Evidence map›Paper›PMID 36164267›Full record

ArticleAlimentary pharmacology & therapeutics2022

Gut metagenome-derived signature predicts hepatic decompensation and mortality in NAFLD-related cirrhosis.

Suzanne R Sharpton, Tae Gyu Oh, Egbert Madamba, Chenjingyi Wang, Ruth T Yu, Annette R Atkins, Tao Huan, Michael Downes, Ronald M Evans, Rohit Loomba

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Alimentary pharmacology & therapeutics, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.4field-weighted citation impact, top 19% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 10 citations in OpenAlex.

  1. Review
  2. Review
  3. Review
  4. Review
  5. Global epidemiology of cirrhosis - aetiology, trends and predictions.Nature reviews. Gastroenterology & hepatology · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 3 institutions in 2 countries.

Suzanne R SharptonDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California, USA.
Tae Gyu OhGene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, California, USA.
Egbert MadambaNAFLD Research Center, Department of Medicine, University of California San Diego, La Jolla, California, USA.
Chenjingyi WangFaculty of Science, Department of Chemistry, University of British Columbia, Vancouver, Canada.
Ruth T YuGene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, California, USA.
Annette R AtkinsGene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, California, USA.
Tao HuanFaculty of Science, Department of Chemistry, University of British Columbia, Vancouver, Canada.
Michael DownesGene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, California, USA.
Ronald M EvansGene Expression Laboratory, Salk Institute for Biological Studies, La Jolla, California, USA.
Rohit LoombaDivision of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, California, USA.ORCID 0000-0002-4845-9991
Salk Institute for Biological Studies · USUniversity of California San Diego · USUniversity of British Columbia · CA

Funding

UC San Diego Clinical and Translational Research InstituteUL1TR001442 · NCATS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI FIRESTEIN, GARY S, HOGARTH, MICHAEL · 2015 to 2024
$88.3M
Viral Vector Core (VVC)P30CA014195 · NCI · SALK INSTITUTE FOR BIOLOGICAL STUDIES · PI Alan Saghatelian · 1985 to 2026
$82.8M
Yeast Genetics and Stress Response Genes-BiomedicalP42ES010337 · NIEHS · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI TUKEY, ROBERT H · 2000 to 2022
$69.8M
Pediatric Trials in Non-Alcoholic Steatohepatitis (NASH)U01DK061734 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI ROHIT LOOMBA · 2002 to 2026
$24.4M
Tissue-specific roles of FXR in CVD and NASHP01HL147835 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI LOOMBA, ROHIT · 2020 to 2024
$12.2M
San Diego Digestive Diseases Research CenterP30DK120515 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Bernd G. Schnabl · 2019 to 2026
$10.8M
HIV MASLD Clinical Research Network (HCRN)R01DK121378 · NIDDK · INDIANA UNIVERSITY INDIANAPOLIS · PI NAGA P CHALASANI, ROHIT LOOMBA · 2020 to 2026
$8.7M
Novel IL-23 inhibitor for the treatment of alcohol associated liver diseaseU01AA029019 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI KISSELEVA, TATIANA, LOOMBA, ROHIT · 2020 to 2024
$3.7M
QUS Technology for Diagnosis and Grading of Hepatic Steatosis in NAFLDR01DK106419 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI LOOMBA, ROHIT, SIRLIN, CLAUDE B · 2015 to 2019
$3.4M
Hormonal Regulation of Mammalian Gene ExpressionR01DK057978 · NIDDK · SALK INSTITUTE FOR BIOLOGICAL STUDIES · PI EVANS, RONALD M · 2021 to 2024
$2.6M
Non-invasive screening of diabetics for advanced fibrosis due to NAFLDR01DK124318 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI LOOMBA, ROHIT · 2020 to 2022
$1.7M
NCATS NIH HHS UL1 TR001442NCI NIH HHS P30 CA014195NHLBI NIH HHS P01 HL147835NIAAA NIH HHS U01 AA029019NIDDK NIH HHS P30 DK120515NIDDK NIH HHS R01 DK057978NIDDK NIH HHS R01 DK106419NIDDK NIH HHS R01 DK121378NIDDK NIH HHS R01 DK124318NIDDK NIH HHS U01 DK061734NIEHS NIH HHS P42 ES010337
6 · The paper itself

Abstract

backgroundThere are limited data on the diagnostic accuracy of gut microbial signatures for predicting hepatic decompensation in patients with cirrhosis.

aimsTo determine whether a stool metagenome-derived signature accurately detects hepatic decompensation and mortality risk in cirrhosis secondary to non-alcoholic fatty liver disease (NAFLD)

methodsShotgun metagenomic sequencing was performed on faecal samples collected at study entry from a prospective cohort of adults with NAFLD-related cirrhosis. A Random Forest machine learning algorithm was utilised to identify a metagenomic signature of decompensated cirrhosis (defined by ascites, hepatic encephalopathy or variceal haemorrhage) and subsequently validated in an external cohort. A Cox proportional hazards regression model was used to examine predictors of all-cause mortality.

resultsIn all, 25 adults with NAFLD-related cirrhosis (training cohort) were included. Among the 16 participants with decompensated cirrhosis, 33% had ascites, 56% had hepatic encephalopathy and 22% had experienced a variceal haemorrhage (not mutually exclusive). We identified a stool metagenomic signature comprising 13 discriminatory species that reliably distinguished decompensated NAFLD-related cirrhosis (diagnostic accuracy, 0.97, 95% confidence interval [CI] 0.96-0.99). Diagnostic accuracy of the 13-species signature remained high after adjustment for lactulose (area under the curve [AUC] 0.99) and rifaximin use (AUC 0.93). The discriminative ability of 13-species metagenomic signature was robust in an independent test cohort (AUC 0.95, 95% CI 0.81-1.00). The 13-species metagenomic signature (hazard ratio [HR] 1.54, 95% CI 1.10-2.15, p = 0.01) was a stronger predictor of mortality than the Model for End-Stage Liver Disease score (HR 1.25, 95% CI 1.03-1.53, p = 0.03).

conclusionsThis study provides evidence for a gut metagenome-derived signature with high diagnostic accuracy for hepatic decompensation that predicts risk of mortality in NAFLD-related cirrhosis.

Indexed as

End Stage Liver DiseaseEsophageal and Gastric VaricesHepatic EncephalopathyNon-alcoholic Fatty Liver DiseaseAdultAscitesGastrointestinal HemorrhageHumansLactuloseLiver CirrhosisMetagenomeProspective StudiesRifaximinSeverity of Illness IndexLactuloseRifaximin

Identifiers

PMID36164267
PMCPMC9746351
OpenAlexW4297261176

What OpenQuestion holds

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Registered trials

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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.