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The gut-liver axis
Abstract
PURPOSE OF REVIEW: The liver adaptively responds to extra-intestinal and intestinal inflammation. In recent years, the role of the autonomic nervous system, intestinal failure and gut microbiota has been investigated in the development of hepatic, intestinal and extra-intestinal disease. RECENT FINDINGS: The autonomic nervous system can be stimulated via enteral fat leading to cholecystokinin release, stimulating receptors in the gut and in the brain. This promotes bowel integrity, dampening the inflammatory response to food antigens. Consensus exists that intravenously administered long-chain fatty acids can cause liver damage but randomized-controlled trials are lacking. Disruption of the enterohepatic circulation of bile salts can give rise to cholestasis and nonalcoholic fatty liver disease, which may progress to fibrosis and cirrhosis. Reduced intestinal availability of bile salts reduces stimulation of the farnesoid X receptor. This may induce hepatic bile salt overload and associated hepatotoxicity through reduced action of intestinal fibroblast growth factor 19. Evidence is put forward to suggest that the intestinal microbiota is associated with liver abnormalities. SUMMARY: Enteral lipids reduce inflammation and liver damage during stress or systemic inflammation, whereas parenteral lipid is associated with liver damage. Maintaining the enterohepatic circulation of bile salts limits hepatic cholestasis through an farnesoid X receptor feedback pathway. Changes in gut microbiota composition may induce liver disease.
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“Different types of chronic comorbidities have a final common pathway of metabolic syndrome, including fatty liver, insulin resistance, dyslipidemia, and atherosclerosis.117”
From Hypoalbuminemia: Pathogenesis and Clinical Significance (2019) · cites this paper as [117]
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Metadata
- Authors
- Visschers, R. G. J., Luyer, M. D., Schaap, F. G., Olde Damink, S. W. M., & Soeters, P. B.
- Affiliations
- Zuyderland Medisch Centrum (NL)
- Catharina Ziekenhuis (NL)
- Maastricht University Medical Centre (NL)
- Corresponding author
- Soeters, Peter B.
- Venue
- Current Opinion in Clinical Nutrition and Metabolic Care
- Published
- 2013-09
- Volume
- 16
- Issue
- 5
- Pages
- 576-581
- ISSN
- 1363-1950 (ISSN-L)
- OpenAlex
- W1987829690
- Cited by
- 60
- References
- 268
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 1 · 2023: 7 · 2022: 5 · 2021: 3 · 2020: 7 · 2019: 2 · 2018: 8 · 2017: 5 · 2016: 6 · 2015: 8 · 2014: 6
- FWCI
- 0.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Current Opinion in Clinical Nutrition & Metabolic Care (publishedVersion)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Pure Amsterdam UMC (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion)
- Topics
- Health Sciences › Nursing › Nutrition and Dietetics › Clinical Nutrition and Gastroenterology
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Gut microbiota and health
- Health Sciences › Medicine › Hepatology › Liver Disease and Transplantation
- Keywords
- gut-liver axis, intestinal inflammation, autonomic nervous system, cholecystokinin, long-chain fatty acids, enterohepatic circulation, bile salts, cholestasis, non-alcoholic fatty liver disease, liver fibrosis, farnesoid X receptor, FGF19, gut microbiota, intestinal failure, hepatotoxicity
- MeSH terms
- Bile Acids and Salts, Cholecystokinin, Cholestasis, Chronic Disease, Fatty Acids, Fatty Liver, Humans, Intestinal Diseases, Liver, Fatty Acids, Omega-3, Metabolic Syndrome, Gastrointestinal Tract, Administration, Intravenous, Microbiota, Non-alcoholic Fatty Liver Disease
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