Bile Duct Colonization With Enterococcus sp. Associates With Disease Progression in Primary Sclerosing Cholangitis.
| Title: | Bile Duct Colonization With Enterococcus sp. Associates With Disease Progression in Primary Sclerosing Cholangitis. |
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| Authors: | Zigmond E; Center for Autoimmune Liver Diseases, Department of Gastroenterology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. Electronic address: zigmond@tlvmc.gov.il.; Zecher BF; First Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.; Bartels AL; First Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.; Ziv-Baran T; Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.; Rösch T; Department for Interdisciplinary Endoscopy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.; Schachschal G; Department for Interdisciplinary Endoscopy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.; Lohse AW; First Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.; Ehlken H; First Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Department for Interdisciplinary Endoscopy, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.; Schramm C; First Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Martin Zeitz Centre for Rare Diseases, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Hamburg Centre for Translational Immunology (HCTI), University Medical Centre Hamburg-Eppendorf, Hamburg, Germany. Electronic address: c.schramm@uke.de. |
| Source: | Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association [Clin Gastroenterol Hepatol] 2023 May; Vol. 21 (5), pp. 1223-1232.e3. Date of Electronic Publication: 2022 Sep 16. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't |
| Language: | English |
| Journal Info: | Publisher: W.B. Saunders for the American Gastroenterological Association Country of Publication: United States NLM ID: 101160775 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1542-7714 (Electronic) Linking ISSN: 15423565 NLM ISO Abbreviation: Clin Gastroenterol Hepatol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Philadelphia, PA : W.B. Saunders for the American Gastroenterological Association, 2003- |
| MeSH Terms: | Cholangitis, Sclerosing*/complications ; Cholangitis, Sclerosing*/drug therapy; Anti-Bacterial Agents/therapeutic use ; Humans ; Enterococcus ; Bile Ducts ; Cholangiopancreatography, Endoscopic Retrograde ; Bacteria ; Disease Progression |
| Abstract: | Background & Aims: Primary sclerosing cholangitis (PSC) is characterized by chronic inflammation of the biliary mucosa. Bile ducts in PSC are often colonized with bacteria. Although accumulating evidence demonstrates the importance of microbiota for mucosal immunity, little is known about the impact of bile duct colonization with bacteria on the clinical course of PSC.; Methods: Bile samples were sent to culture during endoscopic retrograde cholangio-pancreatography before the administration of peri-interventional antibiotics. Procedures during overt bacterial cholangitis or with prior antibiotic treatment were excluded. The primary endpoint was defined as a composite clinical endpoint of decompensated cirrhosis and/or liver transplantation or death.; Results: A cohort of 189 patients with 591 bile fluid cultures was included. In multivariable Cox regression analysis, the presence of Enterococci (present in 28% of the patients), but not of other bacterial species, conferred risk of disease progression with a hazard ratio of 3.61 (95% confidence interval, 1.6-8.11; P = .002) to reach the composite clinical endpoint. Fungobilia, present in 19.6% of patients, was confirmed to associate with disease progression with a hazard ratio of 3.25 (95% confidence interval, 1.87-5.66; P < .001) to reach the composite clinical endpoint.; Conclusions: The novel association of biliary colonization by Enterococci with disease progression underlines the importance of microbiota-mucosal interplay for the pathogenesis of PSC. These results should stimulate further mechanistic studies on the role of microbiota in PSC and highlight potential new therapeutic targets for a disease without effective treatment options.; (Copyright © 2023 The Author(s). Published by Elsevier Inc. All rights reserved.) |
| Comments: | Comment in: Clin Gastroenterol Hepatol. 2023 Sep;21(10):2699-2700. doi: 10.1016/j.cgh.2022.11.017.. (PMID: 36442726) |
| Contributed Indexing: | Keywords: Bactobilia; Bile Culture; Biliary Microbiota; Endoscopic Retrograde Cholangiography |
| Substance Nomenclature: | 0 (Anti-Bacterial Agents) |
| Entry Date(s): | Date Created: 20220918 Date Completed: 20230425 Latest Revision: 20230829 |
| Update Code: | 20260130 |
| DOI: | 10.1016/j.cgh.2022.09.006 |
| PMID: | 36116754 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't