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Intestinal microbiome and NAFLD: molecular insights and therapeutic perspectives

Authors
  • Hu, Haiming1
  • Lin, Aizhen2
  • Kong, Mingwang1
  • Yao, Xiaowei1
  • Yin, Mingzhu1
  • Xia, Hui1
  • Ma, Jun1
  • Liu, Hongtao1
  • 1 Hubei University of Chinese Medicine,
  • 2 Hubei Provincial Hospital of Traditional Chinese Medicine,
Type
Published Article
Journal
Journal of Gastroenterology
Publisher
Springer Singapore
Publication Date
Dec 16, 2019
Volume
55
Issue
2
Pages
142–158
Identifiers
DOI: 10.1007/s00535-019-01649-8
PMID: 31845054
PMCID: PMC6981320
Source
PubMed Central
Keywords
License
Unknown

Abstract

Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of dysregulated lipid and glucose metabolism, which is often associated with obesity, dyslipidemia and insulin resistance. In view of the high morbidity and health risks of NAFLD, the lack of effective cure has drawn great attention. In recent years, a line of evidence has suggested a close linkage between the intestine and liver diseases such as NAFLD. We summarized the composition and characteristics of intestinal microbes and reviewed molecular insights into the intestinal microbiome in development and progression of NAFLD. Intestinal microbes mainly include bacteria, archaea, viruses and fungi, and the crosstalk between non-bacterial intestinal microbes and human liver diseases should be paid more attention. Intestinal microbiota imbalance may not only increase the intestinal permeability to gut microbes but also lead to liver exposure to harmful substances that promote hepatic lipogenesis and fibrosis. Furthermore, we focused on reviewing the latest “gut–liver axis”-targeting treatment, including the application of antibiotics, probiotics, prebiotics, synbiotics, farnesoid X receptor agonists, bile acid sequestrants, gut-derived hormones, adsorbents and fecal microbiota transplantation for NAFLD. In this review, we also discussed the potential mechanisms of “gut–liver axis” manipulation and efficacy of these therapeutic strategies for NAFLD treatment.

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