AUTHOR=Lu Haifeng , Chen Liang , Pan Xiaxia , Yao Yujun , Zhang Hua , Zhu Xiaofei , Lou Xiaobin , Zhu Chunxia , Wang Jun , Li Lanjuan , Wu Zhongwen 

TITLE=Lactitol Supplementation Modulates Intestinal Microbiome in Liver Cirrhotic Patients

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.762930

DOI=10.3389/fmed.2021.762930

ISSN=2296-858X

ABSTRACT=<p><bold>Background:</bold> 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 <italic>Bifidobacteria</italic>. 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.</p><p><bold>Methods:</bold> Here, using shotgun metagenomics and targeted metabolomics methods.</p><p><bold>Results:</bold> we found that health-promoting lactic acid bacteria, including <italic>Bifidobacterium longum, B.pseudocatenulatum</italic>, and <italic>Lactobacillus salivarius</italic>, were increased after lactitol intervention, and significant decrease of pathogen <italic>Klebsiella pneumonia</italic> 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.</p><p><bold>Conclusion:</bold> We identified lactitol-associated metagenomic changes, and provide insight into the understanding of the roles of lactitol in modulating gut microbiome in cirrhotic patients.</p>