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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Salivary Microbiota Reflects Changes in Gut Microbiota in Cirrhosis with Hepatic Encephalopathy</title>
<author><name sortKey="Bajaj, Jasmohan S" sort="Bajaj, Jasmohan S" uniqKey="Bajaj J" first="Jasmohan S" last="Bajaj">Jasmohan S. Bajaj</name>
<affiliation><nlm:aff id="A1"> Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Betrapally, Naga S" sort="Betrapally, Naga S" uniqKey="Betrapally N" first="Naga S" last="Betrapally">Naga S. Betrapally</name>
<affiliation><nlm:aff id="A4">Microbiome Analysis Center, George Mason University, Manassas, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Hylemon, Phillip B" sort="Hylemon, Phillip B" uniqKey="Hylemon P" first="Phillip B" last="Hylemon">Phillip B. Hylemon</name>
<affiliation><nlm:aff id="A2"> Department of Microbiology, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Heuman, Douglas M" sort="Heuman, Douglas M" uniqKey="Heuman D" first="Douglas M" last="Heuman">Douglas M. Heuman</name>
<affiliation><nlm:aff id="A1"> Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Daita, Kalyani" sort="Daita, Kalyani" uniqKey="Daita K" first="Kalyani" last="Daita">Kalyani Daita</name>
<affiliation><nlm:aff id="A1"> Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="White, Melanie B" sort="White, Melanie B" uniqKey="White M" first="Melanie B" last="White">Melanie B. White</name>
<affiliation><nlm:aff id="A1"> Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Unser, Ariel" sort="Unser, Ariel" uniqKey="Unser A" first="Ariel" last="Unser">Ariel Unser</name>
<affiliation><nlm:aff id="A1"> Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Thacker, Leroy R" sort="Thacker, Leroy R" uniqKey="Thacker L" first="Leroy R" last="Thacker">Leroy R. Thacker</name>
<affiliation><nlm:aff id="A3"> Department of Biostatistics, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sanyal, Arun J" sort="Sanyal, Arun J" uniqKey="Sanyal A" first="Arun J" last="Sanyal">Arun J. Sanyal</name>
<affiliation><nlm:aff id="A1"> Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kang, Dae Joong" sort="Kang, Dae Joong" uniqKey="Kang D" first="Dae Joong" last="Kang">Dae Joong Kang</name>
<affiliation><nlm:aff id="A1"> Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sikaroodi, Masoumeh" sort="Sikaroodi, Masoumeh" uniqKey="Sikaroodi M" first="Masoumeh" last="Sikaroodi">Masoumeh Sikaroodi</name>
<affiliation><nlm:aff id="A4">Microbiome Analysis Center, George Mason University, Manassas, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gillevet, Patrick M" sort="Gillevet, Patrick M" uniqKey="Gillevet P" first="Patrick M" last="Gillevet">Patrick M. Gillevet</name>
<affiliation><nlm:aff id="A4">Microbiome Analysis Center, George Mason University, Manassas, Virginia</nlm:aff>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">PMC</idno>
<idno type="pmid">25820757</idno>
<idno type="pmc">4587995</idno>
<idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4587995</idno>
<idno type="RBID">PMC:4587995</idno>
<idno type="doi">10.1002/hep.27819</idno>
<date when="2015">2015</date>
<idno type="wicri:Area/Pmc/Corpus">002728</idno>
<idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">002728</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Salivary Microbiota Reflects Changes in Gut Microbiota in Cirrhosis with Hepatic Encephalopathy</title>
<author><name sortKey="Bajaj, Jasmohan S" sort="Bajaj, Jasmohan S" uniqKey="Bajaj J" first="Jasmohan S" last="Bajaj">Jasmohan S. Bajaj</name>
<affiliation><nlm:aff id="A1"> Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Betrapally, Naga S" sort="Betrapally, Naga S" uniqKey="Betrapally N" first="Naga S" last="Betrapally">Naga S. Betrapally</name>
<affiliation><nlm:aff id="A4">Microbiome Analysis Center, George Mason University, Manassas, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Hylemon, Phillip B" sort="Hylemon, Phillip B" uniqKey="Hylemon P" first="Phillip B" last="Hylemon">Phillip B. Hylemon</name>
<affiliation><nlm:aff id="A2"> Department of Microbiology, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Heuman, Douglas M" sort="Heuman, Douglas M" uniqKey="Heuman D" first="Douglas M" last="Heuman">Douglas M. Heuman</name>
<affiliation><nlm:aff id="A1"> Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Daita, Kalyani" sort="Daita, Kalyani" uniqKey="Daita K" first="Kalyani" last="Daita">Kalyani Daita</name>
<affiliation><nlm:aff id="A1"> Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="White, Melanie B" sort="White, Melanie B" uniqKey="White M" first="Melanie B" last="White">Melanie B. White</name>
<affiliation><nlm:aff id="A1"> Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Unser, Ariel" sort="Unser, Ariel" uniqKey="Unser A" first="Ariel" last="Unser">Ariel Unser</name>
<affiliation><nlm:aff id="A1"> Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Thacker, Leroy R" sort="Thacker, Leroy R" uniqKey="Thacker L" first="Leroy R" last="Thacker">Leroy R. Thacker</name>
