Intestinal Virome Signature Associated With Severity of Nonalcoholic Fatty Liver Disease.

Like Comment
Alterations in the gut microbiome have been associated with the severity of nonalcoholic fatty liver disease (NAFLD). These studies focused exclusively on the bacteria in the microbiome; we investigated changes in the viral microbiome (virome) in patients with NAFLD.In a prospective, cross-sectional, observational study, we extracted RNA and DNA virus-like particles from fecal samples from 73 patients with NAFLD: 29 patients had a NAFLD activity score (NAS) of 0-4, 44 patients had a NAS of 5-8 or cirrhosis (NAS 5-8/LCI), 37 patients had F0-F1 fibrosis, and 36 patients had F2-F4 fibrosis. As controls, 9 subjects without liver disease and 13 patients with mild primary biliary cholangitis were included in the analysis. We performed shotgun metagenomic sequencing of virus-like particles.Patients with NAFLD and NAS 5-8/LCI had a significant decrease in intestinal viral diversity compared with patients with NAFLD and NAS 0-4 or controls. The presence of more advanced NAFLD was associated with a significant reduction in the proportion of bacteriophages (phages) compared with other intestinal viruses. Using multivariate logistic regression analysis with leave-1 out cross validation, we developed a model, including a viral diversity index and simple clinical variables, that identified patients with NAS 5-8/LCI with an area under the curve of 0.95 (95% CI, 0.91-0.99) and F2-F4 fibrosis with an area under the curve of 0.88 (95% CI, 0.80-0.95). Addition of data on viral diversity significantly improved multivariate models, including those based on only clinical parameters or bacterial diversity.In a study of fecal viromes from patients with NAFLD and controls, we associated histologic markers of NAFLD severity with significant decreases in viral diversity and proportion of bacteriophages. We developed a model based on fecal viral diversity and clinical data that identifies patients with severe NAFLD and fibrosis more accurately than models based only on clinical or bacterial data.

Click here to read the full article @ Gastroenterology


The wider, wiser view for healthcare professionals. ClinOwl signposts the latest clinical content from over 100 leading medical journals.
6577 Contributions
0 Following