An Update on the Role of the Microbiome in Non-alcoholic Fatty Liver Disease Pathogenesis, Diagnosis, and Treatment
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Liver (J Bajaj, Section Editor)
An Update on the Role of the Microbiome in Non-alcoholic Fatty Liver Disease Pathogenesis, Diagnosis, and Treatment Marialena Mouzaki, MD MSc1,* Rohit Loomba, MD, MHSc2,* Address *,1 Steatohepatitis Center, Cincinnati Children’s Hospital Medical Center, University of Cincinnati, College of Medicine, 3333 Burnet Ave, Cincinnati, OH, 45229, USA Email: [email protected] *,2 NAFLD Research Center, Division of Gastroenterology, Department of Medicine, University of California at San Diego, ACTRI Building, 1W202, 9452 Medical Center Drive, La Jolla, CA, 92037, USA Email: [email protected]
* Springer Science+Business Media, LLC, part of Springer Nature 2020
This article is part of the Topical Collection on Liver Keywords NASH I Dysbiosis I Ethanol I Intestinal barrier I Bacteria Abbreviations BMI Body mass index F Fibrosis FXR Farnesoid X receptor HC Healthy controls IHF Intrahepatic _ _ _ _ fat NAFL Non-alcoholic fatty liver NAFLD Non-alcoholic fatty liver disease NAS NAFLD activity score NASH Non_ _ _ _ alcoholic steatohepatitis RCT Randomized controlled trial SCFA Short-chain fatty acids SWE Shear wave _ _ _ elastography VFA Variable flip angle VOC Volatile organic compounds
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Abstract The microbiome was originally postulated to contribute to the pathogenesis of NAFLD when the first studies of dysbiosis in NAFLD were reported. Since then, a number of studies have investigated this finding further, in order to discern whether the dysbiosis is the result of the metabolic dysregulation seen with NAFLD or a contributor to the pathogenesis of this condition. Purpose of review This review is aimed at highlighting the most important discoveries from the years 2017–2019 that linked the microbiome to the pathogenesis, diagnosis, and treatment of NAFLD. Recent findings Recent data have revealed further the role of bacterially derived ethanol in the pathogenesis of NAFLD, the crosstalk between microbiome and the gut barrier, and the interplay between genetic risk and dysbiosis. Summary The microbiome is involved in the pathogenesis of NAFLD in a subset of patients and can be used as a therapeutic target.
Liver (J Bajaj, Section Editor)
Introduction Non-alcoholic fatty liver disease (NAFLD) is the leading cause of liver disease in the world, currently thought to affect approximately one in four adults and one in ten children [1, 2]. The pathophysiology of NAFLD is multifactorial, with genetic, metabolic, and environmental factors affecting patients to a variable degree [3–5]. Another contributor to the development and progression of NAFLD is the intestinal microbiome. The role of the
microbiome in the pathophysiology of adult and pediatric NAFLD has been previously summarized [6, 7]. The objective of this review is to highlight the most recent discoveries regarding the role of the microbiome in the pathogenesis of, diagnostic approaches for, and treatment of NAFLD. Herein, we discuss studies on these topics that were published from January 1, 2017 to December 31, 2019.
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