Researchers at the University of California, San Diego (UC San Diego), US, are developing a non-invasive diagnosis test that analyses stool samples to detect liver cirrhosis associated with non-alcoholic fatty liver disease (NAFLD).

Liver cirrhosis is considered as a key predictor for NAFLD survival. The condition is often identified in advanced stages using invasive techniques.

In order to enable fast and easy detection of patients at high risk of NAFLD-cirrhosis, the UC San Diego team identified patterns of bacterial species that are unique to people suffering from the condition.

A prior study in biopsy-proven NAFLD patients revealed a gut microbiome pattern that allowed differentiation of moderate NAFLD from advanced disease.

During the latest study, the researchers assessed microbial makeup in the stool samples obtained from 98 known NAFLD patients and 105 of their first-degree relatives to check if the approach offers insight into cirrhosis status.

The team sequenced 16S rRNA gene, which is a genetic marker specific for bacteria and archaea. This gene is said to aid in identifying bacteria and the relative amounts of each microbe.

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Findings showed less diverse and less stable gut microbiomes in patients with advanced types of NAFLD.

A total of 27 bacterial features unique to the gut microbiomes or stool sample of people with NAFLD-cirrhosis were identified. The stool test was able to detect subjects having NAFLD-cirrhosis with 92% accuracy.

“We will be better at enrolling the right types of patients in clinical trials, and ultimately will be better equipped to prevent and treat it.”

Researchers were able to distinguish the first-degree relative having previously undiagnosed NAFLD-cirrhosis with 87% accuracy.

UC San Diego NAFLD Research Center director Rohit Loomba said: “If we are better able to diagnose NAFLD-related cirrhosis, we will be better at enrolling the right types of patients in clinical trials, and ultimately will be better equipped to prevent and treat it.

“This latest advance toward a non-invasive stool test for NAFLD-cirrhosis may also help pave the way for other microbiome-based diagnostics and therapeutics, and better enable us to provide personalised or precision medicine for a number of conditions.”

A stool-based microbiome diagnostic is estimated to cost approximately $1,500 but the price is expected to lower to less than $400 in the next five years as genomic sequencing and analysis technology advance.

Researchers noted that further research is necessary before the stool test could be available on the market.