Abstract

The concept that interactions between the gut, the liver, and the immune system play an important role in liver diseases is an old concept that has recently seen a resurgence in interest. Altered intestinal bacterial flora and gut-associated endotoxemia are increasingly recognized as critical components in both nonalcoholic fatty liver disease (NAFLD) and alcoholic liver disease (ALD). Probiotics have been proposed in the treatment and prevention of many conditions, including the liver diseases. Probiotics are live microorganisms that, when consumed in adequate amounts, confer a health benefit to the host. There are many mechanisms by which probiotics enhance intestinal health and influence the gut-liver axis, including modulation of the intestinal microflora, modification of intestinal barrier function, and immunomodulation. The present review summarizes the recent studies highlighting the role of the intestinal microflora in the development of NAFLD and ALD and the potential efficacy of probiotics as a therapeutic strategy for liver diseases.Key teaching points: • Interactions between the gut, the liver, and the immune system are involved in pathogenesis of the liver diseases.• Gut microflora plays a significant role in the development of nonalcoholic and alcoholic fatty liver disease.• Probiotics are live microorganisms that, when consumed in adequate amounts, confer a health benefit to the host.• Probiotics have potential as prevention strategies or therapies for multiple gastrointestinal diseases, including liver diseases of different etiology.

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