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Gut microbial trimethylamine is elevated in alcohol-associated hepatitis and contributes to ethanol-induced liver injury in mice.


ABSTRACT: There is mounting evidence that microbes residing in the human intestine contribute to diverse alcohol-associated liver diseases (ALD) including the most deadly form known as alcohol-associated hepatitis (AH). However, mechanisms by which gut microbes synergize with excessive alcohol intake to promote liver injury are poorly understood. Furthermore, whether drugs that selectively target gut microbial metabolism can improve ALD has never been tested. We used liquid chromatography tandem mass spectrometry to quantify the levels of microbe and host choline co-metabolites in healthy controls and AH patients, finding elevated levels of the microbial metabolite trimethylamine (TMA) in AH. In subsequent studies, we treated mice with non-lethal bacterial choline TMA lyase (CutC/D) inhibitors to blunt gut microbe-dependent production of TMA in the context of chronic ethanol administration. Indices of liver injury were quantified by complementary RNA sequencing, biochemical, and histological approaches. In addition, we examined the impact of ethanol consumption and TMA lyase inhibition on gut microbiome structure via 16S rRNA sequencing. We show the gut microbial choline metabolite TMA is elevated in AH patients and correlates with reduced hepatic expression of the TMA oxygenase flavin-containing monooxygenase 3 (FMO3). Provocatively, we find that small molecule inhibition of gut microbial CutC/D activity protects mice from ethanol-induced liver injury. CutC/D inhibitor-driven improvement in ethanol-induced liver injury is associated with distinct reorganization of the gut microbiome and host liver transcriptome. The microbial metabolite TMA is elevated in patients with AH, and inhibition of TMA production from gut microbes can protect mice from ethanol-induced liver injury.

SUBMITTER: Helsley RN 

PROVIDER: S-EPMC8853661 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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Gut microbial trimethylamine is elevated in alcohol-associated hepatitis and contributes to ethanol-induced liver injury in mice.

Helsley Robert N RN   Miyata Tatsunori T   Kadam Anagha A   Varadharajan Venkateshwari V   Sangwan Naseer N   Huang Emily C EC   Banerjee Rakhee R   Brown Amanda L AL   Fung Kevin K KK   Massey William J WJ   Neumann Chase C   Orabi Danny D   Osborn Lucas J LJ   Schugar Rebecca C RC   McMullen Megan R MR   Bellar Annette A   Poulsen Kyle L KL   Kim Adam A   Pathak Vai V   Mrdjen Marko M   Anderson James T JT   Willard Belinda B   McClain Craig J CJ   Mitchell Mack M   McCullough Arthur J AJ   Radaeva Svetlana S   Barton Bruce B   Szabo Gyongyi G   Dasarathy Srinivasan S   Garcia-Garcia Jose Carlos JC   Rotroff Daniel M DM   Allende Daniela S DS   Wang Zeneng Z   Hazen Stanley L SL   Nagy Laura E LE   Brown Jonathan Mark JM  

eLife 20220127


There is mounting evidence that microbes residing in the human intestine contribute to diverse alcohol-associated liver diseases (ALD) including the most deadly form known as alcohol-associated hepatitis (AH). However, mechanisms by which gut microbes synergize with excessive alcohol intake to promote liver injury are poorly understood. Furthermore, whether drugs that selectively target gut microbial metabolism can improve ALD has never been tested. We used liquid chromatography tandem mass spec  ...[more]

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