Evidence map›Paper›PMID 34896404›Full record

ArticleJournal of hepatology2022

The fecal mycobiome in non-alcoholic fatty liver disease.

Münevver Demir, Sonja Lang, Phillipp Hartmann, Yi Duan, Anna Martin, Yukiko Miyamoto, Marina Bondareva, Xinlian Zhang, Yanhan Wang, Philipp Kasper and 10 more

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of hepatology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05793190 (Feal Mycobiome Profiling Depending on Alcoholic Liver Disease Severity.), which is not on this map. Cited by 132 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
132citing papers in PubMed, 1 pooled it
9.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05793190 unknown statusnot on this map

Feal Mycobiome Profiling Depending on Alcoholic Liver Disease Severity.

Typeobservational_patient_registrySponsorChuncheon Sacred Heart HospitalRan2021 to 2023Enrolled500ConditionsAlcoholic Liver Disease
3 · Its place in the literature

Who cites it

132 citing papers in PubMed, 1 synthesis or guideline pooled it, 175 citations in OpenAlex.

  1. Pooled it
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  9. Article
  10. Socioeconomic Factors and Their Role in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Comprehensive Review.Liver international : official journal of the International Association for the Study of the Liver · 2026
    Review
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  18. Phage Therapy in Gastrointestinal Diseases: Current Status and Challenges.International journal of molecular sciences · 2026
    Review
  19. Article
  20. Review

72 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 8 institutions in 5 countries.

Münevver DemirDepartment of Hepatology and Gastroenterology, Campus Virchow Clinic and Campus Charité Mitte, Charité University Medicine, Berlin, Germany.
Sonja LangUniversity of Cologne, Faculty of Medicine, and University Hospital Cologne, Department of Gastroenterology and Hepatology, Cologne, Germany; Department of Medicine, University of California San Diego, La Jolla, CA, USA.
Phillipp HartmannDepartment of Medicine, University of California San Diego, La Jolla, CA, USA; Department of Pediatrics, University of California San Diego, La Jolla, CA, USA.
Yi DuanDepartment of Medicine, University of California San Diego, La Jolla, CA, USA.
Anna MartinUniversity of Cologne, Faculty of Medicine, and University Hospital Cologne, Department of Gastroenterology and Hepatology, Cologne, Germany.
Yukiko MiyamotoDepartment of Medicine, University of California San Diego, La Jolla, CA, USA.
Marina BondarevaBelozerskiy Research Institute for Physical and Chemical Biology and Faculty of Bioengineering and Bioinformatics, M.V. Lomonosov Moscow State University, Moscow, 119991, Russia; Chronic Inflammation Lab, German Rheumatism Research Center, a Leibniz Institute, Berlin, Germany.
Xinlian ZhangDivision of Biostatistics and Bioinformatics, Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA.
Yanhan WangDepartment of Medicine, University of California San Diego, La Jolla, CA, USA.
Philipp KasperUniversity of Cologne, Faculty of Medicine, and University Hospital Cologne, Department of Gastroenterology and Hepatology, Cologne, Germany.
Corinna BangInstitute of Clinical Molecular Biology, Christian-Albrechts-University of Kiel, 24105 Kiel, Germany.
Christoph RoderburgDepartment of Hepatology and Gastroenterology, Campus Virchow Clinic and Campus Charité Mitte, Charité University Medicine, Berlin, Germany; Clinic for Gastroenterology, Hepatology and Infectious Diseases, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Frank TackeDepartment of Hepatology and Gastroenterology, Campus Virchow Clinic and Campus Charité Mitte, Charité University Medicine, Berlin, Germany.
Hans-Michael SteffenUniversity of Cologne, Faculty of Medicine, and University Hospital Cologne, Department of Gastroenterology and Hepatology, Cologne, Germany.
Tobias GoeserUniversity of Cologne, Faculty of Medicine, and University Hospital Cologne, Department of Gastroenterology and Hepatology, Cologne, Germany.
Andrey KruglovBelozerskiy Research Institute for Physical and Chemical Biology and Faculty of Bioengineering and Bioinformatics, M.V. Lomonosov Moscow State University, Moscow, 119991, Russia; Chronic Inflammation Lab, German Rheumatism Research Center, a Leibniz Institute, Berlin, Germany.
Lars EckmannDepartment of Medicine, University of California San Diego, La Jolla, CA, USA.
Peter StärkelSt. Luc University Hospital, Université Catholique de Louvain, Brussels, Belgium.
Derrick E FoutsDepartment of Genomic Medicine, J. Craig Venter Institute, Rockville, MD, USA.
Bernd SchnablDepartment of Medicine, University of California San Diego, La Jolla, CA, USA; Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA. Electronic address: beschnabl@ucsd.edu.
University of California San Diego · USUniversity of Cologne · DECharité - Universitätsmedizin Berlin · DELomonosov Moscow State University · RUChristian-Albrechts-Universität zu Kiel · DEDüsseldorf University Hospital · DEJ. Craig Venter Institute · USUCLouvain · BE

