{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T14:10:33Z","timestamp":1780323033619,"version":"3.54.1"},"reference-count":93,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T00:00:00Z","timestamp":1599436800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u00d6GIAIN","award":["not applicable"],"award-info":[{"award-number":["not applicable"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>Secondary sclerosing cholangitis in critically ill patients (SC-CIP) occurs after long-term intensive care treatment. This study aimed to assess the gut\u2013liver axis in SC-CIP. Stool microbiome composition, gut permeability, bacterial translocation and serum bile acid profiles of 18 SC-CIP patients compared to 11 patients after critical illness without liver disease (CIP controls), 21 patients with cirrhosis and 21 healthy controls were studied. 16S rDNA was isolated from stool and sequenced using the Illumina technique. Diamine oxidase, zonulin, soluble CD14 (sCD14) and lipopolysaccharide binding protein were measured in serum and calprotectin in stool. Serum bile acids were analyzed by high-performance liquid chromatography-mass spectrometry (HPLC-MS). Reduced microbiome alpha diversity and altered beta diversity were seen in SC-CIP, CIP controls and cirrhosis compared to healthy controls. SC-CIP patients showed a shift towards pathogenic taxa and an oralization. SC-CIP, CIP controls and cirrhotic patients presented with impaired gut permeability, and biomarkers of bacterial translocation were increased in SC-CIP and cirrhosis. Total serum bile acids were elevated in SC-CIP and cirrhosis and the bile acid profile was altered in SC-CIP, CIP controls and cirrhosis. In conclusions, observed alterations of the gut\u2013liver axis in SC-CIP cannot solely be attributed to liver disease, but may also be secondary to long-term intensive care treatment.<\/jats:p>","DOI":"10.3390\/nu12092728","type":"journal-article","created":{"date-parts":[[2020,9,7]],"date-time":"2020-09-07T09:18:16Z","timestamp":1599470296000},"page":"2728","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Secondary Sclerosing Cholangitis in Critically Ill Patients Alters the Gut\u2013Liver Axis: A Case Control Study"],"prefix":"10.3390","volume":"12","author":[{"given":"Andreas","family":"Blesl","sequence":"first","affiliation":[{"name":"Division for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christoph","family":"J\u00fcngst","sequence":"additional","affiliation":[{"name":"Division for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Z\u00fcrich, 8032 Z\u00fcrich, Switzerland"},{"name":"Department of Medicine II, Saarland University Medical Center, Saarland University, 66421 Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4450-7201","authenticated-orcid":false,"given":"Frank","family":"Lammert","sequence":"additional","affiliation":[{"name":"Department of Medicine II, Saarland University Medical Center, Saarland University, 66421 Homburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G\u00fcnter","family":"Fauler","sequence":"additional","affiliation":[{"name":"Institute for Medical and Chemical Laboratory Diagnosis, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Rainer","sequence":"additional","affiliation":[{"name":"Division for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2101-7560","authenticated-orcid":false,"given":"Bettina","family":"Leber","sequence":"additional","affiliation":[{"name":"Department of Surgery, Division of Transplantation Surgery, Medical University of Graz, 8036 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Feldbacher","sequence":"additional","affiliation":[{"name":"Division for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"Stromberger","sequence":"additional","affiliation":[{"name":"AUVA Rehabilitation Clinic Tobelbad, 8144 Tobelbad, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renate","family":"Wildburger","sequence":"additional","affiliation":[{"name":"AUVA Rehabilitation Clinic Tobelbad, 8144 Tobelbad, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Walter","family":"Spindelb\u00f6ck","sequence":"additional","affiliation":[{"name":"Division for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Fickert","sequence":"additional","affiliation":[{"name":"Division for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7279-0628","authenticated-orcid":false,"given":"Angela","family":"Horvath","sequence":"additional","affiliation":[{"name":"Division for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Stadlbauer","sequence":"additional","affiliation":[{"name":"Division for Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,9,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"105","DOI":"10.2147\/CEG.S115518","article-title":"Secondary sclerosing cholangitis in critically ill patients: Current perspectives","volume":"10","author":"Gudnason","year":"2017","journal-title":"Clin. 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