Low-diversity microbiota and an increased metabolism of arginine and aromatic amino acids: a hallmark of hepatic encephalopathy in western Mexican patients with alcohol-associated cirrhosis.

This article focuses on characterizing the gut microbiota composition and metabolic functions in Mexican patients with decompensated alcohol-associated cirrhosis, comparing those with hepatic encephalopathy (HE) to those without HE and to healthy controls. The study found that patients with HE exhibit significantly reduced gut microbiota diversity and a predominance of aerotolerant, potentially proinflammatory bacteria such as Escherichia and Shigella, alongside metabolic pathways favoring ammonia production and aromatic amino acid biosynthesis, which are linked to neurotoxic effects. In contrast, patients without HE showed a more anaerobic microbiota enriched with genera like Veillonella and Bacteroides and higher levels of beneficial short-chain fatty acids (SCFAs). These findings suggest a dysbiotic gut environment in HE that may contribute to its pathogenesis through altered microbial metabolism and inflammation, highlighting the gut-liver-brain axis as a potential therapeutic target.