MICROB-PREDICT aims to develop personalised, microbiome-based treatment strategies to prevent and treat decompensated cirrhosis and acute-on-chronic liver failure (ACLF) and reduce mortality by investigating the human gut microbiome. The goal is to identify predictors and mechanisms associated with the development of decompensated cirrhosis and its progression to ACLF. The need for personalised treatment strategies becomes apparent when considering that there are substantial, yet still largely unexplained, individual differences in developing decompensated cirrhosis and ACLF. At the same time, this observation bears the chance for more effective, more individualised and more targeted treatments.
The pan-European research project is integrating microbiome results and other patient data from previous large-scale studies, such as GALAXY, LIVERHOPE and PREDICT, combining more than 200,000 data points from about 10,000 subjects. A comprehensive database will be generated, including data from stool, blood, saliva, mucosa and urine samples over the course of the disease, allowing for a novel longitudinal analysis, thereby clearly providing added value over the previous studies. MICROB-PREDICT will identify and validate microbiome-based individual biomarkers and predictors of a) healthy, low-risk conditions, b) decompensated cirrhosis and progression to ACLF, and c) treatment response. In addition, the role of environmental factors (e.g. exposure to pollutants), lifestyle (e.g. smoking), diet (e.g. alcohol consumption), comorbidities, ageing, geographic differences and socio-economic factors will be taken into account.
Gained knowledge will be translated into clinical tests for doctors and every-day tools for liver-disease patients, such as point-of-care (POC) diagnostic tests and state-of-the-art nanobiosensors for smartphone-based patient self-monitoring. MICROB-PREDICT also tries to identify and validate “biomarker signatures” that reliably predict the therapeutic response to treatment with human albumin in a randomized clinical trial (ALB-TRIAL). In short, the 6-year-long project focusses on factual and guided, rather than symptom-based treatment, and aims to develop personalized, effective and well-targeted treatment approaches to reduce the burden on the patients as well as the health care system.