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Microbiota-based treatments in alcoholic liver disease.

Abstract

Gut microbiota plays a key role in the pathogenesis of alcoholic liver disease (ALD). Consumption of alcohol leads to increased gut permeability, small intestinal bacterial overgrowth, and enteric dysbiosis. These factors contribute to the increased translocation of microbial products to the liver via the portal tract. Subsequently, bacterial endotoxins such as lipopolysaccharide, in association with the Toll-like receptor 4 signaling pathway, induce a gamut of damaging immune responses in the hepatic milieu. Because of the close association between deleterious inflammation and ALD-induced microbiota imbalance, therapeutic approaches that seek to reestablish gut homeostasis should be considered in the treatment of alcoholic patients. To this end, a number of preliminary studies on probiotics have confirmed their effectiveness in suppressing proinflammatory cytokines and improving liver function in the context of ALD. In addition, there have been few studies linking the administration of prebiotics and antibiotics with reduction of alcohol-induced liver damage. Because these preliminary results are promising, large-scale randomized studies are warranted to elucidate the impact of these microbiota-based treatments on the gut flora and associated immune responses, in addition to exploring questions about optimal delivery. Finally, fecal microbiota transplant has been shown to be an effective method of modulating gut microbiota and deserve further investigation as a potential therapeutic option for ALD.

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  • Authors+Show Affiliations

    ,

    Hotaik Sung, Department of Molecular and Cell Physiology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, United States.

    ,

    Hotaik Sung, Department of Molecular and Cell Physiology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, United States.

    ,

    Hotaik Sung, Department of Molecular and Cell Physiology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, United States.

    Hotaik Sung, Department of Molecular and Cell Physiology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, United States.

    Source

    World journal of gastroenterology 22:29 2016 Aug 07 pg 6673-82

    MeSH

    Animals
    Dysbiosis
    Fecal Microbiota Transplantation
    Gastrointestinal Microbiome
    Humans
    Liver Diseases, Alcoholic
    Probiotics
    Toll-Like Receptor 4

    Pub Type(s)

    Journal Article
    Review

    Language

    eng

    PubMed ID

    27547010

    Citation

    Sung, Hotaik, et al. "Microbiota-based Treatments in Alcoholic Liver Disease." World Journal of Gastroenterology, vol. 22, no. 29, 2016, pp. 6673-82.
    Sung H, Kim SW, Hong M, et al. Microbiota-based treatments in alcoholic liver disease. World J Gastroenterol. 2016;22(29):6673-82.
    Sung, H., Kim, S. W., Hong, M., & Suk, K. T. (2016). Microbiota-based treatments in alcoholic liver disease. World Journal of Gastroenterology, 22(29), pp. 6673-82. doi:10.3748/wjg.v22.i29.6673.
    Sung H, et al. Microbiota-based Treatments in Alcoholic Liver Disease. World J Gastroenterol. 2016 Aug 7;22(29):6673-82. PubMed PMID: 27547010.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Microbiota-based treatments in alcoholic liver disease. AU - Sung,Hotaik, AU - Kim,Seung Woo, AU - Hong,Meegun, AU - Suk,Ki Tae, PY - 2016/02/29/received PY - 2016/05/21/revised PY - 2016/06/13/accepted PY - 2016/8/23/entrez PY - 2016/8/23/pubmed PY - 2017/4/20/medline KW - Alcoholic liver disease KW - Gut KW - Microbiota KW - Probiotics KW - Treatment SP - 6673 EP - 82 JF - World journal of gastroenterology JO - World J. Gastroenterol. VL - 22 IS - 29 N2 - Gut microbiota plays a key role in the pathogenesis of alcoholic liver disease (ALD). Consumption of alcohol leads to increased gut permeability, small intestinal bacterial overgrowth, and enteric dysbiosis. These factors contribute to the increased translocation of microbial products to the liver via the portal tract. Subsequently, bacterial endotoxins such as lipopolysaccharide, in association with the Toll-like receptor 4 signaling pathway, induce a gamut of damaging immune responses in the hepatic milieu. Because of the close association between deleterious inflammation and ALD-induced microbiota imbalance, therapeutic approaches that seek to reestablish gut homeostasis should be considered in the treatment of alcoholic patients. To this end, a number of preliminary studies on probiotics have confirmed their effectiveness in suppressing proinflammatory cytokines and improving liver function in the context of ALD. In addition, there have been few studies linking the administration of prebiotics and antibiotics with reduction of alcohol-induced liver damage. Because these preliminary results are promising, large-scale randomized studies are warranted to elucidate the impact of these microbiota-based treatments on the gut flora and associated immune responses, in addition to exploring questions about optimal delivery. Finally, fecal microbiota transplant has been shown to be an effective method of modulating gut microbiota and deserve further investigation as a potential therapeutic option for ALD. SN - 2219-2840 UR - https://www.unboundmedicine.com/medline/citation/27547010/full_citation L2 - http://www.wjgnet.com/1007-9327/full/v22/i29/6673.htm DB - PRIME DP - Unbound Medicine ER -