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Barchetta I, Cimini FA, Sentinelli F, Chiappetta C, Di Cristofano C, Silecchia G, Leonetti F, Baroni MG, Cavallo MG. Reduced Lipopolysaccharide-Binding Protein (LBP) Levels Are Associated with Non-Alcoholic Fatty Liver Disease (NAFLD) and Adipose Inflammation in Human Obesity. Int J Mol Sci 2023; 24:17174. [PMID: 38139003 PMCID: PMC10742626 DOI: 10.3390/ijms242417174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/30/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
Lipopolysaccharide (LPS) and its binding protein LBP have emerged as potential contributors to the progression from overweight/obesity to overt metabolic diseases and NAFLD. While LPS is known to activate hepatocyte inflammation, thus contributing toward NAFLD development, the role of LBP is more intricate, and recent data have shown that experimental reduction in hepatic LBP promotes NAFLD progression. In this cross-sectional investigation, we evaluated circulating LBP in relation to obesity, NAFLD, visceral adipose tissue (VAT) inflammation, and type 2 diabetes (T2D). We recruited 186 individuals (M/F: 81/105; age: 47 ± 10.4 years; BMI: 35.5 ± 8.6 kg/m2); a subgroup (n = 81) underwent bariatric surgery with intra-operative VAT and liver biopsies. LBP levels were higher in obese individuals than non-obese individuals but were inversely correlated with the parameters of glucose metabolism. Reduced LBP predicted T2D independent of age, sex, and BMI (p < 0.001). LBP levels decreased across more severe stages of hepatosteatosis and lobular inflammation, and were inversely associated with VAT inflammation signatures. In conclusion, LBP levels are increased in obese individuals and are associated with a more favorable metabolic profile and lower NAFLD/NASH prevalence. A possible explanation for these findings is that hepatic LBP production may be triggered by chronic caloric excess and facilitate LPS degradation in the liver, thus protecting these individuals from the metabolic consequences of obesity.
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Affiliation(s)
- Ilaria Barchetta
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy; (I.B.); (F.A.C.)
| | - Flavia Agata Cimini
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy; (I.B.); (F.A.C.)
| | - Federica Sentinelli
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy;
| | - Caterina Chiappetta
- Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, 04100 Latina, Italy; (C.C.); (C.D.C.); (F.L.)
| | - Claudio Di Cristofano
- Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, 04100 Latina, Italy; (C.C.); (C.D.C.); (F.L.)
| | - Gianfranco Silecchia
- Department of Medical and Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, St Andrea Hospital, Sapienza University of Rome, 00189 Rome, Italy;
| | - Frida Leonetti
- Department of Medical-Surgical Sciences and Bio-Technologies, Sapienza University of Rome, 04100 Latina, Italy; (C.C.); (C.D.C.); (F.L.)
| | - Marco Giorgio Baroni
- Endocrinology and Diabetes, Department of Clinical Medicine, Public Health, Life and Environmental Sciences (MeSVA), University of L’Aquila, 67100 L’Aquila, Italy;
- Neuroendocrinology and Metabolic Diseases, IRCCS Neuromed, 86077 Pozzilli, Italy
| | - Maria Gisella Cavallo
- Department of Experimental Medicine, Sapienza University of Rome, 00185 Rome, Italy; (I.B.); (F.A.C.)
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Blesl A, Stadlbauer V. The Gut-Liver Axis in Cholestatic Liver Diseases. Nutrients 2021; 13:nu13031018. [PMID: 33801133 PMCID: PMC8004151 DOI: 10.3390/nu13031018] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 03/12/2021] [Accepted: 03/18/2021] [Indexed: 12/12/2022] Open
Abstract
The gut-liver axis describes the physiological interplay between the gut and the liver and has important implications for the maintenance of health. Disruptions of this equilibrium are an important factor in the evolution and progression of many liver diseases. The composition of the gut microbiome, the gut barrier, bacterial translocation, and bile acid metabolism are the key features of this cycle. Chronic cholestatic liver diseases include primary sclerosing cholangitis, the generic term secondary sclerosing cholangitis implying the disease secondary sclerosing cholangitis in critically ill patients and primary biliary cirrhosis. Pathophysiology of these diseases is not fully understood but seems to be multifactorial. Knowledge about the alterations of the gut-liver axis influencing the pathogenesis and the outcome of these diseases has considerably increased. Therefore, this review aims to describe the function of the healthy gut-liver axis and to sum up the pathological changes in these cholestatic liver diseases. The review compromises the actual level of knowledge about the gut microbiome (including the mycobiome and the virome), the gut barrier and the consequences of increased gut permeability, the effects of bacterial translocation, and the influence of bile acid composition and pool size in chronic cholestatic liver diseases. Furthermore, therapeutic implications and future scientific objectives are outlined.
