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The gut-liver axis and gut microbiota in health and liver disease

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Article Food Science & Technology

Inulin intervention attenuates hepatic steatosis in rats via modulating gut microbiota and maintaining intestinal barrier function

Zhandong Yang et al.

Summary: Evidence suggests that the prebiotic inulin can mitigate nonalcoholic fatty liver disease (NAFLD), but its mechanisms of action are not well understood. This study found that inulin consumption improved hepatic steatosis and inflammation, restored liver lipogenesis regulators, and enhanced intestinal barrier integrity and function. Inulin also regulated the gut microbiota composition, increasing the abundance of beneficial bacteria and reducing opportunistic pathogens. Furthermore, inulin intervention affected tryptophan metabolism and altered fecal metabolite levels in NAFLD rats. These findings suggest that inulin intake may be a novel approach for the prevention and treatment of NAFLD.

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Any alcohol use in NAFLD patients is associated with significant changes to the intestinal virome

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Summary: This study compares the intestinal viromes of patients with alcohol use disorder (AUD) and metabolic dysfunction-associated fatty liver disease (MAFLD), in order to evaluate the effects of alcohol consumption on the intestinal viromes of NAFLD patients. The results show significant differences in the intestinal viromes between NAFLD and AUD patients, and that alcohol use in NAFLD patients reclassified to MAFLD accounts for these differences.

HEPATOLOGY (2023)

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Fructooligosaccharides attenuate non-alcoholic fatty liver disease by remodeling gut microbiota and association with lipid metabolism

Xiaoqing Huang et al.

Summary: This study investigated the therapeutic effects of fructooligosaccharides (FOSs) on a mouse model of nonalcoholic fatty liver disease (NAFLD). The results showed that FOSs can attenuate metabolic and hepatic lipid changes caused by NAFLD, reshape the gut microbiota, and down-regulate the expression levels of genes associated with lipid metabolism and inflammation.

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Article Gastroenterology & Hepatology

Differences in Bacterial Translocation and Liver Injury in Ethanol Versus Diet-Induced Liver Disease

Cynthia L. Hsu et al.

Summary: Alcohol-associated liver disease (ALD) and non-alcoholic fatty liver disease (NAFLD)/non-alcoholic steatohepatitis (NASH) are two common causes of chronic liver disease worldwide. Changes in intestinal permeability and gut microbial translocation play important roles in the inflammation of both ALD and NAFLD. However, differences in gut microbial translocation between the two etiologies have not been compared, which can provide better understanding of their pathogenesis.

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Summary: The study found that the fecal fungal composition of patients with non-alcoholic fatty liver disease (NAFLD) is associated with disease severity. Non-obese NAFLD patients have a distinct fungal ratio in their feces compared to other types of patients. Antifungal treatment in a mouse model can reduce liver damage from steatohepatitis.

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Role of bile acids and their receptors in gastrointestinal and hepatic pathophysiology

Claudia D. Fuchs et al.

Summary: Bile acids play a crucial role in regulating metabolism and homeostasis, and their disrupted balance can contribute to gastrointestinal and liver diseases. Targeting bile acid pathways may provide novel treatment strategies for these disorders.

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SER-109, an Oral Microbiome Therapy for Recurrent Clostridioides difficile Infection

Paul Feuerstadt et al.

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Jonathan P. Richardson et al.

Summary: The study identifies the first family of peptide toxins, called candidalysins, in human-pathogenic fungi. These toxins are secreted by Candida albicans, Candida dubliniensis, and Candida tropicalis, and are responsible for causing cell damage, calcium influx, and activation of signaling pathways and cytokine secretion. Candidalysins from C. dubliniensis and C. tropicalis exhibit higher damaging and activation potential than C. albicans candidalysin, with faster membrane binding and disruption.
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Gut microbial trimethylamine is elevated in alcohol-associated hepatitis and contributes to ethanol-induced liver injury in mice

Robert N. Helsley et al.

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Microbiota engraftment after faecal microbiota transplantation in obese subjects with type 2 diabetes: a 24-week, double-blind, randomised controlled trial

Siew C. Ng et al.

Summary: Repeated FMTs enhance microbiota engraftment in obese patients with T2DM, leading to more favorable changes in recipients' microbiota and improvement in lipid profile and liver stiffness when combined with lifestyle intervention.
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Cyriac A. Philips et al.

Summary: This study found that healthy donor fecal microbiota transplantation (FMT) is associated with significantly lower incidence of ascites, infections, encephalopathy, and alcohol relapse, as well as higher survival rates, in patients with severe alcohol-associated hepatitis (SAH) compared to standard of care (SoC). Furthermore, FMT was shown to have beneficial modulation of gut microbiota (GM).

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Article Microbiology

Host hepatic metabolism is modulated by gut microbiota-derived sphingolipids

Henry H. Le et al.

