The gut microbiota has recently evolved as a new important player in the pathophysiology of many intestinal and extraintestinal diseases. The liver is the organ which is in closest contact with the intestinal tract, and is exposed to a substantial amount of bacterial components and metabolites. Various liver disorders such as alcoholic liver disease, non-alcoholic liver disease and primary sclerosing cholangitis have been associated with an altered microbiome. This dysbiosis may influence the degree of hepatic steatosis, inflammation and fibrosis through multiple interactions with the host's immune system and other cell types. Whereas few results from clinical metagenomic studies in liver disease are available, evidence is accumulating that in liver cirrhosis an oral microbiome is overrepresented in the lower intestinal tract, potentially contributing to disease process and severity. A major role for the gut microbiota in liver disorders is also supported by the accumulating evidence that several complications of severe liver disease such as hepatic encephalopathy are efficiently treated by various prebiotics, probiotics and antibiotics. A better understanding of the gut microbiota and its components in liver diseases might provide a more complete picture of these complex disorders and also form the basis for novel therapies.
- ALCOHOLIC LIVER DISEASE
- HEPATIC ENCEPHALOPATHY
- LIVER CIRRHOSIS
- PRIMARY SCLEROSING CHOLANGITIS
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Funding HT is supported by the excellence initiative (Competence Centers for Excellent Technologies) of the Austrian Research Promotion Agency (FFG): Research Center of Excellence in Vascular Ageing—Tyrol, VASCage (K-Project Nr. 843536) funded by the BMVIT, BMWFW, the Wirtschaftsagentur Wien and the Standortagentur Tirol. PDC is a research associate at FRS-FNRS (Fonds de la Recherche Scientifique), Belgium. PDC is the recipient of grants from FNRS (J.0084.15) and ARC (Action de Recherche Concertée—Communauté française de Belgique convention: 12/17-047). This work was supported by WELBIO under grant: WELBIO-CR-2012S-02R, and the Funds Baillet Latour (Grant for Medical Research 2015). PDC is a recipient of an ERC Starting Grant 2013 (European Research Council, starting grant 336452-ENIGMO).
Competing interests None declared.
Provenance and peer review Commissioned; externally peer reviewed.