A story of liver and gut microbes: how does the intestinal flora affect liver disease? A review of the literature

Am J Physiol Gastrointest Liver Physiol. 2020 May 1;318(5):G889-G906. doi: 10.1152/ajpgi.00161.2019. Epub 2020 Mar 9.

Abstract

Each individual is endowed with a unique gut microbiota (GM) footprint that mediates numerous host-related physiological functions, such as nutrient metabolism, maintenance of the structural integrity of the gut mucosal barrier, immunomodulation, and protection against microbial pathogens. Because of increased scientific interest in the GM, its central role in the pathophysiology of many intestinal and extraintestinal conditions has been recognized. Given the close relationship between the gastrointestinal tract and the liver, many pathological processes have been investigated in the light of a microbial-centered hypothesis of hepatic damage. In this review we introduce to neophytes the vast world of gut microbes, including prevalent bacterial distribution in healthy individuals, how the microbiota is commonly analyzed, and the current knowledge of the role of GM in liver disease pathophysiology. Also, we highlight the potentials and downsides of GM-based therapy.

Keywords: chronic liver diseases; dysbiosis; fecal transplantation; gut-brain-liver axis; gut-liver axis; liver cirrhosis; microbiome; oral microbiota; probiotics.

Publication types

  • Review

MeSH terms

  • Animals
  • Bacteria / metabolism
  • Bacteria / pathogenicity*
  • Dysbiosis
  • Fecal Microbiota Transplantation
  • Gastrointestinal Microbiome*
  • Host-Pathogen Interactions
  • Humans
  • Intestines / microbiology*
  • Liver / metabolism
  • Liver / microbiology*
  • Liver / pathology
  • Liver Diseases / metabolism
  • Liver Diseases / microbiology*
  • Liver Diseases / pathology
  • Liver Diseases / therapy
  • Probiotics / therapeutic use