<affiliation><nlm:aff id="A3"> Department of Biostatistics, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sanyal, Arun J" sort="Sanyal, Arun J" uniqKey="Sanyal A" first="Arun J" last="Sanyal">Arun J. Sanyal</name>
<affiliation><nlm:aff id="A1"> Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Kang, Dae Joong" sort="Kang, Dae Joong" uniqKey="Kang D" first="Dae Joong" last="Kang">Dae Joong Kang</name>
<affiliation><nlm:aff id="A1"> Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Sikaroodi, Masoumeh" sort="Sikaroodi, Masoumeh" uniqKey="Sikaroodi M" first="Masoumeh" last="Sikaroodi">Masoumeh Sikaroodi</name>
<affiliation><nlm:aff id="A4">Microbiome Analysis Center, George Mason University, Manassas, Virginia</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Gillevet, Patrick M" sort="Gillevet, Patrick M" uniqKey="Gillevet P" first="Patrick M" last="Gillevet">Patrick M. Gillevet</name>
<affiliation><nlm:aff id="A4">Microbiome Analysis Center, George Mason University, Manassas, Virginia</nlm:aff>
</affiliation>
</author>
</analytic>
<series><title level="j">Hepatology (Baltimore, Md.)</title>
<idno type="ISSN">0270-9139</idno>
<idno type="eISSN">1527-3350</idno>
<imprint><date when="2015">2015</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass></textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Altered gut microbiome is associated with systemic inflammation and cirrhosis decompensation. However, the correlation of the oral microbiome with inflammation in cirrhosis is unclear.</p>
</sec>
<sec id="S2"><title>Aim</title>
<p id="P2">Evaluate the oral microbiome in cirrhosis and compare with stool microbiome.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P3">Cirrhotic outpatients [with/without hepatic encephalopathy (HE)] and controls underwent stool/saliva microbiome analysis (for composition and function) and also systemic inflammatory evaluation. 90-day liver-related hospitalizations were recorded. Salivary inflammation was studied using Th1 cytokines/secretory IgA, histatins and lysozyme in a subsequent group.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">102 cirrhotics (43 prior-HE) and 32 age-matched controls were included. On PCO, stool and saliva microbiome clustered far apart showing differences between sites as a whole.</p>
<sec id="S5"><title>Salivary microbiome</title>
<p id="P5">With prior-HE, relative abundance of autochthonous families decreased while potentially pathogenic ones (<italic>Enterobacteriaceae</italic>
, <italic>Enterococcaceae</italic>
) increased in saliva. Endotoxin-related predicted functions were significantly higher in cirrhotic saliva.</p>
</sec>
<sec id="S6"><title>Stool microbiome</title>
<p id="P6">Relative autochthonous taxa abundance reduced in prior-HE, along with increased <italic>Enterobacteriaceae</italic>
and <italic>Enterococcaceae.</italic>
Cirrhotic stool microbiota demonstrated a significantly higher correlation with systemic inflammation compared to saliva microbiota on correlation networks.</p>
</sec>
<sec id="S7"><title>Outcomes</title>
<p id="P7">38 patients were hospitalized within 90 days. Their salivary dysbiosis was significantly worse and predicted this outcome independent of cirrhosis severity.</p>
</sec>
<sec id="S8"><title>Salivary inflammation</title>
<p id="P8">was studied in an additional 86 age-matched subjects (43 controls/43 cirrhotics); significantly higher IL-6/IL-1β, secretory IgA and lower lysozyme, and histatins 1 and 5 were found in cirrhotics compared to controls.</p>
</sec>
</sec>
<sec id="S9"><title>Conclusions</title>
<p id="P9">Dysbiosis, represented by reduction in autochthonous bacteria, is present in both saliva and stool in cirrhosis patients compared to controls. Cirrhotic patients have impaired salivary defenses and worse inflammation. Salivary dysbiosis was greater in cirrhotics who developed 90-day hospitalizations. These findings could represent a global mucosal-immune interface change in cirrhosis.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8302946</journal-id>
<journal-id journal-id-type="pubmed-jr-id">4093</journal-id>
<journal-id journal-id-type="nlm-ta">Hepatology</journal-id>
<journal-id journal-id-type="iso-abbrev">Hepatology</journal-id>
<journal-title-group><journal-title>Hepatology (Baltimore, Md.)</journal-title>
</journal-title-group>
<issn pub-type="ppub">0270-9139</issn>
<issn pub-type="epub">1527-3350</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">25820757</article-id>
<article-id pub-id-type="pmc">4587995</article-id>
<article-id pub-id-type="doi">10.1002/hep.27819</article-id>
<article-id pub-id-type="manuscript">NIHMS698204</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Salivary Microbiota Reflects Changes in Gut Microbiota in Cirrhosis with Hepatic Encephalopathy</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Bajaj</surname>
<given-names>Jasmohan S</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Betrapally</surname>
<given-names>Naga S</given-names>
</name>
<degrees>MS</degrees>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Hylemon</surname>
<given-names>Phillip B</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Heuman</surname>
