There is rising trend in the prevalence of chronic liver disease and its mortality rate is increasing exponentially. The liver is intimately associated with the gut through the portal vein, and exposure to gut microbiota and their metabolites translocating across the gut lumen may affect both the healthy and diseased liver. Thus, regulation of gut microbiota can act as a promising therapeutic target.

The current study was conducted to characterise the changes in the gut microbiome occurring in chronic liver disease and to determine the effect of manipulation of the microbiome on the liver.

The outcome showed that decreased bacterial diversity, alcohol sensitivity and the development of gut dysbiosis were reported in several chronic liver diseases, such as non-alcoholic fatty liver disease, alcohol-related liver disease and primary sclerosing cholangitis. Moreover, disturbances in gut commensals could cause deficient priming of the immune system stimulating the development of immune-mediated diseases. The study also showed that transfer of stool from an experimental model with the metabolic syndrome might induce steatosis in healthy subjects. Patients with cirrhosis developed dysbiosis, small bowel bacterial overgrowth and increased gut wall permeability, permitting bacterial translocation and uptake of endotoxin inducing hepatic and systemic inflammation.

Thus, the study concluded that use of alternative therapies targeting modification of the gut microbiota with the help of diet, probiotics or faecal microbiota transplantation could enhance the growth of healthy bacteria, which in turn, may improve the dysbiosis and prognosis of chronic liver diseases.

Source: Woodhouse CA, Patel VC, Singanayagam A, Shawcross DL. Review article: the gut microbiome as a therapeutic target in the pathogenesis and treatment of chronic liver disease. Aliment Pharmacol Ther. 2018 Jan;47(2):192-202.