We commend Worland et al for their work associating rifaximin-αuse with imp-roved muscle mass in individuals with liver cirrhosis.This observation adds momentum to the evolving gut-liver-muscle axis hypothesis.Howeve...We commend Worland et al for their work associating rifaximin-αuse with imp-roved muscle mass in individuals with liver cirrhosis.This observation adds momentum to the evolving gut-liver-muscle axis hypothesis.However,the retro-spective design and lack of functional outcomes invite caution in interpretation.Mechanistically,rifaximin may exert benefit beyond ammonia reduction through modulation of systemic inflammation,tumor necrosis factor alpha suppression,and restoration of myocyte integrity.Additionally,concerns about long-term anti-microbial resistance must be acknowledged.Overall,this study represents a valuable first step,but its implications require validation in future,prospective,mechanistically informed clinical trials.展开更多
文摘We commend Worland et al for their work associating rifaximin-αuse with imp-roved muscle mass in individuals with liver cirrhosis.This observation adds momentum to the evolving gut-liver-muscle axis hypothesis.However,the retro-spective design and lack of functional outcomes invite caution in interpretation.Mechanistically,rifaximin may exert benefit beyond ammonia reduction through modulation of systemic inflammation,tumor necrosis factor alpha suppression,and restoration of myocyte integrity.Additionally,concerns about long-term anti-microbial resistance must be acknowledged.Overall,this study represents a valuable first step,but its implications require validation in future,prospective,mechanistically informed clinical trials.