<given-names>Douglas M</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Daita</surname>
<given-names>Kalyani</given-names>
</name>
<degrees>MS</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>White</surname>
<given-names>Melanie B</given-names>
</name>
<degrees>RN</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Unser</surname>
<given-names>Ariel</given-names>
</name>
<degrees>BS</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Thacker</surname>
<given-names>Leroy R</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A3">3</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sanyal</surname>
<given-names>Arun J</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Kang</surname>
<given-names>Dae Joong</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Sikaroodi</surname>
<given-names>Masoumeh</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Gillevet</surname>
<given-names>Patrick M</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</aff>
<aff id="A2"><label>2</label>
Department of Microbiology, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</aff>
<aff id="A3"><label>3</label>
Department of Biostatistics, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia</aff>
<aff id="A4"><label>4</label>
Microbiome Analysis Center, George Mason University, Manassas, Virginia</aff>
<author-notes><corresp id="CR1"><underline>Correspondence</underline>
: Jasmohan S Bajaj, MD, MS, FACG, AGAF, Division of Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University and McGuire VA Medical Center, 1201 Broad Rock Boulevard, Richmond, VA 23221 Telephone: (804)-675-5802, Fax: (804)-675-5816, <email>jsbajaj@vcu.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>23</day>
<month>6</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="epub"><day>06</day>
<month>5</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="ppub"><month>10</month>
<year>2015</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>10</month>
<year>2016</year>
</pub-date>
<volume>62</volume>
<issue>4</issue>
<fpage>1260</fpage>
<lpage>1271</lpage>
<pmc-comment>elocation-id from pubmed: 10.1002/hep.27819</pmc-comment>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">Altered gut microbiome is associated with systemic inflammation and cirrhosis decompensation. However, the correlation of the oral microbiome with inflammation in cirrhosis is unclear.</p>
</sec>
<sec id="S2"><title>Aim</title>
<p id="P2">Evaluate the oral microbiome in cirrhosis and compare with stool microbiome.</p>
</sec>
<sec id="S3"><title>Methods</title>
<p id="P3">Cirrhotic outpatients [with/without hepatic encephalopathy (HE)] and controls underwent stool/saliva microbiome analysis (for composition and function) and also systemic inflammatory evaluation. 90-day liver-related hospitalizations were recorded. Salivary inflammation was studied using Th1 cytokines/secretory IgA, histatins and lysozyme in a subsequent group.</p>
</sec>
<sec id="S4"><title>Results</title>
<p id="P4">102 cirrhotics (43 prior-HE) and 32 age-matched controls were included. On PCO, stool and saliva microbiome clustered far apart showing differences between sites as a whole.</p>
<sec id="S5"><title>Salivary microbiome</title>
<p id="P5">With prior-HE, relative abundance of autochthonous families decreased while potentially pathogenic ones (<italic>Enterobacteriaceae</italic>
, <italic>Enterococcaceae</italic>
) increased in saliva. Endotoxin-related predicted functions were significantly higher in cirrhotic saliva.</p>
</sec>
<sec id="S6"><title>Stool microbiome</title>
<p id="P6">Relative autochthonous taxa abundance reduced in prior-HE, along with increased <italic>Enterobacteriaceae</italic>
and <italic>Enterococcaceae.</italic>
Cirrhotic stool microbiota demonstrated a significantly higher correlation with systemic inflammation compared to saliva microbiota on correlation networks.</p>
</sec>
<sec id="S7"><title>Outcomes</title>
<p id="P7">38 patients were hospitalized within 90 days. Their salivary dysbiosis was significantly worse and predicted this outcome independent of cirrhosis severity.</p>
</sec>
<sec id="S8"><title>Salivary inflammation</title>
<p id="P8">was studied in an additional 86 age-matched subjects (43 controls/43 cirrhotics); significantly higher IL-6/IL-1β, secretory IgA and lower lysozyme, and histatins 1 and 5 were found in cirrhotics compared to controls.</p>
</sec>
</sec>
<sec id="S9"><title>Conclusions</title>
<p id="P9">Dysbiosis, represented by reduction in autochthonous bacteria, is present in both saliva and stool in cirrhosis patients compared to controls. Cirrhotic patients have impaired salivary defenses and worse inflammation. Salivary dysbiosis was greater in cirrhotics who developed 90-day hospitalizations. These findings could represent a global mucosal-immune interface change in cirrhosis.</p>
</sec>
</abstract>
<kwd-group><kwd>hepatic encephalopathy</kwd>
<kwd>dysbiosis</kwd>
<kwd>inflammation</kwd>
<kwd>hospitalization</kwd>
<kwd>outcomes</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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