Funding

The Southernearch Center for ALPD and CirrhosisP50AA011999 · NIAAA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI ANNA S. GUKOVSKAYA · 1999 to 2026
$45.8M
San Diego Digestive Diseases Research CenterP30DK120515 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI LARS ECKMANN, Bernd G. Schnabl · 2019 to 2026
$10.8M
The Role of the Intestinal Mycobiome in Alcoholic Liver DiseaseR01AA024726 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Bernd G. Schnabl · 2018 to 2026
$3.9M
Microbiome and intestinal innate immune response in alcoholic liver diseaseR01AA020703 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SCHNABL, BERND G. · 2011 to 2020
$3.6M
Microbiome and Intestinal Innate Immune Response in Alcoholic Liver DiseaseR37AA020703 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Bernd G. Schnabl · 2021 to 2026
$2.5M
Microbiome as therapeutic target in alcoholic hepatitisU01AA026939 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI FOUTS, DERRICK E, SCHNABL, BERND G. · 2018 to 2022
$1.7M
The role of pathobionts in alcoholic liver diseaseI01BX004594 · VA · VA SAN DIEGO HEALTHCARE SYSTEM · PI Bernd G. Schnabl · 2019 to 2026
–
BLRD VA I01 BX004594NIAAA NIH HHS P50 AA011999NIAAA NIH HHS R01 AA020703NIAAA NIH HHS R01 AA024726NIAAA NIH HHS R37 AA020703NIAAA NIH HHS U01 AA026939NIDDK NIH HHS P30 DK120515
6 · The paper itself

Abstract

BACKGROUND &

aimsStudies investigating the gut-liver axis have largely focused on bacteria, whereas little is known about commensal fungi. We characterized fecal fungi in patients with non-alcoholic fatty liver disease (NAFLD) and investigated their role in a fecal microbiome-humanized mouse model of Western diet-induced steatohepatitis.

methodsWe performed fungal internal transcribed spacer 2 sequencing using fecal samples from 78 patients with NAFLD, 16 controls and 73 patients with alcohol use disorder. Anti-Candida albicans (C. albicans) IgG was measured in blood samples from 17 controls and 79 patients with NAFLD. Songbird, a novel multinominal regression tool, was used to investigate mycobiome changes. Germ-free mice were colonized with feces from patients with non-alcoholic steatohepatitis (NASH), fed a Western diet for 20 weeks and treated with the antifungal amphotericin B.

resultsThe presence of non-obese NASH or F2-F4 fibrosis was associated with a distinct fecal mycobiome signature. Changes were characterized by an increased log-ratio for Mucor sp./Saccharomyces cerevisiae (S. cerevisiae) in patients with NASH and F2-F4 fibrosis. The C. albicans/S. cerevisiae log-ratio was significantly higher in non-obese patients with NASH when compared with non-obese patients with NAFL or controls. We observed a different fecal mycobiome composition in patients with NAFLD and advanced fibrosis compared to those with alcohol use disorder and advanced fibrosis. Plasma anti-C. albicans IgG was increased in patients with NAFLD and advanced fibrosis. Gnotobiotic mice, colonized with human NASH feces and treated with amphotericin B were protected from Western diet-induced steatohepatitis.

conclusionsNon-obese patients with NAFLD and more advanced disease have a different fecal mycobiome composition to those with mild disease. Antifungal treatment ameliorates diet-induced steatohepatitis in mice. Intestinal fungi could be an attractive target to attenuate NASH. LAY SUMMARY: Non-alcoholic fatty liver disease is one of the most common chronic liver diseases and is associated with changes in the fecal bacterial microbiome. We show that patients with non-alcoholic fatty liver disease and more severe disease stages have a specific composition of fecal fungi and an increased systemic immune response to Candida albicans. In a fecal microbiome-humanized mouse model of Western diet-induced steatohepatitis, we show that treatment with antifungals reduces liver damage.

Indexed as

Gastrointestinal MicrobiomeMycobiomeNon-alcoholic Fatty Liver DiseaseAnimalsFecesHumansLiverMiceSaccharomyces cerevisiaeFungigut pathogensmetagenomicsmicrobiomemicrobiotaNAFLDNASH

Identifiers

PMID34896404
PMCPMC8981795
OpenAlexW4200510289

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.