Objective:To analyze the efficacy of Biejiajian Pill(BJJP)on intestinal microbiota in patients with hepatitis B cirrhosis/liver fibrosis,and explore its relationship with liver fibrosis.Methods:This was a prospective,...Objective:To analyze the efficacy of Biejiajian Pill(BJJP)on intestinal microbiota in patients with hepatitis B cirrhosis/liver fibrosis,and explore its relationship with liver fibrosis.Methods:This was a prospective,randomized double-blind controlled trial.Using the stratified block randomization method,35 patients with hepatitis B liver cirrhosis/liver fibrosis were randomly assigned(1:1)to receive entecavir(0.5 mg/d)combined with BJJP(3 g/time,3 times a day)or placebo(simulator as control,SC group,simulator 3 g/time,3 times a day)for 48 weeks.Blood and stool samples were collected from patients at baseline and week 48 of treatment,respectively.Liver and renal functions as well as hematological indices were detected.Fecal samples were analyzed by 16S rDNA V3-V4 high-throughput sequencing,and intestinal microbiota changes in both groups before and after treatment were compared,and their correlations with liver fibrosis were analyzed.Results:Compared with the SC group,there was no significant difference in liver function,renal function and hematology indices in the BJJP group,however,the improvement rate of liver fibrosis was higher in the BJJP group(94.4%vs.64.7%,P=0.041).Principal coordinate analysis(PCoA)based on weighted Unifrac distance showed significant differences in intestinal microbiota community diversity before and after BJJP treatment(P<0.01 and P=0.003),respectively.After 48 weeks'treatment,the abundance levels of beneficial bacteria(Bifidobacteria,Lactobacillus,Faecalibacterium and Blautia)increased,whereas the abundance levels of potential pathogenic bacteria,including Escherichia coli,Bacteroides,Ruminococcus,Parabacteroides and Prevotella decreased,among which Ruminococcus and Parabacteroides were significantly positively correlated with degree of liver fibrosis(r=0.34,P=0.04;r=0.38,P=0.02),respectively.The microbiota in the SC group did not change significantly throughout the whole process of treatment.Conclusion:BJJP had a certain regulatory effect on intestinal microbiota of patients with hepatitis B cirrhosis/liver fibrosis(ChiCTR1800016801).展开更多
It thas been reported that the various experimental liver injuries and patients with liver diseases are accompanied by intestinal endotoxemia (IETM). Up to now, the effect of IETM on the chronicity of hepatitis, its p...It thas been reported that the various experimental liver injuries and patients with liver diseases are accompanied by intestinal endotoxemia (IETM). Up to now, the effect of IETM on the chronicity of hepatitis, its pervention and treatment have received little attention.According to the study of a large number of animal experiments and clinics, we raise a new conception of the pathogenesis of hepatic injury in hepatitis:The various factors induce liver injury(for example,hepatic virus, alcohol, medicines and hepatotoxic agents and so on )by various specific mechanisms,which is called "The primary liver injury ". IETM is occurred in the deveopment of hepatitis. Endotoxin activated kupffer cells and produced a number of chemical mediators. The liver injury caused by mediators is called"The secondary liver injury". This "The secondary liver injury" depends on serious degree of IETM. The repeated and persistent hepatocellular necrosis in light IETM condition accompanying hepatocellular regeneration and inflammatory cells infiltration develop the chronic hepatitis and/or liver fibrosis, even cirrhosis and hepatocarcinoma. The severe IETM offen leads to overinflammation following serious hepatocellular necrosis, even grows up severe hepatitis, liver failure further is appeared.展开更多
基金Supported by the National Key Research and Development Program of China(No.2021YFC2301800)the Capital's Funds for Health Improvement and Research(No.CFH2018-2-2173 and CFH2020-1-2171)Digestive Medical Coordinated Development Center of Beijing Municipal Administration of Hospitals(No.XXT26)。
文摘Objective:To analyze the efficacy of Biejiajian Pill(BJJP)on intestinal microbiota in patients with hepatitis B cirrhosis/liver fibrosis,and explore its relationship with liver fibrosis.Methods:This was a prospective,randomized double-blind controlled trial.Using the stratified block randomization method,35 patients with hepatitis B liver cirrhosis/liver fibrosis were randomly assigned(1:1)to receive entecavir(0.5 mg/d)combined with BJJP(3 g/time,3 times a day)or placebo(simulator as control,SC group,simulator 3 g/time,3 times a day)for 48 weeks.Blood and stool samples were collected from patients at baseline and week 48 of treatment,respectively.Liver and renal functions as well as hematological indices were detected.Fecal samples were analyzed by 16S rDNA V3-V4 high-throughput sequencing,and intestinal microbiota changes in both groups before and after treatment were compared,and their correlations with liver fibrosis were analyzed.Results:Compared with the SC group,there was no significant difference in liver function,renal function and hematology indices in the BJJP group,however,the improvement rate of liver fibrosis was higher in the BJJP group(94.4%vs.64.7%,P=0.041).Principal coordinate analysis(PCoA)based on weighted Unifrac distance showed significant differences in intestinal microbiota community diversity before and after BJJP treatment(P<0.01 and P=0.003),respectively.After 48 weeks'treatment,the abundance levels of beneficial bacteria(Bifidobacteria,Lactobacillus,Faecalibacterium and Blautia)increased,whereas the abundance levels of potential pathogenic bacteria,including Escherichia coli,Bacteroides,Ruminococcus,Parabacteroides and Prevotella decreased,among which Ruminococcus and Parabacteroides were significantly positively correlated with degree of liver fibrosis(r=0.34,P=0.04;r=0.38,P=0.02),respectively.The microbiota in the SC group did not change significantly throughout the whole process of treatment.Conclusion:BJJP had a certain regulatory effect on intestinal microbiota of patients with hepatitis B cirrhosis/liver fibrosis(ChiCTR1800016801).
文摘It thas been reported that the various experimental liver injuries and patients with liver diseases are accompanied by intestinal endotoxemia (IETM). Up to now, the effect of IETM on the chronicity of hepatitis, its pervention and treatment have received little attention.According to the study of a large number of animal experiments and clinics, we raise a new conception of the pathogenesis of hepatic injury in hepatitis:The various factors induce liver injury(for example,hepatic virus, alcohol, medicines and hepatotoxic agents and so on )by various specific mechanisms,which is called "The primary liver injury ". IETM is occurred in the deveopment of hepatitis. Endotoxin activated kupffer cells and produced a number of chemical mediators. The liver injury caused by mediators is called"The secondary liver injury". This "The secondary liver injury" depends on serious degree of IETM. The repeated and persistent hepatocellular necrosis in light IETM condition accompanying hepatocellular regeneration and inflammatory cells infiltration develop the chronic hepatitis and/or liver fibrosis, even cirrhosis and hepatocarcinoma. The severe IETM offen leads to overinflammation following serious hepatocellular necrosis, even grows up severe hepatitis, liver failure further is appeared.
