Analysing the ratio of
good-bad bacteria in saliva, not just in the gut as earlier thought,
could help doctors predict which liver cirrhosis patients would suffer
inflammations and require hospitalisation, say researchers, including
one of Indian-origin.
"It has been believed that most of the pathogenesis of cirrhosis
starts in the gut, which is what makes this discovery so fascinating,"
said Jasmohan Bajaj, associate professor of hepatology at the Virginia
Commonwealth University (VCU) School of Medicine in the US.
"The
fact that saliva, along with fluid in the gut, can be an indicator of
inflammation tells us that we need to further explore the oral cavity
and its connections to liver disease," Bajaj noted.
The study involved more than 100 cirrhosis patients, 38 of which had to be hospitalised within 90 days because of flare-ups.
Researchers
found that the ratio of good-to-bad microbes was similar in the saliva
as in the stool of these patients who required hospitalisation.
Another
part of the same study looked at an additional group of more than 80
people with and without cirrhosis. Those with cirrhosis had impaired
salivary defences, mirroring the immune deficiencies that take place in
the gut.
"The data suggest that there may be a change in the
overall mucosal-immune interface in cirrhosis patients, allowing a more
toxic microbiota to emerge in both the gut and oral cavity," co-author
of the paper Phillip Hylemon, who is also from the VCU School of
Medicine, noted.
The study is forthcoming in the journal Hepatology.
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