Abstract Number: LPB0119
Meeting: ISTH 2021 Congress
Background: Dysbiosis might be a source of systemic inflammation and subsequent increased coagulation activity by translocation of lipopolysaccharides from gram-negative bacteria to the systemic circulation.
Aims: To investigate whether a vancomycin induced gram-negative shift of the microbiome influences systemic inflammation and plasma factor (F)VIII activity.
Methods: We performed a randomized controlled trial including healthy adult volunteers. Participants were randomized to seven days of oral vancomycin treatment or to no intervention. Feces and blood were sampled at baseline (T0) and the day after end of intervention (T1). The gut microbiome composition was assessed before and after intervention. Plasma FVIII activity (FVIII:C) and high-sensitivity (hs)CRP, cytokines, complement activation and zonulin as a marker for intestinal permeability were measured. The differences between T1 and T0 were analysed. All subjects provided informed consent. The study was approved by the Regional Committee for Medical and Health Research Ethics and the Norwegian Data Inspectorate.
Results: Fourty-three participants were included, 21 in the intervention group and 22 in the control group (mean age 26.7 vs. 25.0 years and 14 vs. 15 females respectively). Vancomycin intake significantly reduced gut microbiome diversity and increased the abundance of gram-negative bacteria. Change in FVIII:C in the intervention group was +4 IU/dL vs. -6 IU/dL, (p=0.01) in the control group. A similar change was observed for log-transformed hs-CRP (+0.21 vs. -0.25, p=0.04) The cytokines and complement activation markers remained similar in the two groups. No differences in zonulin levels were found.
Conclusions: Although vancomycin intake did not affect intestinal permeability in this healthy population, our findings support the hypothesis that a vancomycin-induced gram-negative shift in the gut microbiome could lead to an increase in plasma FVIII:C and CRP levels.
To cite this abstract in AMA style:Grimnes G, Bhoelan S, Hindberg K, Davids M, Nieuwdorp M, Mollnes TE, Michelsen A, Ueland T, Braekkan S, Hansen J-, Tichelaar V. Impact of Vancomycin-induced Shift of the Gut Microbiome in Gram Negative Direction on Plasma Factor VIII:C Levels: Results from a Randomized, Controlled Trial [abstract]. Res Pract Thromb Haemost. 2021; 5 (Suppl 1). https://abstracts.isth.org/abstract/impact-of-vancomycin-induced-shift-of-the-gut-microbiome-in-gram-negative-direction-on-plasma-factor-viiic-levels-results-from-a-randomized-controlled-trial/. Accessed September 16, 2021.
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