Targeting the Gut–Liver Axis in Cirrhosis: Antibiotics and Non-Selective β-Blockers
Abstract
The gut-liver axis in cirrhosis and portal hypertension is gaining increasing attention as a key pathophysiological mechanism responsible for progression of liver failure and development of complications such as spontaneous infections and hepatocellular carcinoma. Antibiotics and non-selective β-blockers (NSBB) intercept this axis and each drug has proven efficacy in clinical trials. A synergistic effect is a hitherto unproven possibility. There is an increasing body of evidence supporting improved outcome with expanded use of NSBB and antibiotic therapy beyond current indications. This review addresses the issue of pharmacological treatment of cirrhosis and portal hypertension with antibiotics and NSBB. We discuss their mechanism of action and suggest that combining the two treatment modalities could potentially reduce the risk of complications.
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Nonselective β-adrenergic blockers decrease intestinal transit time and reduce intestinal bacterial overgrowth, intestinal permeability and bacterial translocation in experimental cirrhosis and patients.
“Accordingly, nonselective β-adrenergic blockers decrease intestinal transit time and reduce intestinal bacterial overgrowth, intestinal permeability and bacterial translocation in experimental models of cirrhosis as well as in patients153–157.”
From The gut microbiome and liver cancer: mechanisms and clinical translation (2017) · cites this paper as [154]
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- Authors
- Madsen, B. S., Havelund, T., & Krag, A.
- Affiliations
- Odense University Hospital (DK)
- Corresponding author
- Madsen, Bjørn S.
- Venue
- Advances in Therapy
- Published
- 2013-07
- Volume
- 30
- Issue
- 7
- Pages
- 659-670
- ISSN
- 0741-238X (ISSN-L)
- 1865-8652
- OpenAlex
- W2057245243
- Cited by
- 38
- References
- 102
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 5 · 2023: 4 · 2022: 2 · 2021: 1 · 2020: 1 · 2019: 4 · 2018: 8 · 2017: 5 · 2016: 1 · 2015: 2 · 2014: 1
- FWCI
- 0.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Advances in Therapy (publishedVersion)
- PubMed (publishedVersion)
- University of Southern Denmark Research Portal (University of Southern Denmark) (submittedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Health Sciences › Medicine › Surgery › Abdominal vascular conditions and treatments
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Keywords
- gut-liver axis, liver cirrhosis, portal hypertension, antibiotics, non-selective beta-blockers, spontaneous bacterial peritonitis, hepatocellular carcinoma, liver failure, drug synergy, cirrhosis complications
- MeSH terms
- Adrenergic beta-Antagonists, Anti-Bacterial Agents, Hepatic Encephalopathy, Carcinoma, Hepatocellular, Hepatorenal Syndrome, Humans, Hypertension, Portal, Liver Cirrhosis, Liver Neoplasms, Peritonitis, Bacterial Translocation, Microbiota
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