Potential Contribution of the Gut Microbiota to the Development of Portal Vein Thrombosis in Liver Cirrhosis

Abstract Background: An imbalance in intestinal homeostasis is observed in patients with liver cirrhosis (LC). Portal vein thrombosis (PVT) is a serious complication of LC that is closely related to intestinal homeostasis. The study aimed to investigate the composition of gut microbiota and its putative role in PVT development in LC. Methods: 33 patients with LC admitted between January 2022 and December 2022 were enrolled in this study. Based on imaging findings, they were categorized into LC without PVT (n=21) and LC with PVT (n=12) groups. Fecal samples were collected from each participant and underwent 16S rDNA sequencing. Results: D-dimer and platelet elevations were the main clinical features of LC with PVT. The diversity of the gut bacterial community in the LC with PVT group was found to be significantly higher in both alpha and beta diversity when compared to the control group. The structure of the intestinal microbiota was significantly different between LC with PVT and LC without PVT. Based on LEfSe data, Ligilactobacillus and Enterococcus were identified as the most differentially abundant bacterial taxa in LC with PVT. The fecal microbiota with distinct differences in abundance correlated with coagulation factor parameters. We selected five bacterial genera ( Ligilactobacillus , Pseudomonas , Parabacteroides , Lactococcus , and Weissella ) to distinguishPVT in LC using a random forest model. Conclusion: LC with PVT led to a disorder in the intestinal microbiota, which was characterized by an increase in pathogenic bacteria and a decrease in beneficial bacteria. Furthermore, modulating the gut microbiota could be a promising therapeutic approach to reduce the progression of PVT in LC.