SwePub
Sök i LIBRIS databas

  Utökad sökning

WFRF:(Wendon J)
 

Sökning: WFRF:(Wendon J) > Rifaximin-alpha red...

  • Patel, Vishal C.Kings Coll Hosp NHS Fdn Trust, Inst Liver Studies, Denmark Hill, London SE5 9RS, England.;Kings Coll London, Fac Life Sci & Med, Inst Liver Studies, Sch Immunol & Microbial Sci, 125 Coldharbour Lane, London SE5 9NU, England.;Roger Williams Inst Hepatol, Fdn Liver Res, 111 Coldharbour Lane, London SE5 9NT, England. (författare)

Rifaximin-alpha reduces gut-derived inflammation and mucin degradation in cirrhosis and encephalopathy : RIFSYS randomised controlled trial

  • Artikel/kapitelEngelska2022

Förlag, utgivningsår, omfång ...

  • Elsevier BV,2022
  • printrdacarrier

Nummerbeteckningar

  • LIBRIS-ID:oai:DiVA.org:kth-309444
  • https://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-309444URI
  • https://doi.org/10.1016/j.jhep.2021.09.010DOI

Kompletterande språkuppgifter

  • Språk:engelska
  • Sammanfattning på:engelska

Ingår i deldatabas

Klassifikation

  • Ämneskategori:ref swepub-contenttype
  • Ämneskategori:art swepub-publicationtype

Anmärkningar

  • QC 20220304
  • Background & Aims: Rifaximin-alpha is efficacious for the prevention of recurrent hepatic encephalopathy (HE), but its mechanism of action remains unclear. We postulated that rifaximin-alpha reduces gut microbiota-derived endotoxemia and systemic inflammation, a known driver of HE. Methods: In a placebo-controlled, double-blind, mechanistic study, 38 patients with cirrhosis and HE were randomised 1:1 to receive either rifaximin-alpha (550 mg BID) or placebo for 90 days. Primary outcome: 50% reduction in neutrophil oxidative burst (OB) at 30 days. Secondary outcomes: changes in psychometric hepatic encephalopathy score (PHES) and neurocognitive functioning, shotgun metagenomic sequencing of saliva and faeces, plasma and faecal metabolic profiling, whole blood bacterial DNA quantification, neutrophil toll-like receptor (TLR)-2/4/9 expression and plasma/faecal cytokine analysis. Results: Patients were well-matched: median MELD (11 rifaximin-alpha vs. 10 placebo). Rifaximin-alpha did not lead to a 50% reduction in spontaneous neutrophil OB at 30 days compared to baseline (p = 0.48). However, HE grade normalised (p = 0.014) and PHES improved (p = 0.009) after 30 days on rifaximin-alpha. Rifaximin-alpha reduced circulating neutrophil TLR-4 expression on day 30 (p = 0.021) and plasma tumour necrosis factor-alpha (TNF-alpha) (p <0.001). Rifaximin-a suppressed oralisation of the gut, reducing levels of mucin-degrading sialidase-rich species, Streptococcus spp, Veillonella atypica and parvula, Akkermansia and Hungatella. Rifaximin-alpha promoted a TNF-alpha-and interleukin17E-enriched intestinal microenvironment, augmenting antibacterial responses to invading pathobionts and promoting gut barrier repair. Those on rifaximin-alpha were less likely to develop infection (odds ratio 0.21; 95% CI 0.05-0.96). Conclusion: Rifaximin-alpha led to resolution of overt and covert HE, reduced the likelihood of infection, reduced oralisation of the gut and attenuated systemic inflammation. Rifaximin-alpha plays a role in gut barrier repair, which could be the mechanism by which it ameliorates bacterial translocation and systemic endotoxemia in cirrhosis.

Ämnesord och genrebeteckningar

Biuppslag (personer, institutioner, konferenser, titlar ...)

