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Microbiome in Liver Cirrhosis

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The Evolving Landscape of Liver Cirrhosis Management

Abstract

Humans have a codependent relationship with gut microbiota. Changes in microbiota are proposed to be associated with various pathological conditions. New analyses facilitate the assessment and exhaustive search of these nonculturable bacteria. These new technologies also provide evidence of a relationship between gut microbiota and liver cirrhosis (LC).

Gut microbiota is closely involved in maintenance of the relationship between gut and liver in which commensal gut microbiota inhibits harmful bacteria, produces short-chain fatty acids to protect from mucosal infection, and metabolize bile acids to monitor the intestinal environment. Gut microbiota in patients with LC was different from that in healthy individuals due to dysbiosis regardless of background hepatitis status. In patients with LC, dysbiosis, small intestinal bacterial overgrowth, leaky gut syndrome, and immune paralysis of the gut-associated lymphoid tissue occurred, and the interaction between these induces a disruption of the gut–liver barrier. Dysfunction of the immune system induces translocation of harmful bacteria and endotoxin into the liver. Bacterial translocation worsens LC and contributes to complications such as hepatic encephalopathy, hepatocellular carcinoma, hepatorenal syndrome, and spontaneous bacterial peritonitis. Poorly absorbable antibiotics, probiotics, prebiotics, synbiotics, and fecal microbiota transplantations were reported as potential treatment interventions for dysbiosis in patients with LC.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan

    Akira Sakamaki, Masaaki Takamura & Shuji Terai

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  1. Akira Sakamaki
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  2. Masaaki Takamura
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  3. Shuji Terai
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Correspondence to Shuji Terai .

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  1. Third Department of Internal Medicine, Nara Medical University, Kashihara, Nara, Japan

    Hitoshi Yoshiji

  2. Third Department of Internal Medicine, Nara Medical University, Kashihara, Nara, Japan

    Kosuke Kaji

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Sakamaki, A., Takamura, M., Terai, S. (2019). Microbiome in Liver Cirrhosis. In: Yoshiji, H., Kaji, K. (eds) The Evolving Landscape of Liver Cirrhosis Management. Springer, Singapore. https://doi.org/10.1007/978-981-13-7979-6_7

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