Cited by 974Gut microbiota and healthLiver Disease Diagnosis and TreatmentAlcohol Consumption and Health Effects

Interactions Between the Intestinal Microbiome and Liver Diseases

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Schnabl, Bernd, Brenner, David A.·2014·Gastroenterology

Abstract

The human intestine harbors a diverse community of microbes that promote metabolism and digestion in their symbiotic relationship with the host. Disturbance of its homeostasis can result in disease. We review factors that disrupt intestinal homeostasis and contribute to nonalcoholic fatty liver disease, steatohepatitis, alcoholic liver disease, and cirrhosis. Liver disease has long been associated with qualitative and quantitative (overgrowth) dysbiotic changes in the intestinal microbiota. Extrinsic factors, such as the Western diet and alcohol, contribute to these changes. Dysbiosis results in intestinal inflammation, a breakdown of the intestinal barrier, and translocation of microbial products in animal models. However, the contribution of the intestinal microbiome to liver disease goes beyond simple translocation of bacterial products that promote hepatic injury and inflammation. Microbial metabolites produced in a dysbiotic intestinal environment and host factors are equally important in the pathogenesis of liver disease. We review how the combination of liver insult and disruptions in intestinal homeostasis contribute to liver disease.

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Crossref · 10.1053/j.gastro.2014.01.020

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  • Changes to the composition and function of the microbiome in NASH include altered bile acid metabolism and loss of integrity of the gut-vascular barrier, precipitating leakage of LPS and bacteria into the liver via the portal circulation.

    “the impact of changes to the composition and function of the microbiome in NASH include altered bile acid metabolism and loss of integrity of the gut-vascular barrier, precipitating leakage of LPS and bacteria into the liver via the portal circulation (14–16).”

    From Hepatic Stellate Cell-Immune Interactions in NASH (2022) · cites this paper as [14]

  • Changes in gut microbiota (dysbiosis) may play a key role in the pathogenesis of NAFLD/NASH and cholestasis and may impact on BA composition and signalling.

    “Changes in gut microbiota (dysbiosis) may play a key role in the pathogenesis of NAFLD/NASH and cholestasis52–54 and may also impact on BA composition and signalling.51 55”
  • In chronic liver disease, a failing gut barrier and altered gut microbiota drive chronic inflammation and liver disease progression, which raises the risk of hepatocellular carcinoma.

    “However, a failing gut barrier and alterations of the gut microbiota in chronic liver disease (CLD) contribute to chronic inflammation and the progression of liver diseases12, and thereby increase risk for the development of hepatocellular carcinoma (HCC) as the final stage of the disease process 13–15.”
  • Metagenomic studies have revealed substantial alterations in gut microbiota composition across a range of chronic liver diseases and in patients with cirrhosis.

    “Metagenomic studies have revealed substantial alterations in the composition of the gut microbiota in a range of CLD as well as in patients with cirrhosis12,32.”

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Authors
Schnabl, B., & Brenner, D. A.
Affiliations
University of California San Diego (US)
Corresponding author
Schnabl, Bernd
Venue
Gastroenterology
Publisher
Elsevier BV
Published
2014-05
Volume
146
Issue
6
Pages
1513-1524
ISSN
0016-5085 (ISSN-L)
OpenAlex
W1975691929
Cited by
971
References
86
Citations by year
2026: 37 · 2025: 56 · 2024: 88 · 2023: 101 · 2022: 88 · 2021: 92 · 2020: 102 · 2019: 88 · 2018: 89 · 2017: 58 · 2016: 64 · 2015: 77 · 2014: 31
FWCI
7.23
Type
journal article
Language
en
Open access
Locations
  • Gastroenterology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
National Institutes of Health (U01 AA021856, R01 AA020703, 2 P42 ES010337, K08 DK081830)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
  • Health Sciences › Medicine › Epidemiology › Liver Disease Diagnosis and Treatment
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
Keywords
gut microbiota, gut-liver axis, non-alcoholic fatty liver disease, steatohepatitis, alcoholic liver disease, liver cirrhosis, dysbiosis, intestinal homeostasis, intestinal barrier dysfunction, intestinal inflammation, microbial translocation, microbial metabolites, Western diet, alcohol
MeSH terms
Animals, Bacteria, Bile Acids and Salts, Fatty Liver, Humans, Intestines, Liver Cirrhosis, Liver Diseases, Liver Diseases, Alcoholic, Risk Factors, Host-Pathogen Interactions, Microbiota, Dysbiosis, Non-alcoholic Fatty Liver Disease

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