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Affiliation(s)
- Andreas Blesl
- Division for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria;
- Correspondence:
| | - Vanessa Stadlbauer
- Division for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, 8036 Graz, Austria;
- Center for Biomarker Research in Medicine (CBmed), 8010 Graz, Austria
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Kanazawa A, Aida M, Yoshida Y, Kaga H, Katahira T, Suzuki L, Tamaki S, Sato J, Goto H, Azuma K, Shimizu T, Takahashi T, Yamashiro Y, Watada H. Effects of Synbiotic Supplementation on Chronic Inflammation and the Gut Microbiota in Obese Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Study. Nutrients 2021; 13:nu13020558. [PMID: 33567701 PMCID: PMC7914668 DOI: 10.3390/nu13020558] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 01/27/2021] [Accepted: 02/04/2021] [Indexed: 12/23/2022] Open
Abstract
The aim of this study was to investigate the effects of 24-week synbiotic supplementation on chronic inflammation and the gut microbiota in obese patients with type 2 diabetes. We randomized 88 obese patients with type 2 diabetes to one of two groups for 24 weeks: control or synbiotic (Lacticaseibacillus paracasei strain Shirota (previously Lactobacillus casei strain Shirota) and Bifidobacterium breve strain Yakult, and galactooligosaccharides). The primary endpoint was the change in interleukin-6 from baseline to 24 weeks. Secondary endpoints were evaluation of the gut microbiota in feces and blood, fecal organic acids, high-sensitivity C-reactive protein, lipopolysaccharide-binding protein, and glycemic control. Synbiotic administration for 24 weeks did not significantly affect changes in interleukin-6 from baseline to 24 weeks (0.35 ± 1.99 vs. −0.24 ± 1.75 pg/mL, respectively). Relative to baseline, however, at 24 weeks after synbiotic administration there were positive changes in the counts of Bifidobacterium and total lactobacilli, the relative abundances of Bifidobacterium species such as Bifidobacterium adolescentis and Bifidobacterium pseudocatenulatum, and the concentrations of acetic and butyric acids in feces. No significant changes in inflammatory markers were found in the synbiotic group compared to the control group. However, synbiotic administration at least partially improved the gut environment in obese patients with type 2 diabetes.
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Affiliation(s)
- Akio Kanazawa
- Department of Metabolism & Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (H.K.); (T.K.); (L.S.); (S.T.); (J.S.); (H.G.); (K.A.); (T.S.); (H.W.)
- Correspondence: ; Tel.: +81-3-5802-1579
| | - Masanori Aida
- Food Research Department, Yakult Central Institute, Tokyo 186-8650, Japan; (M.A.); (Y.Y.)
| | - Yasuto Yoshida
- Food Research Department, Yakult Central Institute, Tokyo 186-8650, Japan; (M.A.); (Y.Y.)
| | - Hideyoshi Kaga
- Department of Metabolism & Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (H.K.); (T.K.); (L.S.); (S.T.); (J.S.); (H.G.); (K.A.); (T.S.); (H.W.)
| | - Takehiro Katahira
- Department of Metabolism & Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (H.K.); (T.K.); (L.S.); (S.T.); (J.S.); (H.G.); (K.A.); (T.S.); (H.W.)
| | - Luka Suzuki
- Department of Metabolism & Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (H.K.); (T.K.); (L.S.); (S.T.); (J.S.); (H.G.); (K.A.); (T.S.); (H.W.)
| | - Shoko Tamaki
- Department of Metabolism & Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (H.K.); (T.K.); (L.S.); (S.T.); (J.S.); (H.G.); (K.A.); (T.S.); (H.W.)
| | - Junko Sato
- Department of Metabolism & Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (H.K.); (T.K.); (L.S.); (S.T.); (J.S.); (H.G.); (K.A.); (T.S.); (H.W.)
| | - Hiromasa Goto
- Department of Metabolism & Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (H.K.); (T.K.); (L.S.); (S.T.); (J.S.); (H.G.); (K.A.); (T.S.); (H.W.)
| | - Kosuke Azuma
- Department of Metabolism & Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (H.K.); (T.K.); (L.S.); (S.T.); (J.S.); (H.G.); (K.A.); (T.S.); (H.W.)
| | - Tomoaki Shimizu
- Department of Metabolism & Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (H.K.); (T.K.); (L.S.); (S.T.); (J.S.); (H.G.); (K.A.); (T.S.); (H.W.)
| | - Takuya Takahashi
- Yakult Honsha European Research Center for Microbiology, 9052 Gent-Zwijnaarde, Belgium;
| | - Yuichiro Yamashiro
- Probiotics Research Laboratory, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan;
| | - Hirotaka Watada
- Department of Metabolism & Endocrinology, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan; (H.K.); (T.K.); (L.S.); (S.T.); (J.S.); (H.G.); (K.A.); (T.S.); (H.W.)
