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We hypothesized that obeticholic acid (OCA), a semisynthetic bile acid, would change the microbiome composition and reduce bacterial translocation in experimental cirrhosis. Rats with cirrhosis induced by carbon tetrachloride inhalation (a nonseptic model) with ascites present for at least 7\u00a0days were randomized to receive a 14\u2010day course of OCA at a dose of 5\u00a0mg\/kg\/day (n\u00a0=\u00a034) or placebo (n\u00a0=\u00a034). Stool was collected at days 1 (randomization), 8, and 14 (sacrifice) for analysis of intestinal microbiome using the V4 hypervariable region of the bacterial 16S gene amplified by polymerase chain reaction. Bacteriological cultures of mesenteric lymph nodes, blood, and ascites were performed at end of study. Twenty\u2010four animals in each group reached the end of study. Compared with placebo, rats treated with OCA had decreased relative abundance of <jats:italic toggle=\"yes\">Enterococcus<\/jats:italic> in both ileum content (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0=\u00a00.02) and in stool (<jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.001). BT from pathogenic bacteria was not different between groups. At end of treatment, rats on OCA had a significantly lower aspartate aminotransferase (AST) (266 vs. 369\u00a0IU\/L; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.01) and higher serum albumin (0.9 vs. 0.7\u00a0g\/dL; <jats:italic toggle=\"yes\">P<\/jats:italic>\u00a0&lt;\u00a00.01) than rats on placebo. <jats:italic toggle=\"yes\">Conclusion:<\/jats:italic> Although OCA did not appear to reduce BT by pathogenic bacteria, the reduction in intestinal content of <jats:italic toggle=\"yes\">Enterococcus<\/jats:italic>, which has been associated with hepatocyte death, in OCA\u2010treated animals is consistent with our observed improvements in AST and in liver function, as evidenced by higher serum albumin.<\/jats:p>","DOI":"10.1002\/hep4.1740","type":"journal-article","created":{"date-parts":[[2021,6,10]],"date-time":"2021-06-10T23:07:59Z","timestamp":1623366479000},"page":"1507-1517","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":10,"title":["Obeticholic Acid Decreases Intestinal Content of Enterococcus in Rats With Cirrhosis and Ascites"],"prefix":"10.1097","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0744-9102","authenticated-orcid":false,"given":"Kathleen","family":"Yan","sequence":"first","affiliation":[{"name":"Digestive Diseases Section,Yale University,New Haven,CT,USA"},{"name":"VA\u2010Connecticut Healthcare System,West Haven,CT,USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adelina","family":"Hung","sequence":"additional","affiliation":[{"name":"Digestive Diseases Section,Yale University,New Haven,CT,USA"},{"name":"VA\u2010Connecticut Healthcare System,West 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