Digital Polymerase Chain Reaction-Based Fecal Streptococcus Quantification for Liver Fibrosis Assessment in Chronic...

Area of Science:

• Gastroenterology
• Microbiology
• Biomarker Discovery

Background:

• Chronic liver disease (CLD) impacts millions globally.
• Noninvasive biomarkers for liver fibrosis are crucial for patient management.
• Fecal microbiota composition is increasingly recognized as relevant in CLD.

Purpose of the Study:

• To identify clinical factors linked to fecal Streptococcus spp. load in CLD patients.
• To assess the utility of fecal Streptococcus spp. load as a noninvasive biomarker for liver fibrosis using digital PCR (dPCR).

Main Methods:

• Retrospective analysis of 146 CLD patients.
• Quantification of fecal Streptococcus spp. load using dPCR and 16S rRNA gene primers.
• Separate analysis of proton pump inhibitor (PPI) users due to their impact.
• Correlation and receiver operating characteristic (ROC) curve analyses to evaluate diagnostic performance for cirrhosis.

Main Results:

• Fecal Streptococcus spp. load was significantly higher in PPI users and cirrhotic patients.
• ROC analysis for cirrhosis showed an AUC of 0.728, lower than established markers.
• Streptococcus spp. load correlated positively with age and negatively with BMI.
• Higher loads were observed in older patients (>65 years) with lower BMI (≤25 kg/m²).

Conclusions:

• Fecal Streptococcus spp. load measured by dPCR could potentially supplement existing noninvasive fibrosis markers in CLD.
• Host-related factors like age and BMI may influence the diagnostic accuracy of this biomarker.
• Further research is needed to refine its clinical utility.