Abstract
Nonalcoholic fatty liver disease (NAFLD) is considered as one of the most prevalent chronic liver diseases worldwide due to the rapidly rising prevalence of obesity and metabolic syndrome. As a hepatic manifestation of metabolic disease, NAFLD begins with hepatic fat accumulation and progresses to hepatic inflammation, termed as non-alcoholic steatohepatitis (NASH), hepatic fibrosis/cirrhosis, and finally leading to NAFLD-related hepatocellular carcinoma (NAFLD-HCC). Accumulating evidence showed that the gut microbiome plays a vital role in the initiation and progression of NAFLD through the gut–liver axis. The gut–liver axis is the mutual communication between gut and liver comprising the portal circulation, bile duct, and systematic circulation. The gut microbiome dysbiosis contributes to NAFLD development by dysregulating the gut–liver axis, leading to increased intestinal permeability and unrestrained transfer of microbial metabolites into the liver. In this review, we systematically summarized the up-to-date information of gut microbiome dysbiosis and metabolomic changes along the stages of steatosis, NASH, fibrosis, and NAFLD-HCC. The components and functions of the gut–liver axis and its association with NAFLD were then discussed. In addition, we highlighted current knowledge of gut microbiome-based treatment strategies targeting the gut–liver axis for preventing NAFLD and its associated HCC.
Highlights
Non-alcoholic fatty liver disease (NAFLD) is characterized by lipid accumulation in more than 5% of hepatocytes [1]
In the metabolites present review, we summarize of gut Based microbiota dysbiosis and microbial changes in NAFLD the andevidence on this, the compomicrobial metabolites changes in
Except for clinical evidence, a recent study from our team showed that there is an alteration of gut bacterial metabolites such as increased level of serum taurocholic acid (TCA) and decreased level of serum 3-indolepropionic acid (IPA) in mice with NAFLDHCC [50]
Summary
Non-alcoholic fatty liver disease (NAFLD) is characterized by lipid accumulation in more than 5% of hepatocytes [1]. The gut–liver axis plays a critical role sion of NAFLD liver (Figure 2). On mediating the function of gut microbiota in the progression of NAFLD liver (Figure 2). Liver axis with NAFLD development can supply possible strategies for the prevention and Elucidating the association of gut microbiota and gut–liver axis with NAFLD development treatment. Liver can regulate intestinal function and gut microbiota balance through the bile acid circulation, which is an important enterohepatic circulation in regulating NAFLD (Created with BioRender.com). (probiotics metabolites) can vein repair the intestinal barrierMicrobiome-based and the beneficial treatment metabolites can reachand thebeneficial liver through the portal to the intestinal barrier and the beneficial metabolites can reach the liver through the portal vein prevent NAFLD progression
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