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Thématique :
- Foie
Originalité :
Très original
Solidité :
Intermédiaire
Doit faire évoluer notre pratique :
Pas encore
 
 
Nom du veilleur :
Docteur Bertrand HANSLIK
Coup de coeur :
 
 
Gut
  2016/05  
 
  2016 May;65(5):830-9  
  doi: 10.1136/gutjnl-2015-310585  
 
  Intestinal microbiota contributes to individual susceptibility to alcoholic liver disease.  
 
  Llopis M, Cassard AM, Wrzosek L, Boschat L, Bruneau A, Ferrere G, Puchois V, Martin JC, Lepage P, Le Roy T, Lefèvre L, Langelier B, Cailleux F, González-Castro AM, Rabot S, Gaudin F, Agostini H, Prévot S, Berrebi D, Ciocan D, Jousse C, Naveau S, Gérard P, Perlemuter G  
  http://www.ncbi.nlm.nih.gov/pubmed/26642859  
 
 

OBJECTIVE:

There is substantial inter-individual diversity in the susceptibility of alcoholics to liver injury. Alterations of intestinal microbiota (IM) have been reported in alcoholic liver disease (ALD), but the extent to which they are merely a consequence or a cause is unknown. We aimed to demonstrate that a specific dysbiosis contributes to the development of alcoholic hepatitis (AH).

DESIGN:

We humanised germ-free and conventional mice using human IM transplant from alcoholic patients with or without AH. The consequences on alcohol-fed recipient mice were studied.

RESULTS:

A specific dysbiosis was associated with ALD severity in patients. Mice harbouring the IM from a patient with severe AH (sAH) developed more severe liver inflammation with an increased number of liver T lymphocyte subsets and Natural Killer T (NKT) lymphocytes, higher liver necrosis, greater intestinal permeability and higher translocation of bacteria than mice harbouring the IM from an alcoholic patient without AH (noAH). Similarly, CD45(+) lymphocyte subsets were increased in visceral adipose tissue, and CD4(+)T and NKT lymphocytes in mesenteric lymph nodes. The IM associated with sAH and noAH could be distinguished by differences in bacterial abundance and composition. Key deleterious species were associated with sAH while the Faecalibacterium genus was associated with noAH. Ursodeoxycholic acid was more abundant in faeces from noAH mice. Additionally, in conventional mice humanised with the IM from an sAH patient, a second subsequent transfer of IM from an noAH patient improved alcohol-induced liver lesions.

CONCLUSIONS:

Individual susceptibility to ALD is substantially driven by IM. It may, therefore, be possible to prevent and manage ALD by IM manipulation.

 
Question posée
 
Altérations du microbiote intestinal chez les patients avec lésions alcooliques du foie : cause ou conséquence ?
 
Question posée
 
1) Des profils particuliers de dysbiose intestinale sont associés à la survenue lésions hépatiques sévères induite par l’alcool. 2) La transplantation du microbiote de patients alcooliques sans hépatite alcoolique peut faire régresser les lésions inflammatoires induites par l’alcool
 
Commentaires

Le cirrhotique alcoolique victime de sa flore digestive. Très belle étude. A quand des études d’intervention ?

 
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