- Center for Therapeutic Innovations in Diabetes, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
- Center for Identification of Diabetic Therapeutic Targets, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
- Sportology Center, Graduate School of Medicine, Juntendo University, Tokyo 113-8421, Japan
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Maekawa M, Yoshitani K, Yahagi M, Asahara T, Shishido Y, Fukushima S, Tadokoro N, Fujita T, Ohnishi Y. Association between postoperative changes in the gut microbiota and pseudopsia after cardiac surgery: prospective observational study. BMC Surg 2020; 20:247. [PMID: 33081782 PMCID: PMC7576870 DOI: 10.1186/s12893-020-00907-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 10/12/2020] [Indexed: 12/15/2022] Open
Abstract
Background Delirium after cardiac surgery affects mortality, but the mechanism remains unclear. Previous studies have reported gut microbiota are associated with brain activity. Systemic inflammation and antibiotics can damage the gut microbiota after cardiac surgery. We aimed to investigate changes in the gut microbiota and the association between the gut microbiota and delirium after cardiac surgery. Methods Twenty-one patients who underwent cardiac surgery were enrolled. Microbiota counts and fecal organic acid concentrations were measured in fecal samples harvested before surgery, just after surgery, and before discharge. To quantify the microbiota, we extracted total RNA fractions and examined gut microbiota composition using 16S and 23S rRNA-targeted quantitative-reverse Transcription-PCR. Postoperative delirium, insomnia, and pseudopsia were assessed for 1 week. Postoperative total bacterial counts changed significantly from 10.2 ± 0.2 log10 cells/g of feces to 9.8 ± 0.5 in the first postoperative samples (p = 0.003) and 10.0 ± 0.4 in the samples before discharge (p = 0.039). Fecal pH was 6.9 ± 0.6 before surgery and 7.4 ± 0.7 in the first postoperative samples (p = 0.001). Postoperative Staphylococcus and Pseudomonas counts were significantly higher in patients with postoperative pseudopsia than in patients without pseudopsia (3.2 ± 1.3 vs. 5.4 ± 0.9; p = 0.012 and 1.7 ± 0.8 vs. 4.6 ± 2.7; p = 0.001). Conclusions Total bacterial counts were significantly lower after surgery and until discharge. Fecal pH was significantly higher than preoperative levels. Staphylococcus and Pseudomonas counts were significantly higher in patients with postoperative pseudopsia.
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Affiliation(s)
- Masaki Maekawa
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Kenji Yoshitani
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Japan.
| | - Musashi Yahagi
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Japan
| | | | | | - Satsuki Fukushima
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Naoki Tadokoro
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tomoyuki Fujita
- Department of Cardiovascular Surgery, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoshihiko Ohnishi
- Department of Anesthesiology, National Cerebral and Cardiovascular Center, Suita, Japan
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Watanabe H, Katsura T, Takahara M, Miyashita K, Katakami N, Matsuoka TA, Kawamori D, Shimomura I. Plasma lipopolysaccharide binding protein level statistically mediates between body mass index and chronic microinflammation in Japanese patients with type 1 diabetes. Diabetol Int 2020; 11:293-297. [PMID: 32802711 DOI: 10.1007/s13340-020-00428-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 02/20/2020] [Indexed: 12/17/2022]
Abstract
Recently, it is widely recognized that microinflammation plays important roles in the pathophysiology of metabolic diseases, especially obesity-related disorders, diabetes and their complications. Lipopolysaccharide-binding protein (LBP) is a liver-derived acute-phase protein responsive to lipopolysaccharides (LPS) produced by gram-negative bacteria, thus reflects the systemic inflammation caused by the infection of those bacteria including gut dysbiosis. In this study, we evaluated the plasma LBP levels and investigated its clinical significance in 67 Japanese patients with type 1 diabetes. Univariable analysis showed that LBP levels were significantly associated with body mass index (BMI; r = 0.43, p < 0.01) and serum high-sensitivity C-reactive protein (hs-CRP; r = 0.64, p < 0.001) levels. However, there was no significant association between plasma LBP levels and diabetic complications. Mediation analysis revealed that LBP had significant mediation effects on the association between hs-CRP and BMI (0.27 [95% confidence interval 0.10-0.48]). These results suggest that the systemic condition where the LBP level increases, such as gut dysbiosis, at least partly, impacts on chronic microinflammation in patients with type 1 diabetes.
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Affiliation(s)
- Hirotaka Watanabe
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871 Japan
| | - Takashi Katsura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871 Japan.,Present Address: Department of Diabetes and Metabolism, Osaka General Medical Center, Osaka, Japan
| | - Mitsuyoshi Takahara
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871 Japan.,Department of Diabetes Care Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871 Japan
| | - Kazuyuki Miyashita
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871 Japan
| | - Naoto Katakami
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871 Japan.,Department of Atherosclerosis and Metabolism, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871 Japan
| | - Taka-Aki Matsuoka
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871 Japan
| | - Dan Kawamori
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871 Japan.,Medical Education Center, Faculty of Medicine, Osaka University, 2-2 Yamada-oka, Suita, Osaka 565-0871 Japan
| | - Iichiro Shimomura
- Department of Metabolic Medicine, Osaka University Graduate School of Medicine, 2-2 Yamada-oka, Suita, Osaka 565-0871 Japan
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