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The Gut Microbiome and Cirrhosis: Basic Aspects

  • Conference paper
Portal Hypertension VI

Abstract

In this chapter the basic aspects helping to understand the microbiome in terms of quantity, diversity, complexity, function, and interaction with the host are discussed. First the nomenclature, definitions of taxa, and measures of diversity as well as methods to unravel this kingdom are outlined. A brief summary on its physiological relevance for general health and the functions exerted specifically by the microbiome is presented. Differences in the composition of the microbiome along the gastrointestinal tract and across the gut wall and its interindividual variations, enterotypes, and stability are highlighted. The reader will be familiarized with all different modulators impacting on the microbiome, namely, intrinsic and extrinsic factors. Intrinsic factors include gastrointestinal secretions (gastric acid, bile, pancreatic juice, mucus), antimicrobial peptides, motility, enteric nervous system, and host genotype. Extrinsic factors are mainly dietary choices, hygiene, stress, alcohol consumption, exercise, and medications. The second part of the chapter focuses on quantitative and qualitative changes in microbiome in liver cirrhosis. The mechanisms contributing to dysbiosis, small intestinal bacterial overgrowth, and bacterial translocation are delineated underscoring their role for the liver-gut axis.

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Abbreviations

AMP:

Antimicrobial peptide

BSH:

Bile salt hydrolase

BT:

Bacterial translocation

CFU:

Colony forming units

FXR:

Farnesoid X receptor

GI:

Gastrointestinal

HFD:

High-fat diet

HIP/PAP:

Hepatocarcinoma-intestine-pancreas/pancreatic-associated protein

HT:

Hydroxyl-tryptamine

NE:

Norepinephrine

SIBO:

Small intestinal bacterial overgrowth

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  1. Bauchzentrum, Gastroenterology, Freiburgstrasse, Inselspital, University for Visceral Surgery and Medicine, Bern, Switzerland

    Reiner Wiest MD

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  1. Gastroenterology Unit, Luigi Sacco University Hospital, Milan, Italy

    Roberto de Franchis

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Wiest, R. (2016). The Gut Microbiome and Cirrhosis: Basic Aspects. In: de Franchis, R. (eds) Portal Hypertension VI. Springer, Cham. https://doi.org/10.1007/978-3-319-23018-4_18

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