The gut-liver axis is a bidirectional connection through the biliary tract, portal vein, and systemic circulation. This unique interaction between the liver and the gastrointestinal tract allows the transport of nutrients from the intestines directly to the liver, whereas the liver provides feedback via bile secretion into the digestive tract. NAFLD is associated with changes in the composition and function of the gut microbiota, known dysbiosis.
GUT MICROBIOTA TARGETTING: NAFLD THERAPY STRATEGY
The most recommended therapy for NAFLD patients is still limited to lifestyle changes that include exercise, diet, and weight loss to prevent worsening risk factors such as obesity and diabetes.
Pharmacological therapy to improve insulin resistance, reduce oxidative stress and inflammation, or slow the mechanism of fibrosis has been widely used in NAFLD patients but has not been fully demonstrated.
Altering the gut microbiota is widely cited as having a potential role in treating NAFLD. Several approaches to changing the gut microbiota have been investigated in NAFLD patients, including antibiotics, probiotics, prebiotics, synbiotics, and fecal transplantation.
CONCLUSION
Pathogenicity is a complex mechanism involving many factors. Recent evidence reveals that the gut microbiota is one of the main factors in the pathogenesis and progression of NAFLD through several mechanisms, particularly dysbiosis. This significant role makes the gut microbiota a noninvasive biomarker for NAFLD examination and a more effective therapeutic target. However, further research is needed to evaluate the effectiveness of the gut microbiota as a biomarker or therapy.
Key words: Fatty Liver, NAFLD, Steatorrhea, Microbiome, Microbiota, Probiotic, Prebiotic, FMT, Synbiotic
Ref:
Maimunah U, Soelistijo SA, Hadisuwarno W, Miftahussurur M. Gut Microbiota and Non-Alcoholic Fatty Liver Disease: Current Pathogenic Paradigm and Therapeutic Aspect. The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy. 2023 Nov 24; 24(2):154-62.
Ebrahimzadeh Leylabadlo H, Ghotaslou R, Samadi Kafil H, Feizabadi MM, Moaddab SY, Farajnia S, et al. Nonalcoholic fatty liver diseases: from role of gut microbiota to microbial-based therapies. Eur J Clin Microbiol Infect Dis. 2020;39:613–۲۷
Provided by: Dr. Nazila Kassaian
