Elderly patients have an altered gut-brain axis regardless of the presence of cirrhosis.
Elderly patients have an altered gut-brain axis regardless of the presence of cirrhosis.
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DOI：
10.1038/srep38481
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发表时间：
2016-12-06
影响因子：
4.6
通讯作者：
Wade JB
中科院分区：
文献类型：
--
作者：
Bajaj JS;Ahluwalia V;Steinberg JL;Hobgood S;Boling PA;Godschalk M;Habib S;White MB;Fagan A;Gavis EA;Ganapathy D;Hylemon PB;Stewart KE;Keradman R;Liu EJ;Wang J;Gillevet PM;Sikaroodi M;Moeller FG;Wade JB
越来越多的老年肝硬化患者表现出的认知困难可能是健忘性（与记忆相关）或非健忘性（与记忆无关）。在这一人群中潜在的神经生物学和肠-脑变化尚不清楚。我们的目的是根据肝硬化的存在和神经心理学表现来确定老年肝硬化患者与非肝硬化患者的肠-脑轴改变。年龄匹配的有/没有肝硬化的门诊患者接受了认知测试（遗忘/非遗忘域）、生活质量（HRQOL）、多模态MRI （fMRI go/no-go任务、体积测量和磁共振光谱）、血液（炎症细胞因子）和粪便收集（微生物群）。各组根据肝硬化/非肝硬化以及神经心理学表现（健忘型、健忘/非健忘型和未受损）进行研究。与非肝硬化患者相比，肝硬化患者在非遗忘和选择性遗忘测试、HRQOL和全身性炎症方面均受损。肝硬化患者在磁共振光谱学上表现出明显的变化，但在功能磁共振成像或体积学上没有明显的变化。相关网络显示乳酸菌科成员与认知呈正相关，而肠杆菌科和卟啉单胞菌科成员与认知呈负相关。采用神经心理学分类，遗忘型/非遗忘型患者以肝硬化为主，HRQOL较差，炎症较高，原生类群相对丰度较低。该分类还预测了组间fMRI、MR光谱和体积学的变化。我们得出结论，肠-脑轴改变可能与老年肝硬化患者的神经行为下降或炎症老化类型有关。
Cognitive difficulties manifested by the growing elderly population with cirrhosis could be amnestic (memory-related) or non-amnestic (memory-unrelated). The underlying neuro-biological and gut-brain changes are unclear in this population. We aimed to define gut-brain axis alterations in elderly cirrhotics compared to non-cirrhotic individuals based on presence of cirrhosis and on neuropsychological performance. Age-matched outpatients with/without cirrhosis underwent cognitive testing (amnestic/non-amnestic domains), quality of life (HRQOL), multi-modal MRI (fMRI go/no-go task, volumetry and MR spectroscopy), blood (inflammatory cytokines) and stool collection (for microbiota). Groups were studied based on cirrhosis/not and also based on neuropsychological performance (amnestic-type, amnestic/non-amnestic-type and unimpaired). Cirrhotics were impaired on non-amnestic and selected amnestic tests, HRQOL and systemic inflammation compared to non-cirrhotics. Cirrhotics demonstrated significant changes on MR spectroscopy but not on fMRI or volumetry. Correlation networks showed that Lactobacillales members were positively while Enterobacteriaceae and Porphyromonadaceae were negatively linked with cognition. Using the neuropsychological classification amnestic/non-amnestic-type individuals were majority cirrhosis and had worse HRQOL, higher inflammation and decreased autochthonous taxa relative abundance compared to the rest. This classification also predicted fMRI, MR spectroscopy and volumetry changes between groups. We conclude that gut-brain axis alterations may be associated with the type of neurobehavioral decline or inflamm-aging in elderly cirrhotic subjects.
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影响因子：
3.7
作者：
Biagi E;Nylund L;Candela M;Ostan R;Bucci L;Pini E;Nikkïla J;Monti D;Satokari R;Franceschi C;Brigidi P;De Vos W
通讯作者：
De Vos W
影响因子：
2.9
作者：
Gillevet, Patrick;Sikaroodi, Masoumeh;Keshavarzian, Ali;Mutlu, Ece A.
通讯作者：
Mutlu, Ece A.
DOI：
10.1073/pnas.96.14.8301
发表时间：
1999-07-06
影响因子：
11.1
作者：
Garavan, H;Ross, TJ;Stein, EA
通讯作者：
Stein, EA
影响因子：
5.7
作者：
Patenaude, Brian;Smith, Stephen M.;Kennedy, David N.;Jenkinson, Mark
通讯作者：
Jenkinson, Mark
影响因子：
9.9
作者：
McPhail, Mark J. W.;Leech, Robert;Taylor-Robinson, Simon D.
通讯作者：
Taylor-Robinson, Simon D.