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Portosystemic shunt placement reveals blood signatures for the development of hepatic encephalopathy through mass spectrometry

Author

Listed:
  • Ana Carolina Dantas Machado

    (University of California, San Diego)

  • Stephany Flores Ramos

    (University of California, San Diego
    University of California, San Diego
    University of California, San Diego)

  • Julia M. Gauglitz

    (University of California, San Diego)

  • Anne-Marie Fassler

    (University of Florida)

  • Daniel Petras

    (University of California, San Diego
    University of Tübingen)

  • Alexander A. Aksenov

    (University of California, San Diego
    University of Connecticut)

  • Un Bi Kim

    (University of Florida)

  • Michael Lazarowicz

    (University of Florida)

  • Abbey Barnard Giustini

    (University of California, San Diego
    Veterans Affairs Puget Sounds Health Care System
    University of Washington)

  • Hamed Aryafar

    (San Diego Imaging
    University of California San Diego Medical Center)

  • Irine Vodkin

    (University of California, San Diego)

  • Curtis Warren

    (University of Florida)

  • Pieter C. Dorrestein

    (University of California, San Diego
    University of California, San Diego
    University of California, San Diego
    University of California, San Diego)

  • Ali Zarrinpar

    (University of Florida
    University of Florida
    University of Florida)

  • Amir Zarrinpar

    (University of California, San Diego
    University of California, San Diego
    Jennifer Moreno Department of Veterans Affairs Medical Center
    University of California, San Diego)

Abstract

Elective transjugular intrahepatic portosystemic shunt (TIPS) placement can worsen cognitive dysfunction in hepatic encephalopathy (HE) patients due to toxins, including possible microbial metabolites, entering the systemic circulation. We conducted untargeted metabolomics on a prospective cohort of 22 patients with cirrhosis undergoing elective TIPS placement and followed them up to one year post TIPS for HE development. Here we suggest that pre-existing intrahepatic shunting predicts HE severity post-TIPS. Bile acid levels decrease in the peripheral vein post-TIPS, and the abundances of three specific conjugated di- and tri-hydroxylated bile acids are inversely correlated with HE grade. Bilirubins and glycerophosphocholines undergo chemical modifications pre- to post-TIPS and based on HE grade. Our results suggest that TIPS-induced metabolome changes can impact HE development, and that pre-existing intrahepatic shunting could be used to predict HE severity post-TIPS.

Suggested Citation

  • Ana Carolina Dantas Machado & Stephany Flores Ramos & Julia M. Gauglitz & Anne-Marie Fassler & Daniel Petras & Alexander A. Aksenov & Un Bi Kim & Michael Lazarowicz & Abbey Barnard Giustini & Hamed Ar, 2023. "Portosystemic shunt placement reveals blood signatures for the development of hepatic encephalopathy through mass spectrometry," Nature Communications, Nature, vol. 14(1), pages 1-14, December.
    • Handle: RePEc:nat:natcom:v:14:y:2023:i:1:d:10.1038_s41467-023-40741-9
    DOI: 10.1038/s41467-023-40741-9
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    References listed on IDEAS

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    1. Robin Schmid & Daniel Petras & Louis-Félix Nothias & Mingxun Wang & Allegra T. Aron & Annika Jagels & Hiroshi Tsugawa & Johannes Rainer & Mar Garcia-Aloy & Kai Dührkop & Ansgar Korf & Tomáš Pluskal & , 2021. "Ion identity molecular networking for mass spectrometry-based metabolomics in the GNPS environment," Nature Communications, Nature, vol. 12(1), pages 1-12, December.
    2. Judith Behnsen & Hui Zhi & Allegra T. Aron & Vivekanandan Subramanian & William Santus & Michael H. Lee & Romana R. Gerner & Daniel Petras & Janet Z. Liu & Keith D. Green & Sarah L. Price & Jose Camac, 2021. "Siderophore-mediated zinc acquisition enhances enterobacterial colonization of the inflamed gut," Nature Communications, Nature, vol. 12(1), pages 1-15, December.
    3. Robert A. Quinn & Alexey V. Melnik & Alison Vrbanac & Ting Fu & Kathryn A. Patras & Mitchell P. Christy & Zsolt Bodai & Pedro Belda-Ferre & Anupriya Tripathi & Lawton K. Chung & Michael Downes & Ryan , 2020. "Global chemical effects of the microbiome include new bile-acid conjugations," Nature, Nature, vol. 579(7797), pages 123-129, March.
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