"It has been believed that most of the pathogenesis of cirrhosis starts in the gut, which is what makes this discovery so fascinating," said Jasmohan Bajaj, associate professor of hepatology at the Virginia Commonwealth University (VCU) School of Medicine in the US.

"The fact that saliva, along with fluid in the gut, can be an indicator of inflammation tells us that we need to further explore the oral cavity and its connections to liver disease," Bajaj noted.

The study involved more than 100 cirrhosis patients, 38 of which had to be hospitalised within 90 days because of flare-ups. Researchers found that the ratio of good-to-bad microbes was similar in the saliva as in the stool of these patients who required hospitalisation.

Another part of the same study looked at an additional group of more than 80 people with and without cirrhosis. Those with cirrhosis had impaired salivary defences, mirroring the immune deficiencies that take place in the gut.

"The data suggest that there may be a change in the overall mucosal-immune interface in cirrhosis patients, allowing a more toxic microbiota to emerge in both the gut and oral cavity,"  co-author of the paper Phillip Hylemon, who is also from the VCU School of Medicine, noted.

The study is forthcoming in the journal Hepatology.

 

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