A study presented at the AASLD Liver Meeting found that microbiome subtypes may predict patients’ response to ursodeoxycholic acid (UDCA) treatment for primary biliary cholangitis (PBC).
The study included patients who were treatment-naïve to UDCA; patients underwent metagenomic sequencing and metabolomic profiling using stool and serum samples collected before (n=132) and after (n=59) treatment. The study utilized machine learning methods for microbiome subtype identification, and the outcomes were validated in 2 independent cohorts.
Patients were classified as either Clostridia-low or Clostridia-high, with the latter cohort being more similar to healthy controls. The study team determined that patients with the Clostridia-low subtype were twice as likely to not respond to UDCA when compared with patients in the Clostridia-high group (41% vs 20%; P=.015).
The researchers observed that the Clostridia-low subtype was associated with diminished anaerobic fermentation and the production of bioactive metabolites, including tryptophan derivatives and secondary bile acids, which are critical for immune regulation and gut barrier maintenance. UDCA appeared to reconfigure the fecal microbial and metabolic profiles.
“Characterizing baseline microbiota patterns may enable prediction of treatment outcomes in PBC and facilitate personalized treatment strategies,” the authors concluded.
Reference
Tang R, Ma X, Qiaoyan L. Gut microbiome pattern impacts treatment response in primary biliary cholangitis. Abstract 0102. Presented at the 2024 American Association for the Study of Liver Diseases’ 75th Liver Meeting; November 15–19, 2024; San Diego.
