Contribution of the Intestinal Microbiome and Gut Barrier to Hepatic Disorders

Gastroenterology. 2020 Sep;159(3):849-863. doi: 10.1053/j.gastro.2020.04.077. Epub 2020 Jun 20.

Abstract

Intestinal barrier dysfunction and dysbiosis contribute to development of diseases in liver and other organs. Physical, immunologic, and microbiologic (bacterial, fungal, archaeal, viral, and protozoal) features of the intestine separate its nearly 100 trillion microbes from the rest of the human body. Failure of any aspect of this barrier can result in translocation of microbes into the blood and sustained inflammatory response that promote liver injury, fibrosis, cirrhosis, and oncogenic transformation. Alterations in intestinal microbial populations or their functions can also affect health. We review the mechanisms that regulate intestinal permeability and how changes in the intestinal microbiome contribute to development of acute and chronic liver diseases. We discuss individual components of the intestinal barrier and how these are disrupted during development of different liver diseases. Learning more about these processes will increase our understanding of the interactions among the liver, intestine, and its flora.

Keywords: Alcoholic Liver Disease; Drug Induced Liver Injury; Gut Permeability; Hepatic Disorders; Leaky Gut; Liver Disease; Microbiome; Nonalcoholic Liver Disease; Primary Sclerosing Cholangitis.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Bacterial Translocation / immunology*
  • Disease Models, Animal
  • Dysbiosis / complications*
  • Dysbiosis / immunology
  • Dysbiosis / microbiology
  • Dysbiosis / physiopathology
  • Gastrointestinal Microbiome / immunology*
  • Humans
  • Intestinal Mucosa / metabolism
  • Intestinal Mucosa / microbiology
  • Intestinal Mucosa / physiopathology*
  • Liver / immunology
  • Liver / pathology
  • Liver Diseases / immunology*
  • Liver Diseases / microbiology
  • Liver Diseases / pathology
  • Permeability