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Rifaximin ameliorates hepatic encephalopathy and endotoxemia without affecting the gut microbiome diversity.
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- Author(s): Kaji K;Kaji K; Takaya H; Takaya H; Saikawa S; Saikawa S; Furukawa M; Furukawa M; Sato S; Sato S; Kawaratani H; Kawaratani H; Kitade M; Kitade M; Moriya K; Moriya K; Namisaki T; Namisaki T; Akahane T; Akahane T; Mitoro A; Mitoro A; Yoshiji H; Yoshiji H
- Source:
World journal of gastroenterology [World J Gastroenterol] 2017 Dec 21; Vol. 23 (47), pp. 8355-8366.- Publication Type:
Journal Article- Language:
English - Source:
- Additional Information
- Source: Publisher: Baishideng Publishing Group Country of Publication: United States NLM ID: 100883448 Publication Model: Print Cited Medium: Internet ISSN: 2219-2840 (Electronic) Linking ISSN: 10079327 NLM ISO Abbreviation: World J Gastroenterol Subsets: MEDLINE
- Publication Information: Publication: 2014- : Pleasanton, CA : Baishideng Publishing Group
Original Publication: Beijing : WJG Press, c1998- - Subject Terms: Anti-Bacterial Agents/*therapeutic use ; Endotoxemia/*drug therapy ; Gastrointestinal Microbiome/*drug effects ; Hepatic Encephalopathy/*drug therapy ; Liver Cirrhosis/*complications ; Rifamycins/*therapeutic use; Aged ; Aged, 80 and over ; Ammonia/blood ; Ammonia/toxicity ; Anti-Bacterial Agents/pharmacology ; Case-Control Studies ; Cognition/drug effects ; Endotoxemia/etiology ; Endotoxins/blood ; Endotoxins/toxicity ; Feces/microbiology ; Female ; Gastrointestinal Microbiome/physiology ; Hepatic Encephalopathy/blood ; Hepatic Encephalopathy/etiology ; Humans ; Liver Cirrhosis/blood ; Male ; Middle Aged ; Neuropsychological Tests ; Rifamycins/pharmacology ; Rifaximin ; Treatment Outcome
- Abstract: Aim: To determine the efficacy of rifaximin for hepatic encephalopathy (HE) with the linkage of gut microbiome in decompensated cirrhotic patients.
Methods: Twenty patients (12 men and 8 women; median age, 66.8 years; range, 46-81 years) with decompensated cirrhosis (Child-pugh score > 7) underwent cognitive neuropsychological testing, endotoxin analysis, and fecal microbiome assessment at baseline and after 4 wk of treatment with rifaximin 400 mg thrice a day. HE was determined by serum ammonia level and number connection test (NCT)-A. Changes in whole blood endotoxin activity (EA) was analyzed by endotoxin activity assay. Fecal microbiome was assessed by 16S ribosome RNA (rRNA) gene sequencing.
Results: Treatment with rifaximin for 4 wk improved hyperammonemia (from 90.6 ± 23.9 μg/dL to 73.1 ± 33.1 μg/dL; P < 0.05) and time required for NCT (from 68.2 ± 17.4 s to 54.9 ± 20.3 s; P < 0.05) in patients who had higher levels at baseline. Endotoxin activity was reduced (from 0.43 ± 0.03 to 0.32 ± 0.09; P < 0.05) in direct correlation with decrease in serum ammonia levels ( r = 0.5886, P < 0.05). No statistically significant differences were observed in the diversity estimator (Shannon diversity index) and major components of the gut microbiome between the baseline and after treatment groups (3.948 ± 0.548 at baseline vs 3.980 ± 0.968 after treatment; P = 0.544), but the relative abundances of genus Veillonella and Streptococcus were lowered.
Conclusion: Rifaximin significantly improved cognition and reduced endotoxin activity without significantly affecting the composition of the gut microbiome in patients with decompensated cirrhosis.
Competing Interests: Conflict-of-interest statement: The authors declare that there is no conflict of interest regarding the publication of this paper. - References: Aliment Pharmacol Ther. 2016 Jan;43 Suppl 1:11-26. (PMID: 26618922)
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- Accession Number: 0 (Anti-Bacterial Agents)
0 (Endotoxins)
0 (Rifamycins)
7664-41-7 (Ammonia)
L36O5T016N (Rifaximin) - Publication Date: Date Created: 20180109 Date Completed: 20180808 Latest Revision: 20220409
- Publication Date: 20221213
- Accession Number: PMC5743506
- Accession Number: 10.3748/wjg.v23.i47.8355
- Accession Number: 29307995
- Source:
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