Fecal microbiota transplantation in as alcoholic hepatitis and non alcoholic steatohepatitis is emerging
Affirmative. The gut microbome - liver axis is now well accepted(Compare et al. 2012) and there is significant body of evidence supporting gut microbiota plays role in nonalcoholic fatty liver disease (NAFLD) and exacerbate this to more dangerous nonalcoholic steatohepatitis (NASH) (Abu-Shanab and Quigley 2010). The overall school of thought is that the altered flora lead to dysregulation of the liver innate immunity and excessivle TLR stimulation (Miura and Ohnishi 2014). In fact E. coli mediated Small intestinal bacterial overgrowth (SIBO) is significantly increased in pediatric nonalcoholic steatohepatitis (NASH). Very interestingly Janssen et al recently reported the link between gut microbiota and bile acids(Janssen et al. 2017). In the Asian context we have observed SIBO, specially mediated by of Gram-negative pathogens result innate immune dysregulation (Ghosh 2011), insulin resistance, choline deficiency which are all signs of NAFLD, but this has not been published yet. Together, application of strategic probiotics in mitigating liver disease in high risk cohorts is increasingly suggested (Xue et al. 2017).
Suggested References
Abu-Shanab, A. and E. M. Quigley (2010). "The role of the gut microbiota in nonalcoholic fatty liver disease." Nat Rev Gastroenterol Hepatol 7(12): 691-701.
Compare, D., et al. (2012). "Gut–liver axis: the impact of gut microbiota on non alcoholic fatty liver disease." Nutrition, Metabolism and Cardiovascular Diseases 22(6): 471-476.
Ghosh, D. (2011). "Probiotics and intestinal defensins: augmenting the first line of defense in gastrointestinal immunity." probiotic foods in health and disease. Oxford& IBH Publishing Co, Delhi: 61-74.
Janssen, A. W. F., et al. (2017). "Modulation of the gut microbiota impacts nonalcoholic fatty liver disease: a potential role for bile acids." J Lipid Res 58(7): 1399-1416.
Miura, K. and H. Ohnishi (2014). "Role of gut microbiota and Toll-like receptors in nonalcoholic fatty liver disease." World J Gastroenterol 20(23): 7381-7391.
Xue, L., et al. (2017). "Probiotics may delay the progression of nonalcoholic fatty liver disease by restoring the gut microbiota structure and improving intestinal endotoxemia." Sci Rep 7: 45176.
There was also a paper about mice. Fat ones and skinny ones and how taking gut samples, knocking out gut biota and reintroducing bacteria from opposite group, brought about changes to body weight. IE fat mice became skinny and skinny mice became fat.
There is a tendency to attribute to microbiota changes as the main cause of multiple diseases and seems a great exaggeration and simplification of the problems in my modest opinion....
There are very strong recommendations suggesting connections between gut-liver axis. Both with respect to the progression of inflammation as well as treatment strategies. We have also got some very interesting results in this aspect. We are in different stages of manuscript submission.
I will anxiously waiting with the arrival of good news
Best regards
Luis
- Badges
- Science method