Gut–Liver Axis in Nonalcoholic Fatty Liver Disease: the Impact of the Metagenome, End Products, and the Epithelial and Vascular Barriers

Antonio Gil-Gómez; Paola Brescia; Maria Rescigno; Manuel Romero-Gómez

doi:10.1055/s-0041-1723752

Seminars in Liver Disease, Table of Contents

Semin Liver Dis 2021; 41(02): 191-205
DOI: 10.1055/s-0041-1723752

Review Article

Gut–Liver Axis in Nonalcoholic Fatty Liver Disease: the Impact of the Metagenome, End Products, and the Epithelial and Vascular Barriers

Authors

Antonio Gil-Gómez

¹SeLiver Group at Institute of Biomedicine of Seville (IBiS), Virgen del Rocio University Hospital/CSIC/University of Seville, Seville, Spain

²Hepatic and Digestive Diseases Networking Biomedical Research Centre (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain
Paola Brescia

³Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy
Maria Rescigno

³Humanitas Clinical and Research Center – IRCCS, Rozzano, Milan, Italy
Manuel Romero-Gómez

¹SeLiver Group at Institute of Biomedicine of Seville (IBiS), Virgen del Rocio University Hospital/CSIC/University of Seville, Seville, Spain

²Hepatic and Digestive Diseases Networking Biomedical Research Centre (CIBERehd), Instituto de Salud Carlos III, Madrid, Spain

⁴UCM Digestive Diseases, Virgen del Rocío University Hospital, Seville, Spain

Abstract

Nonalcoholic fatty liver disease (NAFLD) is a systemic, dynamic, heterogeneous, and multiaxis entity, the pathogenesis of which is still uncertain. The gut–liver axis is regulated and stabilized by a complex network encompassing a metabolic, immune, and neuroendocrine cross-talk between the gut, the microbiota, and the liver. Changes in the gut–liver axis affect the metabolism of lipids and carbohydrates in the hepatocytes, and they impact the balance of inflammatory mediators and cause metabolic deregulation, promoting NAFLD and its progression to nonalcoholic steatohepatitis. Moreover, the microbiota and its metabolites can play direct and indirect roles in gut barrier function and fibrosis development. In this review, we will highlight findings from the recent literature focusing on the gut–liver axis and its relation to NAFLD. Finally, we will discuss the impact of technical issues, design bias, and other limitations on current knowledge of the gut microbiota in the context of NAFLD.

Keywords

Microbiota - Microbiome - NAFLD - NASH - Gut–Liver axis

Full Text

References

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