Changes in intestinal microbiota and abnormal amino acid metabolism lead to neurotransmitter disorders in patients with liver cirrhosis

The 16S rRNA sequencing technology was used to investigate changes in the abundance of intestinal microbiota, metabolites of blood and fecal samples were analyzed and their relationships with neurotransmitters were evaluated in patients with liver cirrhosis after hepatitis B infection. The liver function phenotypes correlated with Phylum Proteobacteria, Class Clostridia and Gamma Proteobacteria, Family Enterobacteriaceae, Ruminococcaceae, Streptococcaceae, Lachnospiraceae and Lactobacillaceae, Genus Faecalibacterium, Streptococcus, species Escherichia coli, etc. Genus Streptococcus has a good diagnostic value for patients with liver cirrhosis in the COM (Compensated liver disease) group, with an AUC of 0.81 (95% CI: 0.70-0.92), while Genus Streptococcus, Veillonella, Faecalibacterium, Blautia, and Bacteroides have a better diagnostic value for patients with liver cirrhosis in the DECOM (Decompensated liver disease) group (including DECOM1 and DECOM2), with the combined AUC reaching 0.93 (95% CI: 0.88-0.98). The level of ammonia in the DECOM2 group was significantly higher than that of the COM group (P < 0.01). Patients with post-hepatitis B cirrhosis have intestinal flora disorder, which leads to abnormal amino acid metabolism and further leads to neurotransmitter disorder in patients with cirrhosis and accelerates the disease progression. Probiotics can reduce the serum ammonia level in patients with cirrhosis and may prevent the occurrence of hepatic encephalopathy.