ArticleNature microbiology2023
Bifidobacteria metabolize lactulose to optimize gut metabolites and prevent systemic infection in patients with liver disease.
Article in Nature microbiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
37 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- The Efficacy of Gut Microbiome-Modulating Therapies on Liver Cirrhosis: A Systematic Review and Network Meta-Analysis.Clinical and translational gastroenterology · 2026Pooled it
- The intestinal microbiota impacts nutritional immunity and resistance toProceedings of the National Academy of Sciences of the United States of America · 2026Article
- Preliminary insights into gut microbiome shifts as screening proxy for MASLD disease progression.Scientific reports · 2026Article
- Muribaculum intestinale alleviates depressive-like behaviors by inhibiting Th17 cell differentiation and M1 microglia polarization.Microbiome · 2026Article
- Fecal butyrate and deoxycholic acid quantitation for rapid assessment of the gut microbiome.PloS one · 2026Article
- Gut-Liver Axis Failure in Critical Alcohol-Associated Liver Disease: From ICU Secondary Hits to Microbiome-Targeted Therapy.Mediators of inflammation · 2026Review
- The multi-omic basis for hepatic encephalopathy recurrence: Analysis of the THEMATIC trial.JHEP reports : innovation in hepatology · 2026Article
- Statistical design of a synthetic microbiome that suppresses diverse gut pathogens.bioRxiv : the preprint server for biology · 2025Article
- Lantibiotic-producing bacteria impact microbiome resilience and colonization resistance.Cell host & microbe · 2025Article
- Targeting gut microbiota in liver disease: A pharmacological approach for hepatic encephalopathy and beyond.World journal of gastrointestinal pharmacology and therapeutics · 2025Review
- Lactulose selectively stimulates members of the gut microbiota, as determined by multi-modal activity-based sorting.Gut microbes · 2025Article
- LCMSpector: A simple open-source viewer for targeted hyphenated mass spectrometry analysis.PLoS computational biology · 2025Article
- Article
- A Review of Recent Advances in Fecal Microbiota Transplantation for the Treatment of Hepatic Encephalopathy.Medical science monitor : international medical journal of experimental and clinical research · 2025Review
- Diallyl disulfide attenuates DSS-induced colonic fibrosis in mice by modulating gut microbiota and Nrf2 signaling.Inflammopharmacology · 2025Article
- Review
- The Role of the Intestinal Microbiome in Inflammation and Cancer.Deutsches Arzteblatt international · 2025Review
- A Lactobacillus Combination Ameliorates Lung Inflammation in an Elastase/LPS-induced Mouse Model of Chronic Obstructive Pulmonary Disease.Probiotics and antimicrobial proteins · 2025Article
- Intestinal lymphatic vasculature is functionally adapted to different drainage regions and is altered by helminth infection.The Journal of experimental medicine · 2025Article
- Gut Microbiota and Metabolites: Biomarkers and Therapeutic Targets for Diabetes Mellitus and Its Complications.Nutrients · 2025Review
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
32 authors at 4 institutions in 1 country.
Funding
Abstract
Progression of chronic liver disease is precipitated by hepatocyte loss, inflammation and fibrosis. This process results in the loss of critical hepatic functions, increasing morbidity and the risk of infection. Medical interventions that treat complications of hepatic failure, including antibiotic administration for systemic infections and lactulose treatment for hepatic encephalopathy, can impact gut microbiome composition and metabolite production. Here, using shotgun metagenomic sequencing and targeted metabolomic analyses on 847 faecal samples from 262 patients with acute or chronic liver disease, we demonstrate that patients hospitalized for liver disease have reduced microbiome diversity and a paucity of bioactive metabolites, including short-chain fatty acids and bile acid derivatives, that impact immune defences and epithelial barrier integrity. We find that patients treated with the orally administered but non-absorbable disaccharide lactulose have increased densities of intestinal bifidobacteria and reduced incidence of systemic infections and mortality. Bifidobacteria metabolize lactulose, produce high concentrations of acetate and acidify the gut lumen in humans and mice, which, in combination, can reduce the growth of antibiotic-resistant bacteria such as vancomycin-resistant Enterococcus faecium in vitro. Our studies suggest that lactulose and bifidobacteria serve as a synbiotic to reduce rates of infection in patients with severe liver disease.
Indexed as
Identifiers
What OpenQuestion holds
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.