Targeting the Gut Microbiome to Treat Metabolic Dysfunction-Associated Fatty Liver Disease: Ready for Prime Time?
Nicolas LanthierNathalie M DelzennePublished in: Cells (2022)
Numerous studies show a modification of the gut microbiota in patients with obesity or diabetes. Animal studies have also shown a causal role of gut microbiota in liver metabolic disorders including steatosis whereas the human situation is less clear. Patients with metabolic dysfunction associated fatty liver disease (MAFLD) also have a modification in their gut microbiota composition but the changes are not fully characterized. The absence of consensus on a precise signature is probably due to disease heterogeneity, possible concomitant medications and different selection or evaluation criteria. The most consistent changes were increased relative abundance of Proteobacteria, Enterobacteriaceae and Escherichia species and decreased abundance of Coprococcus and Eubacterium . Possible mechanisms linking the microbiota and MAFLD are increased intestinal permeability with translocation of microbial products into the portal circulation, but also changes in the bile acids and production of microbial metabolites such as ethanol, short chain fatty acids and amino acid derivatives able to modulate liver metabolism and inflammation. Several interventional studies exist that attempt to modulate liver disease by administering antibiotics, probiotics, prebiotics, synbiotics, postbiotics or fecal transplantation. In conclusion, there are both gaps and hopes concerning the interest of gut microbiome evaluation for diagnosis purposes of MAFLD and for new therapeutic developments that are often tested on small size cohorts.
Keyphrases
- fatty acid
- oxidative stress
- type diabetes
- case control
- insulin resistance
- endothelial cells
- microbial community
- amino acid
- cardiovascular disease
- antibiotic resistance genes
- metabolic syndrome
- pseudomonas aeruginosa
- high fat diet induced
- multidrug resistant
- weight loss
- single cell
- high fat diet
- ms ms
- cancer therapy
- physical activity
- escherichia coli
- induced pluripotent stem cells
- wastewater treatment
- clinical practice
- drug delivery
- cell therapy
- pluripotent stem cells