Abstracts of the 2025 Annual Meeting of the ALEH
More infoIn Mexico, alcohol-associated cirrhosis is one of the leading causes of death. ACLF represents a critical scenario with elevated systemic inflammation and high mortality. The gut microbiota has been extensively studied; however, the blood microbiota (BM) remains unexplored. This study aims to analyze the composition and diversity of BM in patients with alcohol-associated decompensated cirrhosis (DC), ACLF, and healthy controls (HC); and to evaluate LPS, IL-6, leukocyte count and their association with mortality.
Materials and MethodsCross-sectional analytical study, including 58 ACLF patients, 14 DC patients and 14 HC. BM was characterized in blood samples by 16S-rRNA gene sequencing. LPS and IL-6 levels were quantified by ELISA, and leukocyte counts were recovered from clinical files. Bioinformatic analysis was performed using QIIME2. Approval number: 00012.
ResultsACLF patients showed significantly reduced alpha diversity, particularly in ACLF grade III, compared to HC. Beta diversity revealed significant differences between DC vs ACLF, and ACLF vs HC. Proteobacteria was the predominant phylum in all groups; notably, Enterobacteriaceae, Escherichia/Shigella, Prevotella, and Lactobacillus were enriched in ACLF. Both DC and ACLF patients exhibited elevated LPS levels. IL-6 >7645 pg/mL and leukocyte count >17,470*10^3/µL were associated with increased 28- and 90-day mortality risk (HR=3.16 and 2.65).
ConclusionsACLF is associated with circulating dysbiosis marked by expansion of potentially pathogenic bacteria and elevated LPS levels. These findings suggest an active bacterial translocation process that may contribute to systemic inflammation and higher mortality. These pioneering results in ACLF provide important insights into the gut-liver axis.
