Implication of the intestinal microbiome in complications of cirrhosis

Table 1 Characterization of Intestinal microbiota across spectrum of liver disease severity

Patient population	Changes in IM
Healthy patients	Comprised principally of Bacteroides and Firmicutes (over 90% of IM)[3]
Compensated cirrhosis	Higher Enterobacteriaceae, Staphylococcaeae, and Enterococcaceae[53,55,56]
	Decreased Lachnospiraceae, Ruminococcaceae, Clostridiales XIV, Bacteroides, Faecalibacterium prausnitzii and Coprococcus comes[45,53,55,56]
Alcoholic cirrhosis	Higher Enterobacteriaceae and endotoxemia compared to other cirrhosis[46]
Decompensated cirrhosis	Enterobacteriaceae species correlated with increasing MELD score, Ruminococcaceae species associated with lower MELD scores[56]
Overt hepatic encephalopathy	Higher Enterobacteriaceae[57]
Hepatorenal syndrome	No established data
Hepatocellular carcinoma	No established data
Therapeutic strategies and effects on IM
Lactulose	No RCT or prospective studies of microbiome
	Decreased urea-producing Klebsiella and Proteus species, increased non-urease-producing lactobacilli[70]
Rifaximin	Improved cognitive function due to change in microbiome-metabolome correlation networks, particularly Enterobacteriaceae
Probiotics	Decreased risk of endotoxemia, TNF-α[74]
	Enteric dysbiosis reduced, relatively decreased proportion of Enterobacteriaceae and Porphyromonadaceae[74,75]
Fecal microbiota transplantation	Case report data[76]
	Resolution of hepatic encephalopathy with healthy IM transfer, however IM not characterized

MELD: Model for end stage liver disease; IM: Intestinal microbiome; RCT: Randomized controlled trial; TNF: Tumor necrosis factor.