Summary: Microbially-derived gut metabolites play an important role in host phenotypes. This study traces bacterial sphingolipids from gut symbiont Bacteroides thetaiotaomicron to mouse colons and livers, and finds that bacterial sphingolipid synthesis can rescue excess lipid accumulation in a mouse model of hepatic steatosis. The transfer of this sphingolipid to the liver potentially contributes to microbiota-mediated liver function.

CELL HOST & MICROBE (2022)

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Fecal microbiota transplantation in alcohol-associated acute-on-chronic liver failure: an open-label clinical trial

Anima Sharma et al.

Summary: Fecal microbiota transplantation (FMT) is safe and improves short-term and medium-term survival, as well as clinical severity scores, in patients with severe alcoholic hepatitis presenting as acute-on-chronic liver failure.

HEPATOLOGY INTERNATIONAL (2022)

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The effect of increasing intestinal short-chain fatty acid concentration on gut permeability and liver injury in the context of liver disease: A systematic review

Keith Pohl et al.

Summary: Supplementation of short chain fatty acids (SCFAs) has shown potential as a therapy for liver disease by improving gut barrier function. Studies have demonstrated that SCFA supplementation can reduce liver injury and intestinal permeability, leading to improved liver disease models. However, the outcome measures used in the existing research may not be practical for human studies.

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY (2022)

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Interactions between Tryptophan Metabolism, the Gut Microbiome and the Immune System as Potential Drivers of Non-Alcoholic Fatty Liver Disease (NAFLD) and Metabolic Diseases

Charlotte Teunis et al.

Summary: The prevalence of non-alcoholic fatty liver disease (NAFLD) and its burden of disease are increasing. NAFLD is associated with cirrhosis and other metabolic conditions such as diabetes, obesity, and atherosclerosis. These cardiometabolic diseases are linked by a state of low-grade inflammation, characterized by elevated levels of cytokines and C-reactive protein. The metabolism of tryptophan, specifically its three main pathways, may be a therapeutic target for reducing the inflammation associated with NAFLD and its related conditions.

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Effect of a specific Escherichia coli Nissle 1917 strain on minimal/mild hepatic encephalopathy treatment

Elina Manzhalii et al.

Summary: The study found that patients treated with rifaximin or EcN showed a more significant reduction in serum ammonia and normalization of Bifidobacteria and Lactobacilli abundance compared to the lactulose group. Moreover, EcN-treated patients performed 15% faster on the Stroop test than the lactulose group patients.

WORLD JOURNAL OF HEPATOLOGY (2022)

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Postbiotics Prepared Using Lactobacillus paracasei CCFM1224 Prevent Nonalcoholic Fatty Liver Disease by Modulating the Gut Microbiota and Liver Metabolism

Zhenghao Pan et al.

Summary: Postbiotics may protect against non-alcoholic fatty liver disease (NAFLD) by modulating the gut microbiota and liver metabolism, improving weight, lipid metabolism, and inflammation. These findings are significant for the development of functional foods related to NAFLD.

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Intestinal transgene delivery with native E. coli chassis allows persistent physiological changes

Baylee J. Russell et al.

Summary: This study demonstrates the potential of using native bacteria as chassis for transgene delivery to manipulate the gut microbiome and reverse pathology in conventionally raised hosts.
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Within-host evolution of a gut pathobiont facilitates liver translocation

Yi Yang et al.

Summary: This study reveals that within-host evolution of gut commensal bacteria plays a critical role in bacterial translocation and initiation of inflammation. Gut microbiota strains can adapt and evolve, affecting their propensity to elicit inflammatory diseases. The changes in bacterial behavior are associated with genetic mutations, altered microbial gene expression programs, and remodelled cell wall structures.

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GUT PHYSIOLOGY The microbiome and gut homeostasis

Jee-Yon Lee et al.

Summary: Changes in gut microbiota composition are linked to various human diseases. However, defining homeostasis or dysbiosis based on the presence or absence of specific microbial species has been unsuccessful. The adult gut microbiota is regulated by diet and host factors, with oxygen and nitrate availability shaping the bacterial community in different parts of the gut. Poor diet weakens host control mechanisms, potentially leading to dysbiosis. Therefore, quantifying host parameters that control microbial growth could offer alternative approaches to define and remediate dysbiosis.

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Effect of Fecal Microbiota Transplantation on Non-Alcoholic Fatty Liver Disease: A Randomized Clinical Trial

Lanfeng Xue et al.

Summary: Fecal microbiota transplantation (FMT) can attenuate fat accumulation in patients with non-alcoholic fatty liver disease (NAFLD) by improving gut microbiota dysbiosis. Significant differences in clinical features and gut microbiota were observed between lean and obese NAFLD patients, with FMT showing better effects in lean NAFLD patients.

