Clin Mol Hepatol.  2018 Jun;24(2):100-107. 10.3350/cmh.2017.0067.

Microbiota, a key player in alcoholic liver disease

• Cassard AM
• Ciocan D

• KMID: 2417056
• DOI: http://doi.org/10.3350/cmh.2017.0067

Abstract

Alcoholic liver disease (ALD) is a major cause of morbidity and mortality worldwide. Only 20% of heavy alcohol consumers develop alcoholic liver cirrhosis. The intestinal microbiota (IM) has been recently identified as a key player in the severity of liver injury in ALD. Common features of ALD include a decrease of gut epithelial tight junction protein expression, mucin production, and antimicrobial peptide levels. This disruption of the gut barrier, which is a prerequisite for ALD, leads to the passage of bacterial products into the blood stream (endotoxemia). Moreover, metabolites produced by bacteria, such as short chain fatty acids, volatile organic compounds (VOS), and bile acids (BA), are involved in ALD pathology. Probiotic treatment, IM transplantation, or the consumption of dietary fiber, such as pectin, which all alter the ratio of bacterial species, have been shown to improve liver injury in animal models of ALD and to be associated with an improvement in gut barrier function. Although the connections between the microbiota and the host in ALD are well established, the underlying mechanisms are still an active area of research. Targeting the microbiome through the use of prebiotic, probiotic, and postbiotic modalities could be an attractive new approach to manage ALD.

Keyword

Alcoholic liver disease; Intestinal microbiota; Probiotics; Pectin; Fiber

MeSH Terms

Alcoholics*
Bacteria
Bile Acids and Salts
Dietary Fiber
Fatty Acids, Volatile
Gastrointestinal Microbiome
Humans
Liver
Liver Cirrhosis, Alcoholic
Liver Diseases, Alcoholic*
Microbiota*
Models, Animal
Mortality
Mucins
Pathology
Prebiotics
Probiotics
Rivers
Tight Junctions
Bile Acids and Salts
Fatty Acids, Volatile
Mucins
Prebiotics