Background:
Cirrhosis is a common chronic
liver disease characterized by irreversible diffuse liver damage. Intestinal microbiome
dysbiosis and metabolite dysfunction contribute to the development of
cirrhosis.
Lactitol (4-β-D-galactopyranosyl-D-glucitol) was previously reported to promote the growth of intestinal Bifidobacteria. However, the effect of
lactitol on the intestinal microbiome and fecal
short-chain fatty acids (SCFAs) and
bile acids (BAs) and the interactions among these factors in cirrhotic patients pre- and post-
lactitol treatment remain poorly understood. Methods: Here, using shotgun metagenomics and targeted metabolomics methods. Results: we found that health-promoting lactic acid bacteria, including Bifidobacterium longum, B.pseudocatenulatum, and Lactobacillus salivarius, were increased after
lactitol intervention, and significant decrease of pathogen Klebsiella
pneumonia and associated
antibiotic resistant genes /
virulence factors. Functionally, pathways including Pseudomonas aeruginosa biofilm formation,
endotoxin biosynthesis, and horizontal transfer of pathogenic genes were decreased in cirrhotic patients after 4-week
lactitol intervention compared with before treatment. Conclusion: We identified
lactitol-associated metagenomic changes, and provide insight into the understanding of the roles of
lactitol in modulating gut microbiome in cirrhotic patients.