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Microbiome-derived ethanol in nonalcoholic fatty liver disease

Abraham S. Meijnikman et al.

Summary: This study found that microbial ethanol might contribute to pathogenesis in some patients with nonalcoholic fatty liver disease. The research suggests that microbial ethanol could be considered in the pathogenesis of this highly prevalent liver disease.

NATURE MEDICINE (2022)

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Variability of strain engraftment and predictability of microbiome composition after fecal microbiota transplantation across different diseases

Gianluca Ianiro et al.

Summary: Our study on the dynamics of microbiome engraftment after FMT and its association with clinical variables uncovered species-specific patterns and presented machine learning models able to predict donors and optimize microbial engraftment.

NATURE MEDICINE (2022)

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Elda Hasa et al.

Summary: Cirrhosis is a common cause of death worldwide, and it is an end-stage liver disease caused by various factors. The progression of cirrhosis involves the continuation of alcohol or toxin exposure, dysbiosis of gut microbiota, increased gut permeability, and disrupted immune response.

INTERNATIONAL IMMUNOLOGY (2022)

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Intestinal virome in patients with alcohol use disorder and after abstinence

Cynthia L. Hsu et al.

Summary: Alcohol use contributes to the progression of liver disease through changes in the intestinal virome. Patients with alcohol use disorder (AUD) have a different virome composition compared to controls, and the virome signature is also different between patients with progressive and nonprogressive liver disease. The interactions between bacteriophages and their target bacteria play a role in the progression of alcohol-associated liver disease.

HEPATOLOGY COMMUNICATIONS (2022)

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Efficacy and Safety of Aldafermin, an Engineered FGF19 Analog, in a Randomized, Double-Blind, Placebo-Controlled Trial of Patients With Nonalcoholic Steatohepatitis

Stephen A. Harrison et al.

Summary: In a phase 2 trial of patients with NASH, aldafermin reduced liver fat content significantly and showed potential improvement in fibrosis.

GASTROENTEROLOGY (2021)

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A Randomized Clinical Trial of Fecal Microbiota Transplant for Alcohol Use Disorder

Jasmohan S. Bajaj et al.

Summary: This study suggests that FMT may be a safe and effective treatment for patients with alcohol-related cirrhosis, reducing alcohol craving and consumption while improving cognition and quality of life.

HEPATOLOGY (2021)

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Microbiota tryptophan metabolism induces aryl hydrocarbon receptor activation and improves alcohol-induced liver injury

Laura Wrzosek et al.

Summary: This study demonstrates that targeting the intestinal microbiota can improve alcoholic liver disease, with a key role played by the aryl hydrocarbon receptor (AhR) pathway.
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Jasmohan S. Bajaj et al.

Summary: Altered bacterial composition in the gut is associated with disease progression in cirrhosis, while the role of phages, especially in virome, is less significant. Rifaximin therapy resulted in changes in certain types of bacteria and phages related to disease progression and hospitalizations in patients with cirrhosis.
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Yong Fan et al.

Summary: The intestinal microbiota plays a significant role in human metabolic health, potentially contributing to the development of common metabolic disorders when dysregulated. Current research is shifting towards cause-and-effect studies and utilizing high-throughput human multi-omics data to identify potential molecular mechanisms behind these associations.

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Zhiyun Zhu et al.

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CELLULAR AND MOLECULAR BIOLOGY (2021)

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Commensal-driven immune zonation of the liver promotes host defence

Anita Gola et al.

Summary: The study reveals that immune cells in the liver also exhibit zonation, which is regulated by microbiome sensing by liver sinusoidal endothelial cells and plays a crucial role in host defense. Immune cells concentrate asymmetrically around periportal regions in the liver, and this spatial polarization is more efficient in protecting against systemic bacterial dissemination compared to a uniform distribution. Liver sinusoidal endothelial cells actively sense the microbiome and orchestrate the localization of immune cells to optimize host defense.

NATURE (2021)

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Pui Lin Chong et al.

Summary: The study found that VSL#3 (R) probiotics did not significantly improve cardiovascular risk and liver injury biomarkers in patients with NAFLD. However, the study supported an association between endothelial dysfunction and inflammation in patients with NAFLD and suggested a link between NAFLD and insulin resistance.

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Elizabeth E. Powell et al.

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Seppo Salminen et al.

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Cynthia L. Hsu et al.

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Jonel Trebicka et al.

Summary: Cirrhosis, the end-stage of chronic liver disease, is closely associated with intestinal bacterial overgrowth and dysbiosis. These factors contribute to hepatocyte death, infections, systemic inflammation, and organ failure. Targeting the microbiota with strategies such as antibiotics, fecal microbial transplantation, and enterosorbents may prevent acute decompensation and improve outcomes for patients with ACLF.

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