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Mouth, as well
as gut, could hold key to liver disease flare-ups

Date:

April 17, 2015

Source:

Virginia Commonwealth
University

Summary:

In a recent study,
researchers predicted which cirrhosis patients would suffer inflammations and
require hospitalization by analyzing their saliva, revealing a new target for
research into a disease that accounts for more than 30,000 deaths in the United
States each year.

.....................

In  a recent study, Virginia Commonwealth
University School of Medicine researchers predicted which cirrhosis patients
would suffer inflammations and require hospitalization by analyzing their
saliva, revealing a new target for research into a disease that accounts for
more than 30,000 deaths in the United States each year.

The findings could trigger a change in the way researchers study chronic
liver disease and associated microbiota, the network of tiny organisms in the
human body such as bacteria and fungi that can either bolster an immune system
or weaken it.

The breakdown of defenses in the mucosa of the gut has long been a signal
of inflammation in those with cirrhosis, which sees healthy liver tissue
replaced by scar tissue.

The recent findings suggest that another part of the body also can produce
warning signs.

"It has been believed that most of the pathogenesis of cirrhosis
starts in the gut, which is what makes this discovery so fascinating,"
said Jasmohan S. Bajaj, M.D., associate professor of hepatology in the VCU
School of Medicine and Hunter Holmes McGuire Veterans Affairs Medical Center.
"The fact that saliva, along with fluid in the gut, can be an indicator of
inflammation tells us that we need to further explore the oral cavity and its
connections to liver disease."

Bajaj is the senior author of a paper, "Salivary Microbiota Reflects
Changes in Gut Microbiota in Cirrhosis with Hepatic Encephalopathy,"
accepted March 29 for publication in the journal Hepatology.

The paper describes a study of more than 100 cirrhosis patients from VCU
and VA Medical Center, 38 of which had to be hospitalized within 90 days
because of flare-ups. Researchers found that the ratio of good-to-bad microbes
was similar in the saliva as in the stool of these patients who required
hospitalization.

Another part of the same study looked at an additional group of more than
80 people with and without cirrhosis. Those with cirrhosis had impaired
salivary defenses, mirroring the immune deficiencies that take place in the
gut.

"The data suggest that there may be a change in the overall
mucosal-immune interface in cirrhosis patients, allowing a more toxic
microbiota to emerge in both the gut and oral cavity," said Phillip B.
Hylemon, Ph.D., professor of microbiology and immunology in the VCU School of
Medicine and co-author of the paper.

In addition to using oral microbiota to predict the disease status of
cirrhosis patients, Hylemon said the new evidence could provide a useful tool
for testing treatment protocols for patients with cirrhosis or other diseases
driven by inflammation.







Story Source:

The above story is based on materials provided by Virginia
Commonwealth University. Note: Materials may be edited for content and length.







Journal Reference:

1.    Jasmohan S Bajaj, Naga S Betrapally,
Phillip B Hylemon, Douglas M Heuman, Kalyani Daita, Melanie B White, Ariel
Unser, Leroy R Thacker, Arun J Sanyal, Dae Joong Kang, Masoumeh Sikaroodi,
Patrick M Gillevet. Salivary Microbiota Reflects Changes in Gut
Microbiota in Cirrhosis with Hepatic Encephalopathy. Hepatology,
2015; DOI: 10.1002/hep.27819

http://www.sciencedaily.com/releases/2015/04/150417130724.htm

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