VCU study: Complex gut microbiota analysis unnecessary in diagnosis of cirrhosis

VCU-logoIn a recent issue of the journal Nature, Virginia Commonwealth University School of Medicine associate professor Jasmohan S. Bajaj, M.D., provides new data to reinterpret conclusions from a July 2014 Nature journal study that had reported on a novel way to diagnose cirrhosis using complex microbiota analysis. The term microbiota refers to the network of tiny organisms in the human body such as bacteria and fungi that can either bolster an immune system or weaken it.

Cirrhosis, which is characterized by prominent and irreversible scarring of the liver, is caused by a variety of conditions such as viral hepatitis and chronic alcohol abuse. It is diagnosed clinically using ultrasound or blood tests.

The original Nature journal study proposed a novel but complicated diagnostic approach to identify patients with cirrhosis and did not differentiate between patients with advanced, or decompensated, cirrhosis and those in the early stages of the disease. While novel, that diagnostic method is cumbersome, expensive and not available outside of a few centers. “Therefore, it is unlikely to replace current techniques, especially in decompensated cirrhosis,” Bajaj said.

Patients who have been diagnosed with cirrhosis can be categorized as having compensated or decompensated cirrhosis. Compensated cirrhosis means that the body still functions fairly well despite scarring of the liver. Decompensated cirrhosis means that the severe scarring of the liver has damaged and disrupted essential body functions.

In the study published on Sept. 17, “Decompensated Cirrhosis and Microbiome Interpretation,” Bajaj and his colleagues argue against the complicated proposed diagnostic process and provide evidence demonstrating that patients with decompensated cirrhosis have a different gut microbiome than those who are in earlier stages of the disease.

“Decompensated cirrhosis is easy to diagnose,” Bajaj said. “You don’t need to go through any complicated techniques to diagnose it.”

Bajaj, who practices in the Department of Internal Medicine’s Division of Gastroenterology, Hepatology and Nutrition, worked with researchers from the Microbiome Analysis Center at George Mason University to re-analyze the findings from the 2014 study and conduct an independent study with 360 new patients from VCU Medical Center and the Hunter Holmes McGuire VA Medical Center in Richmond.

“The conclusions from the 2014 study were not something we agreed with, so we had to re-analyze the original study data in addition to doing our own study,” Bajaj said. “We found that the current need is not for us to diagnose cirrhosis late in the disease because we already know how to do that. What we need are techniques that will help us find out which people with cirrhosis will do worse over time.”

The research was supported by grants from the National Institutes of Health and the U.S. Department of Veterans Affairs.

Books from AFP

2018-19 UVA Basketball Preview: Just $1.99 on Amazon!

UVA Basketball finished the 2017-18 season ranked at the top of the national polls. Augusta Free Press editor Chris Graham offers his insight and analysis on the 2018-19 'Hoos, breaking down the roster, the legacy of coach Tony Bennett, and how the loss to UMBC could fuel a run through March Madness next spring.

The Worst Wrestling Pay-Per-View Ever: Just $3.49 on Amazon!

Chris Graham offers a glimpse behind the curtain of the pro wrestling business in his new book, The Worst Wrestling Pay-Per-View Ever, the inside story of the 2011 Night of Legends, a live pay-per-view event featuring stars including WWE Hall of Famers Kevin Nash, "Hacksaw" Jim Duggan and The Rock 'n Roll Express that was met with almost universally negative reviews.

Mad About U: History of University Hall available on Amazon for just $5.99!

Mad About U: Four Decades of at University Hall is a comprehensive book covering the players, coaches and memories of University Hall at the University of Virginia. Join us as we look back at the memories from more than 40 years in U Hall.

News From Around the Web

Shop Google