Abstract
There is unique co-ordination between gut and liver; portal venous blood derived from the mesenteric venous circulation constitutes approximately 75% of total hepatic blood flow and its content activates multiple liver functions. Intestinal microbiota plays an important role in health and disease. The gut-liver axis provides interaction between microbial components and liver causing liver damage. Bacterial overgrowth, dysfunctional immunity, altered intestinal permeability are implicated in pathogenesis of infections, hepatic encephalopathy, spontaneous bacterial peritonitis and hepatorenal syndrome etc. Probiotics may prevent these abnormal interactions between gut and liver by improving intestinal barrier function and prevention of bacterial translocation. This review addresses gut-liver axis, gut microbiota in liver disease and probiotics in management of liver diseases.
Highlights
The gut microbiota is a very diverse ecosystem in that it is comprised of over 2,000 distinct species and has a collective gemone of 150 fold more genes than the human genome [1]
The altered gut microbiota, intestinal permeability and bacterial translocation plays a relevant role in the development of bacterial infections and other complications of cirrhosis such as variceal bleed, ascites, hepatic encephalopathy (HE) and acute on chronic liver failure
Endotoxemia leads to initiation of liver injury via interaction with Toll-like receptors (TLRs); [6] TLR independent mechanisms by which gut microbiota produces liver injury has been described [9]
Summary
The gut microbiota is a very diverse ecosystem in that it is comprised of over 2,000 distinct species and has a collective gemone of 150 fold more genes than the human genome [1]. It performs vital functions related to nutrition, metabolism and secretes a number of biologically active compounds which perform various functions like inhibition of pathogens and detoxification of toxic compounds. The gut-liver axis plays important role in the pathogenesis of various liver diseases [2]. The altered gut microbiota, intestinal permeability and bacterial translocation plays a relevant role in the development of bacterial infections and other complications of cirrhosis such as variceal bleed, ascites, hepatic encephalopathy (HE) and acute on chronic liver failure. Probiotics may modulate gut microbiota and alter pathogenic interactions in chronic liver disease [3,4]
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