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Association of Enteric Protist Blastocystis spp. and Gut Microbiota with Hepatic Encephalopathy
Sedat Yildiz1, İbrahim Doğan2, Funda Doğruman-Al3
1Etimesgut Sait Ertürk State Hospital, Ankara, Turkey. drsedatyildiz06@gmail.com.
Background And Aims:
Hepatic encephalopathy (HE) is a serious neuropsychiatric sequela emerging in the advanced stages of cirrhosis. The gut microbiota plays an important role in the development of HE. The aim of the study was to analyze the dynamic interplay between microbiota and Blastocystis in cirrhotic patients with or without encephalopathy.
Methods:
The study was designed as cross-sectional study. A total of 37 patients from the Ankara city, admitted to the University Hospital within a 6-month period prior to enrolment into the study were included in the study. After the regular health checks, clinical histories, clinical examinations, and Psychometric HE Score (PHES) points, patients' MELD and CTP scores were recorded. The fecal microbiota configurations were characterized by targeting hypervariable regions V3 and V4 of the 16S rRNA gene using Illumina MiSeq System.
Results:
Blastocystis spp. were detected in 21.6% (n = 8) of all cirrhotic patients. When those were analyzed by subgroups, four of them were subtype 2, three were subtype 3 and one was subtype 1. Blastocystis spp. were not found in any of the patients with HE; however, they were detected in 38.1% of the patients without HE. Also the increase in the bacterial diversity was observed along with the absence of Blastocystis. It was suggested that there was an inverse relationship between Blastocystis spp. and advanced stages of HE and the structure and composition of gut microbiota.
Conclusion:
The absence of Blastocystis spp. is associated with the HE severity and dysbiosis in the gut microbiota.
Insights
The absence of Blastocystis, a common gut microbe, correlates with increased severity of hepatic encephalopathy (HE) and gut dysbiosis in cirrhosis patients. This suggests Blastocystis may play a protective role in HE development.
Area of Science:
- Gastroenterology
- Microbiology
- Neuroscience
Background:
- Hepatic encephalopathy (HE) is a severe neuropsychiatric complication of advanced cirrhosis.
- Gut microbiota dysbiosis is implicated in HE pathogenesis.
- The role of Blastocystis in HE remains unclear.
Purpose of the Study:
- To investigate the dynamic interplay between gut microbiota and Blastocystis in cirrhotic patients.
- To determine the association of Blastocystis with the presence and severity of HE.
Main Methods:
- Cross-sectional study of 37 cirrhotic patients.
- Clinical data collection including MELD and CTP scores.
- Fecal microbiota analysis using 16S rRNA gene sequencing (V3-V4 regions).
Main Results:
- Blastocystis spp. were found in 21.6% of cirrhotic patients, with subtypes 1, 2, and 3 identified.
- Blastocystis was absent in patients with HE but present in 38.1% of those without HE.
- Increased bacterial diversity was observed in the absence of Blastocystis, suggesting an inverse relationship with HE severity and gut microbiota structure.
Conclusions:
- The absence of Blastocystis spp. is linked to HE severity.
- Blastocystis absence correlates with gut microbiota dysbiosis in cirrhotic patients.
