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May 8, 2019

Featured microbiome investigator: Rohit Loomba, MD, MHSC

Dr. Loomba and colleagues are investigating whether a unique microbiome signature can be used to identify patients with NAFLD-cirrhosis who have advanced fibrosis but are unaware of it.

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Dr. Loomba is professor of medicine (with tenure) in the division of gastroenterology, director of the NAFLD Research Center and director of hepatology at UC San Diego School of Medicine and a 2009 recipient of the AGA Research Scholar Award from the AGA Research Foundation.

Cirrhosis is an important predictor of survival for the millions of U.S. adults and children living with nonalcoholic fatty liver disease (NAFLD), but it is difficult to detect in those who have early cirrhosis and are asymptomatic. Dr. Loomba and collaborators have been working on investigating familial risk of NAFLD-cirrhosis among first-degree relatives of patients with NAFLD-cirrhosis at the NAFLD Research Center at the UC San Diego School of Medicine. Using a familial study design, Dr. Loomba and colleagues recently investigated whether a unique microbiome signature can be used to identify first-degree relatives of probands with NAFLD-cirrhosis who have advanced fibrosis but are unaware of it.

As published March 29, 2019, in Nature Communications, Dr. Loomba and colleagues analyzed stool samples from 98 NAFLD patients and more than 100 first-degree relatives. Using 16S rRNA sequencing, the research team identified 27 unique microbial features such as an enrichment of the Megasphaera genus in NAFLD patients with cirrhosis. These features, along with age, sex and body mass index were used to develop a predictive model for NAFLD-cirrhosis that was determined to have a diagnostic accuracy of 86 percent. Though the results are promising and this is the largest study of its kind to date, Dr. Loomba and his team acknowledge that it needs to be validated in an independent and larger cohort of patients before the predictive model is applied in clinical practice. The team is currently seeking additional grant funding to expand their study in a larger patient cohort and validate this approach as a potential new diagnostic for cirrhosis in patients with NAFLD.

AGA members David A. Brenner, MD, and Rob Knight, PhD, were co-authors on this study. See the complete list of co-authors and read the publication at Nature Communications

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