Review article: emerging role of the gut microbiome in the progression of nonalcoholic fatty liver disease and potential therapeutic implications

Jun 1, 2019Alimentary pharmacology & therapeutics

The Gut Microbiome's Role in Worsening Fatty Liver Disease and Possible Treatments

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Circadian Biology on OpenScience ↗PubMed ↗DOI ↗OA ↗

Abstract

The composition of gut bacteria may influence fat deposition and inflammation related to (NAFLD).

Gut microbiota composition is associated with enhanced fat deposition and altered energy metabolism.
Emerging evidence links the to obesity and metabolic syndrome, which are often related to NAFLD.
The gut microbiome may help differentiate between the two forms of NAFLD: nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH).
There is a possible connection between gut microbiome composition and fibrosis progression in NAFLD.
Therapeutics targeting the gut microbiome may provide new treatment options for patients with NAFLD.

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BACKGROUND: (NAFLD) is a prevalent disorder associated with obesity and diabetes. Few treatment options are effective for patients with NAFLD, but connections between the and NAFLD and NAFLD-associated conditions suggest that modulation of the gut microbiota could be a novel therapeutic option.

AIM: To examine the effect of the gut microbiota on pathophysiologic causes of NAFLD and assess the potential of microbiota-targeting therapies for NAFLD.

METHODS: A PubMed search of the literature was performed; relevant articles were included.

RESULTS: The composition of bacteria in the gastrointestinal tract can enhance fat deposition, modulate energy metabolism and alter inflammatory processes. Emerging evidence suggests a role for the gut microbiome in obesity and metabolic syndrome. NAFLD is often considered the hepatic manifestation of metabolic syndrome, and there has been tremendous progress in understanding the association of gut microbiome composition with NAFLD disease severity. We discuss the role of the gut microbiome in NAFLD pathophysiology and whether the microbiome composition can differentiate the two categories of NAFLD: nonalcoholic fatty liver (NAFL, the non-progressive form) vs nonalcoholic steatohepatitis (NASH, the progressive form). The association between gut microbiome and fibrosis progression in NAFLD is also discussed. Finally, we review whether modulation of the gut microbiome plays a role in improving treatment outcomes for patients with NAFLD.

CONCLUSIONS: Multiple pathophysiologic pathways connect the gut microbiome with the pathophysiology of NAFLD. Therefore, therapeutics that effectively target the gut microbiome may be beneficial for the treatment of patients with NAFLD.

Key numbers

37 of 40 features

Increased Proteobacteria Levels

Features predicting advanced fibrosis in patients related to gut microbiota.

< 0.01

Higher Blood Ethanol Levels

Comparison of blood ethanol levels between NASH and obese patients.

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Review article: emerging role of the gut microbiome in the progression of nonalcoholic fatty liver disease and potential therapeutic implications

Abstract

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