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REVIEW article

Front. Gastroenterol.
Sec. Hepatology
Volume 3 - 2024 | doi: 10.3389/fgstr.2024.1534431

Gut Microbiome in Non-alcoholic Fatty Liver Disease (NAFLD)

Provisionally accepted
Anastasios Mpountouridis Anastasios Mpountouridis 1*Christina Tsigalou Christina Tsigalou 2Ioanna Bezirtzoglou Ioanna Bezirtzoglou 3Eugenia Bezirtzoglou Eugenia Bezirtzoglou 2Elisavet Stavropoulou Elisavet Stavropoulou 2
  • 1 Theageneio General Hospital, Thessaloniki, Greece
  • 2 Laboratory of Hygiene and Environmental Protection, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
  • 3 School of Chemistry, University of Edinburgh, Scotland, United Kingdom

The final, formatted version of the article will be published soon.

    Non-alcoholic fatty liver disease (NAFLD) has a rapidly growing incidence worldwide, affecting approximately one-third of world population. The disturbance of gut commensal bacteria impacting host's homeostasis is referred to as gut dysbiosis. The gut microbiome contributes to the pathogenesis of NAFLD through various pathways. Gut microbiota is at constant interactions with the intestinal epithelial barrier and affects its integrity. Through gutliver axis, gut microbiota may influence liver immune function. The release of lipopolysaccharides (LPS) from intestines to portal vein which are transported to the liver, may trigger hepatic inflammation, steatosis and even fibrosis. Moreover, the gut microbiome induces the conversion of primary bile acids (BAs) to secondary BAs, which activates intestinal receptors, such as FXR and TGR5. FXR activation decreases fat absorption and thus reduces hepatic lipid accumulation, while TGR5 activation promotes the release of glucagon-like peptide-1 (GLP-1) in blood. Furthermore, gut ethanol-producing bacteria has been implicated in NAFLD development. Additionally, in NAFLD there is a reduction in intestinal levels of short-chain fatty acids, such as butyrate, propionate and acetate. Many bacterial alterations have been observed in NAFLD, including the increased Bacteroidetes and decreased Firmicutes.Many probiotics have been tried in NAFLD prevention and management, including a plethora of strains from Lactobacilli, Bifidobacteria and Streptococcus and some of them have promising perspectives. There is also some promising data from the administration of prebiotics (such as inulin and fructo-oligosaccharides) and symbiotics (probiotics plus prebiotics). Faecal microbiota transplantation (FMT) is yet to be evaluated for its efficacy against NAFLD.

    Keywords: Non-alcoholic fatty liver disease (NAFLD), Non-alcoholic steatohepatitis (NASH), gut microbiome, Gut Microbiota, gut dysbiosis

    Received: 25 Nov 2024; Accepted: 26 Dec 2024.

    Copyright: © 2024 Mpountouridis, Tsigalou, Bezirtzoglou, Bezirtzoglou and Stavropoulou. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Anastasios Mpountouridis, Theageneio General Hospital, Thessaloniki, Greece

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.