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The Role of the Gut-Liver Axis in Metabolic Dysfunction-Associated Fatty Liver Disease

期刊

FRONTIERS IN IMMUNOLOGY
卷 12, 期 -, 页码 -

出版社

FRONTIERS MEDIA SA
DOI: 10.3389/fimmu.2021.660179

关键词

gut abnormalities; steatosis; intestinal immunity; intestinal microbiota; metabolic liver disease

资金

  1. Spanish Ministerio de Ciencia e Innovacio'n [SAF 2017-86343-R]
  2. Spanish Ministerio de Ciencia e Innovacio'n (Instituto de Salud Carlos) [PI20/01302]
  3. Instituto de Salud Carlos III
  4. European Development Regional Fund A way to achieve Europe (EDRF)

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The intricate relationship between gut microbiota, intestinal barrier, immune system, and liver is essential for the pathogenesis of metabolic disorders like fatty liver disease. Diet is a key modulator of microbiota composition, affecting gut barrier stability and immune responses, leading to inflammation and liver dysfunction. Therapeutic strategies targeting the gut-liver-axis are being explored for potential treatments, and distinctive microbial signatures in the gut may provide non-invasive diagnostic tools for disease monitoring and severity assessment.
The complex interplay between the gut microbiota, the intestinal barrier, the immune system and the liver is strongly influenced by environmental and genetic factors that can disrupt the homeostasis leading to disease. Among the modulable factors, diet has been identified as a key regulator of microbiota composition in patients with metabolic syndrome and related diseases, including the metabolic dysfunction-associated fatty liver disease (MAFLD). The altered microbiota disrupts the intestinal barrier at different levels inducing functional and structural changes at the mucus lining, the intercellular junctions on the epithelial layer, or at the recently characterized vascular barrier. Barrier disruption leads to an increased gut permeability to bacteria and derived products which challenge the immune system and promote inflammation. All these alterations contribute to the pathogenesis of MAFLD, and thus, therapeutic approaches targeting the gut-liver-axis are increasingly being explored. In addition, the specific changes induced in the intestinal flora may allow to characterize distinctive microbial signatures for non-invasive diagnosis, severity stratification and disease monitoring.

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