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Review
. 2023 Oct 5;24(19):14918.
doi: 10.3390/ijms241914918.

Prebiotics and Probiotics: Therapeutic Tools for Nonalcoholic Fatty Liver Disease

Alejandra Mijangos-Trejo  1 , Natalia Nuño-Lambarri  1 , Varenka Barbero-Becerra  1 , Misael Uribe-Esquivel  1 , Paulina Vidal-Cevallos  1 , Norberto Chávez-Tapia  1
Affiliations
Review

Prebiotics and Probiotics: Therapeutic Tools for Nonalcoholic Fatty Liver Disease

Alejandra Mijangos-Trejo et al. Int J Mol Sci. .

Abstract

Alterations in the gut-liver axis and changes in the gut microbiome are among the risk factors for the pathogenesis of non-alcoholic fatty liver disease (NAFLD). These patients show increased bacterial overgrowth in the small intestine and impaired intestinal permeability. Therefore, therapeutic options such as probiotics or prebiotics have been investigated to modulate intestinal microbiota composition to improve NAFLD. Most in vivo and in vitro probiotic studies have focused on reducing hepatic fat accumulation. The beneficial effects of probiotics on NAFLD have been demonstrated in animal models, and the most widely used microorganisms are those of the Lactobacillus and Bifidobacterium genera. In animal models, probiotics help restore the intestinal microbiota and improve the integrity of the intestinal barrier. This narrative review summarizes published evidence and the likely benefits of probiotics and prebiotics as a therapeutic option for patients with NAFLD.

Keywords: NAFLD; dysbiosis; gut–liver axis; probiotics.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Gut–liver axis and intestinal barrier. (A) Gut, portal circulation, liver, and bile duct are connected anatomically. (B) The intestinal barrier has three layers: the outer layer is made up of mucus, microbiota, and defense proteins such as immunoglobulin A (IgA); the middle layer corresponds to intestinal epithelial cells that are sealed together by tight junctions (TJs), and the inner layer is composed of immune cells. The gut–vascular barrier (GVB) constitutes a second protective barrier. Adapted from ref. [4]. Created by BioRender (accessed on 29 August 2023).
Figure 2
Figure 2
The function of the intestinal barrier after being damaged. Alteration of the intestinal barrier increases in intestinal permeability and facilitates the translocation of bacteria and endotoxins, which can damage the gut–vascular barrier (GVB). The entry of pathogens and pathogen-associated molecular patterns (PAMPs) into the portal circulation triggers an inflammatory response. Gut-derived PAMPs can bind to specific toll-like receptors in the liver and activate the proinflammatory pathways, which result in hepatic inflammation. Adapted from ref. [4]. Created by BioRender (accessed on 29 August 2023).
See this image and copyright information in PMC

References

    1. Lazarus J.V., Mark H.E., Anstee Q.M., Arab J.P., Batterham R.L., Castera L., Cortez-Pinto H., Crespo J., Cusi K., Dirac M.A., et al. Advancing the global public health agenda for NAFLD: A consensus statement. Nat. Rev. Gastroenterol. Hepatol. 2022;19:60–78. doi: 10.1038/s41575-021-00523-4. - DOI - PubMed
    1. Makri E., Goulas A., Polyzos S.A. Epidemiology, Pathogenesis, Diagnosis and Emerging Treatment of Nonalcoholic Fatty Liver Disease. Arch. Med. Res. 2021;52:25–37. doi: 10.1016/j.arcmed.2020.11.010. - DOI - PubMed
    1. Fang J., Yu C.H., Li X.J., Yao J.M., Fang Z.Y., Yoon S.H., Yu W.Y. Gut dysbiosis in nonalcoholic fatty liver disease: Pathogenesis, diagnosis, and therapeutic implications. Front. Cell. Infect. Microbiol. 2022;12:997018. doi: 10.3389/fcimb.2022.997018. - DOI - PMC - PubMed
    1. Albillos A., de Gottardi A., Rescigno M. The gut-liver axis in liver disease: Pathophysiological basis for therapy. J. Hepatol. 2020;72:558–577. doi: 10.1016/j.jhep.2019.10.003. - DOI - PubMed
    1. Gomaa E.Z. Human gut microbiota/microbiome in health and diseases: A review. Antonie Van Leeuwenhoek. 2020;113:2019–2040. doi: 10.1007/s10482-020-01474-7. - DOI - PubMed

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