Gut microbiota in alcoholic liver disease: Pathogenetic role and therapeutic perspectives

作     者：Giulia Malaguarnera Maria Giordano Giuseppe Nunnari Gaetano Bertino Michele Malaguarnera 

作者机构：Department of Clinical and Molecular Biomedicine Section of Pharmacology and Biochemistry Research Centre "The Great Senescence" University of Catania Cannizzaro Hospital Infective Diseases Department of Clinical and Molecular Biomedicine Garibaldi Hospital of Nesima Hepatology Unit Department of Medical and Pediatric Science University of Catania 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2014年第20卷第44期

页      面：16639-16648页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Alcoholic liver disease Bacterial translocation Dysbiosis Prebiotics Probiotics Synbiotic Gut microbiota Endotoxin 

摘      要：Alcoholic liver disease(ALD) is the commonest cause of cirrhosis in many Western countries and it has a high rate of morbidity and mortality. The pathogenesis is characterized by complex interactions between metabolic intermediates of alcohol. Bacterial intestinal flora is itself responsible for production of endogenous ethanol through the fermentation of carbohydrates. The intestinal metabolism of alcohol produces a high concentration of toxic acetaldehyde that modifies gut permeability and microbiota equilibrium. Furthermore it causes direct hepatocyte damage. In patients who consume alcohol over a long period, there is a modification of gut microbiota and, in particular, an increment of Gram negative bacteria. This causes endotoxemia and hyperactivation of the immune system. Endotoxin is a constituent of Gram negative bacteria cell walls. Two types of receptors, cluster of differentiation 14 and Toll-like receptors-4, present on Kupffer cells, recognize endotoxins. Several studies have demonstrated the importance of gut-liver axis and new treatments have been studied in recent years to reduce progression of ALD modifying gut microbiota. It has focused attention on antibiotics, prebiotics, probiotics and synbiotics.