Fecal Microbiomes Distinguish Patients With Autoimmune Hepatitis From Healthy Individuals.

Jiamin Lou,Zhigang Ren,Zujiang Yu,Qingmiao Shi,Benchen Rao,Ang Li,Guangying Cui,Zhenguo Liu,Yan Jiang,Suying Ding,Heqi Zhou,Hang Yan

doi:10.3389/fcimb.2020.00342

Abstract

Objective: The intestinal microbiome is associated with various autoimmune diseases. Regional difference is the main influencing factor of intestinal microbial difference. This study aimed to identify the differences in fecal microbiome between autoimmune hepatitis (AIH) patients and healthy controls (HCs) in Central China, and to validate the efficacy of fecal microbiome as a diagnostic tool for AIH.Design: We collected 115 fecal samples from AIH patients (N = 37) and HCs (N = 78) in Central China and performed gene sequencing. Fecal microbiomes were characterized and microbial markers for AIH were identified.Results: Fecal microbial diversity showed a downward trend in AIH compared with HCs. Fecal microbial communities significantly differed between both groups. At the phylum level, Verrucomicrobia abundance was significantly increased, while Lentisphaerae and Synergistetes were significantly decreased in the AIH patients vs. the HCs. Compared to the HCs, 15 genera, including Veillonella, Faecalibacterium, and Akkermansia, were enriched, while 19 genera, such as Pseudobutyrivibrio, Lachnospira, and Ruminococcaceae, were decreased in the AIH patients. Ten genera, including Veillonella, Faecalibacterium, and Akkermansia, predominated in the AIH patients. Five microbial biomarkers were deemed optimal diagnostic tools for AIH. The probability of disease was significantly increased in AIH group vs. HCs, achieving 83.25% value of area under the curve.Conclusion: We present the characteristics of AIH patients in Central China for the first time. Five microbial biomarkers, including Lachnospiraceae, Veillonella, Bacteroides, Roseburia, and Ruminococcaceae, achieved a high potential distinguishing AIH patients from HCs.

Highlights

The human intestinal mucosa is extremely vulnerable to changes in the surrounding environment
Diagnosed patients with Autoimmune hepatitis (AIH) were excluded for the following reasons: (1) diagnosis of primary biliary cholangitis (PBC), (2) diagnosis of overlap syndrome (OS), (3) antibiotic consumption within the past 2 wks, (4) diagnosis of non-alcoholic steatohepatitis (NASH), viral hepatitis, alcoholic liver disease (ALD), or drug-induced liver injury (DILI) (Balitzer et al, 2017; Sebode et al, 2018), (5) had been treated with steroids or UDCA
Clinical characteristics were matched between the AIH and healthy controls (HCs) groups (P > 0.05)

Summary

Introduction

The human intestinal mucosa is extremely vulnerable to changes in the surrounding environment. Increasing attention has been given to fecal microbiota as intestinal microecology plays important roles in the diagnosis and pathogenesis of numerous diseases (Sun et al, 2018). AIH is globally distributed and occurs in children and adults It is characterized by etiological and clinical heterogeneity and is distinct from other hypothetical autoimmune liver diseases such as primary bile cirrhosis (PBC) and primary sclerosing cholangitis (PSC). It shares certain features in common with these conditions (Wang et al, 2016). There are certain confounders including autoantibody variability (such as autoantibody-negative AIH), drug-induced AIH, similarities among AIH, PBC, and PSC, overlap syndrome (OS), and post-transplant AIH (Anand et al, 2018)

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Results

Conclusion