Depression alters the structure of the gut microbiome in patients with autoimmune hepatitis (AIH) and could contribute to the progression of liver cirrhosis, according to study results intended to be presented at Digestive Disease Week 2020.

Researchers sought to determine the incidence of depression among patients with autoimmune hepatitis and elucidate its role in the progression of AIH. They assessed depression in 310 consecutive patients attending AIH clinics using clinical scales and analyzed the correlation between AIH and the progression of cirrhosis.

The researchers supplemented these findings with information from another study in which chronic liver injury and depression caused by chronic unpredictable stress were induced in mice colonized with the microbiota of patients with major depressive disorder or healthy controls.

The rate of depression among patients with AIH was 3 times (30.8%) higher than that of the control group (10.2%). Patients with AIH and depression also had a higher rate of cirrhosis, and patients with severe depression showed poor treatment response. Results from the mouse study showed that depression promoted the progression of cirrhosis. Furthermore, treatment with antidepressant drugs resulted in decreased liver injury. In addition, mice transplanted with the microbiota of patients with major depressive disorder exhibited more severe liver damage than those transplanted with the microbiota of controls.

The researchers concluded that “depression promoted the progression of liver cirrhosis in AIH patients by altering the structure of gut microbiome.” They added that depression screening could be a new breakthrough in the treatment of patients with refractory AIH.

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