Comprehensive Analysis of Serum and Fecal Bile Acid Profiles and Interaction with Gut Microbiota in Primary Biliary Cholangitis.
Accumulation of bile acids (BAs) contributes significantly to the pathogenesis of primary biliary cholangitis (PBC). Here, we sought to systematically characterize the serum and fecal BA profiles and the linkage between BAs and gut microbiota in PBC. The serum and fecal BAs were compared between 65 UDCA treatment-naive PBC and 109 healthy controls using UPLC-MS in cross-sectional study. In a prospective study, a subgroup of patients was enrolled for BA and microbiota analysis before and after UDCA therapy. BA compositions in serum and feces significantly differed between treatment-naive PBC and controls. Particularly, PBC was associated with decreased conversions of conjugated to unconjugated, and primary to secondary BAs, indicating impaired microbial metabolism of BAs. PBC patients at advanced stage exhibited a more abnormal BA profile compared with early-stage patients. UDCA treatment led to a decreased level of taurine-conjugated BAs, thereby reversing the conjugated/unconjugated ratio in PBC. Moreover, the level of secondary BAs such as DCA and conjugated DCA inversely correlated with PBC-enriched gut microbes (e.g., Veillonella, Klebsiella), while positively correlated with control-enriched microbes (e.g., Faecalibacterium, Oscillospira). Microbiota analysis also revealed a significant increase of taurine-metabolizing bacteria Bilophila spp. in patients after UDCA, which was strongly correlated with decreased taurine-conjugated BAs. In addition, serum FGF19 was remarkably increased in treatment-naïve PBC and decreased after UDCA. Our study established specific alterations of BA compositions in serum and feces of PBC, suggesting the potential for using BAs for diagnosis, and highlighting the possibility of modulating BA profile by altering gut microbiota. Graphical Abstract.
['Chen|Weihua|W|', 'Wei|Yiran|Y|', 'Xiong|Aizhen|A|', 'Li|Yanmei|Y|', 'Guan|Huida|H|', 'Wang|Qixia|Q|', 'Miao|Qi|Q|', 'Bian|Zhaolian|Z|', 'Xiao|Xiao|X|', 'Lian|Min|M|', 'Zhang|Jun|J|', 'Li|Bo|B|', 'Cao|Qin|Q|', 'Fan|Zhuping|Z|', 'Zhang|Weici|W|', 'Qiu|Dekai|D|', 'Fang|Jingyuan|J|', 'Gershwin|M Eric|ME|', 'Yang|Li|L|', 'Tang|Ruqi|R|', 'Ma|Xiong|X|']
D000328:Adult D000368:Aged D001647:Bile Acids and Salts D015415:Biomarkers D016022:Case-Control Studies D016000:Cluster Analysis D019295:Computational Biology D003430:Cross-Sectional Studies D004198:Disease Susceptibility D005243:Feces D005260:Female D005346:Fibroblast Growth Factors D000069196:Gastrointestinal Microbiome D006801:Humans D057927:Hydrophobic and Hydrophilic Interactions D008105:Liver Cirrhosis, Biliary D008111:Liver Function Tests D008297:Male D054892:Metagenome D056186:Metagenomics D008875:Middle Aged D008954:Models, Biological D012720:Severity of Illness Index
Bile acids Gut microbiota Primary biliary cholangitis Ursodeoxycholic acid