher proportion of neurological alterations associated with a pro-inflammatory environment. Nature Publishing Group UK 2022-02-14 /pmc/articles/PMC8844048/ /pubmed/35165326 http://dx.doi.org/10.1038/s41598-022-06416-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/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 licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence 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 licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Ballester, María-Pilar Gallego, Juan-José Fiorillo, Alessandra Casanova-Ferrer, Franc Giménez-Garzó, Carla Escudero-García, Desamparados Tosca, Joan Ríos, María-Pilar Montón, Cristina Durbán, Lucía Ballester, José Benlloch, Salvador Urios, Amparo San-Miguel, Teresa Kosenko, Elena Serra, Miguel-Ángel Felipo, Vicente Montoliu, Carmina Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy |
title | Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy |
title_full | Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy |
title_fullStr | Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy |
title_full_unstemmed | Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy |
title_short | Metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy |
title_sort | metabolic syndrome is associated with poor response to rifaximin in minimal hepatic encephalopathy |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8844048/ https://www.ncbi.nlm.nih.gov/pubmed/35165326 http://dx.doi.org/10.1038/s41598-022-06416-z |
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