{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T12:26:48Z","timestamp":1793276808771,"version":"4.5.0"},"reference-count":54,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T00:00:00Z","timestamp":1741910400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T00:00:00Z","timestamp":1741910400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["OE821\/1\u20101;Ta434\/8\u20101;CRC1382Project\u2010ID403224013"],"award-info":[{"award-number":["OE821\/1\u20101;Ta434\/8\u20101;CRC1382Project\u2010ID403224013"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006379","name":"Office of Research and Development","doi-asserted-by":"publisher","award":["BX004594"],"award-info":[{"award-number":["BX004594"]}],"id":[{"id":"10.13039\/100006379","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aims<\/jats:title>\n                    <jats:p>\n                      Primary sclerosing cholangitis (PSC) is an immune\u2010related cholangiopathy without treatment options beyond liver transplantation. The gut\u2013liver axis, especially the role of gut microbes, has emerged as a crucial pathway contributing to PSC pathogenesis. Recent research has revealed\n                      <jats:italic>Enterococcus (E.) faecalis<\/jats:italic>\n                      and its virulence factor cytolysin to increase mortality risk in patients with alcohol\u2010associated hepatitis. Thus, we studied the role of enterococci, particularly\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>E. faecalis<\/jats:italic>\n                      <\/jats:styled-content>\n                      and its virulence factor genes cytolysin and gelatinase, in faecal samples from patients with PSC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      To assess the relevance of\n                      <jats:italic>Enterococcus<\/jats:italic>\n                      species, we performed 16S rRNA gene amplicon analysis in faecal samples from 60 patients with PSC. We validated our findings by qPCR of faecal microbial DNA in an extended cohort of 105 patients with PSC, 104 patients with inflammatory bowel disease (IBD) and 68 healthy subjects.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      High\u2010throughput 16S rRNA amplicon analysis revealed an increased relative abundance of enterococci in PSC patients compared with healthy controls and IBD patients, respectively, (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.0001). PSC patients with high enterococci abundance had a decreased probability of transplant\u2010free survival (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028).\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>E. faecalis<\/jats:italic>\n                      <\/jats:styled-content>\n                      and its virulence factors cytolysin and gelatinase were more abundant in patients with PSC. Higher faecal cytolysin was associated with lower overall survival (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04), while survival was independent of gelatinase levels.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Our data highlight the association of\n                      <jats:styled-content style=\"fixed-case\">\n                        <jats:italic>E. faecalis<\/jats:italic>\n                      <\/jats:styled-content>\n                      and faecal cytolysin with lower survival in patients with PSC. These data should prompt further research into the pathogenic role of cytolysin\u2010positive\n                      <jats:italic>\n                        <jats:styled-content style=\"fixed-case\">E. faecalis<\/jats:styled-content>\n                        ,\n                      <\/jats:italic>\n                      and to explore its role as a potential therapeutic target.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/liv.16181","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T03:52:40Z","timestamp":1741924360000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Faecal Cytolysin is Associated With Worse Survival in Patients With Primary Sclerosing Cholangitis"],"prefix":"10.1111","volume":"45","author":[{"given":"Burcin","family":"\u00d6zdirik","sequence":"first","affiliation":[{"name":"Department of Medicine University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hilmar","family":"Berger","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Gastroenterology Campus Virchow Klinikum (CVK) and Campus Charit\u00e9 Mitte (CCM), Charit\u00e9 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda Raya","family":"Tonetti","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noem\u00ed","family":"Cabr\u00e9","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Diego  La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Treichel","sequence":"additional","affiliation":[{"name":"Functional Microbiome Research Group, Institute of Medical Microbiology University Hospital of RWTH Aachen  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Clavel","sequence":"additional","affiliation":[{"name":"Functional Microbiome Research Group, Institute of Medical Microbiology University Hospital of RWTH Aachen  Aachen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6206-0226","authenticated-orcid":false,"given":"Frank","family":"Tacke","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Gastroenterology Campus Virchow Klinikum (CVK) and Campus Charit\u00e9 Mitte (CCM), Charit\u00e9 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Sigal","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Gastroenterology Campus Virchow Klinikum (CVK) and Campus Charit\u00e9 Mitte (CCM), Charit\u00e9 Universit\u00e4tsmedizin Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6281-825X","authenticated-orcid":false,"given":"Bernd","family":"Schnabl","sequence":"additional","affiliation":[{"name":"Department of Medicine University of California San Diego  La Jolla California USA"},{"name":"Department of Medicine VA San Diego Healthcare System  San Diego California 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