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Gut–Liver Axis in Alcoholic Liver Disease
Open accessAbstract
Alcoholic liver disease (ALD) has been among the leading causes of cirrhosis and liver-related death worldwide for decades. Early discoveries in alcoholic liver disease identified increased levels of bacterial endotoxin in the portal circulation, suggesting a role for gut-derived toxins in ALD. Indeed, alcohol consumption can disrupt the intestinal epithelial barrier and result in increased gut permeability that increasingly is recognized as a major factor in ALD. Bacterial endotoxin, lipopolysaccharide, is a prototypic microbe-derived inflammatory signal that contributes to inflammation in ALD through activation of the Toll-like receptor 4. Recent studies also have shown that alcohol consumption is associated with alterations in the gut microbiome, and the dysbalance of pathogenic and commensal organisms in the intestinal microbiome may contribute to the abnormal gut-liver axis in ALD. Indeed, bacterial decontamination improves ALD both in human and animal models. This short review summarizes recent findings and highlights emerging trends in the gut-liver axis relevant to ALD.
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“the gut-liver axis has been shown to play an important role in the development of ALD.5,6”
From Opposite regulation of intestinal and intrahepatic CD8 + T cells controls alcohol-associated liver disease progression (2025) · cites this paper as [6]
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“A number of functional studies have shown a key contribution of the gut-microbiota–TLR4 axis to ALD45:”
From The gut microbiome and liver cancer: mechanisms and clinical translation (2017) · cites this paper as [45]
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Metadata
- Authors
- Szabo, G.
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2015-01
- Volume
- 148
- Issue
- 1
- Pages
- 30-36
- ISSN
- 0016-5085 (ISSN-L)
- PMC
- PMC4274189
- OpenAlex
- W2034801500
- Cited by
- 754
- References
- 81
- Citations by year
- 2026: 64 · 2025: 67 · 2024: 72 · 2023: 67 · 2022: 89 · 2021: 77 · 2020: 63 · 2019: 59 · 2018: 67 · 2017: 49 · 2016: 51 · 2015: 28
- FWCI
- 6.05
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Gastroenterology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- The Journal of the American Medical Association (JAMA) Network (American Medical Association) (submittedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (AA021907, AA017729, AA010744)
- Topics
- Health Sciences › Medicine › Pathology and Forensic Medicine › Alcohol Consumption and Health Effects
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Keywords
- alcoholic liver disease, gut-liver axis, bacterial endotoxin, lipopolysaccharide, intestinal permeability, intestinal epithelial barrier, TLR4, gut microbiota, bacterial decontamination, liver cirrhosis, inflammation
- MeSH terms
- Animals, Bacteria, Humans, Intestinal Mucosa, Intestines, Liver, Liver Diseases, Alcoholic, Permeability, Prognosis, Signal Transduction, Microbiota
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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