  • Lee, SunjaeKTH,Science for Life Laboratory, SciLifeLab,Kings Coll London, Inst Dent, Ctr Host Microbiome Interact, London, England.;Gwangju Inst Sci & Technol, Sch Life Sci, Gwangju 61005, South Korea.(Swepub:kth)u15y67rb (författare)
  • McPhail, Mark J. W.Kings Coll Hosp NHS Fdn Trust, Inst Liver Studies, Denmark Hill, London SE5 9RS, England.;Kings Coll London, Fac Life Sci & Med, Inst Liver Studies, Sch Immunol & Microbial Sci, 125 Coldharbour Lane, London SE5 9NU, England.;Imperial Coll London, Biomol Med, Div Computat & Syst Med, Dept Surg & Canc, London, England. (författare)
  • Da Silva, KevinUniv Paris Saclay, INRAE, MetaGenoPolis, F-78350 Jouy En Josas, France. (författare)
  • Guilly, SusieUniv Paris Saclay, INRAE, MetaGenoPolis, F-78350 Jouy En Josas, France. (författare)
  • Zamalloa, AneKings Coll Hosp NHS Fdn Trust, Inst Liver Studies, Denmark Hill, London SE5 9RS, England. (författare)
  • Witherden, ElizabethKings Coll London, Inst Dent, Ctr Host Microbiome Interact, London, England. (författare)
  • Stoy, SidselAarhus Univ Hosp, Dept Gastroenterol & Hepatol, Aarhus, Denmark. (författare)
  • Vijay, Godhev Kumar ManakkatKings Coll London, Fac Life Sci & Med, Inst Liver Studies, Sch Immunol & Microbial Sci, 125 Coldharbour Lane, London SE5 9NU, England. (författare)
  • Pons, NicolasUniv Paris Saclay, INRAE, MetaGenoPolis, F-78350 Jouy En Josas, France. (författare)
  • Galleron, NathalieUniv Paris Saclay, INRAE, MetaGenoPolis, F-78350 Jouy En Josas, France. (författare)
  • Huang, XaiohongKings Coll London, Fac Life Sci & Med, Inst Liver Studies, Sch Immunol & Microbial Sci, 125 Coldharbour Lane, London SE5 9NU, England. (författare)
  • Gencer, SelinImperial Coll London, Biomol Med, Div Computat & Syst Med, Dept Surg & Canc, London, England. (författare)
  • Coen, MuireannImperial Coll London, Biomol Med, Div Computat & Syst Med, Dept Surg & Canc, London, England. (författare)
  • Tranah, Thomas HenryKings Coll Hosp NHS Fdn Trust, Inst Liver Studies, Denmark Hill, London SE5 9RS, England.;Kings Coll London, Fac Life Sci & Med, Inst Liver Studies, Sch Immunol & Microbial Sci, 125 Coldharbour Lane, London SE5 9NU, England. (författare)
  • Wendon, Julia AlexisKings Coll Hosp NHS Fdn Trust, Inst Liver Studies, Denmark Hill, London SE5 9RS, England.;Kings Coll London, Fac Life Sci & Med, Inst Liver Studies, Sch Immunol & Microbial Sci, 125 Coldharbour Lane, London SE5 9NU, England. (författare)
  • Bruce, Kenneth D.Kings Coll London, Inst Pharmaceut Sci, 5th Floor Franklin Wilkins Bldg, London, England. (författare)
  • Le Chatelier, EmmanuelleUniv Paris Saclay, INRAE, MetaGenoPolis, F-78350 Jouy En Josas, France. (författare)
  • Ehrlich, Stanislav DuskoUniv Paris Saclay, INRAE, MetaGenoPolis, F-78350 Jouy En Josas, France. (författare)
  • Edwards, Lindsey AnnKings Coll London, Fac Life Sci & Med, Inst Liver Studies, Sch Immunol & Microbial Sci, 125 Coldharbour Lane, London SE5 9NU, England. (författare)
  • Shoaie, SaeedKTH,Science for Life Laboratory, SciLifeLab,Kings Coll London, Inst Dent, Ctr Host Microbiome Interact, London, England.(Swepub:kth)u1buycsp (författare)
  • Shawcross, Debbie LindsayKings Coll Hosp NHS Fdn Trust, Inst Liver Studies, Denmark Hill, London SE5 9RS, England.;Kings Coll London, Fac Life Sci & Med, Inst Liver Studies, Sch Immunol & Microbial Sci, 125 Coldharbour Lane, London SE5 9NU, England. (författare)
  • Kings Coll Hosp NHS Fdn Trust, Inst Liver Studies, Denmark Hill, London SE5 9RS, England.;Kings Coll London, Fac Life Sci & Med, Inst Liver Studies, Sch Immunol & Microbial Sci, 125 Coldharbour Lane, London SE5 9NU, England.;Roger Williams Inst Hepatol, Fdn Liver Res, 111 Coldharbour Lane, London SE5 9NT, England.Science for Life Laboratory, SciLifeLab (creator_code:org_t)

Sammanhörande titlar

  • Ingår i:Journal of Hepatology: Elsevier BV76:2, s. 332-3420168-82781600-0641

Internetlänk

Hitta via bibliotek

Till lärosätets databas

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

 
pil uppåt Stäng

Kopiera och spara länken för att återkomma till aktuell vy