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Are Probiotics Effective in Targeting Alcoholic Liver Diseases?

Abstract

Alcoholic liver disease (ALD) encompasses a broad spectrum of disorders including steatosis, steatohepatitis, fibrosis, and cirrhosis. Despite intensive research in the last two decades, there is currently no Food and Drug Administration-approved therapy for treating ALD. Several studies have demonstrated the importance of the gut-liver axis and gut microbiome on the pathogenesis of ALD. Alcohol may induce intestinal dysbiosis and increased intestinal permeability, which in turn result in increased levels of pathogen-associated molecular patterns such as lipopolysaccharide (LPS) and translocation of microbial products from the gut to the liver (bacterial translocation). LPS is an inflammatory signal that activates toll-like receptor 4 on Kupffer cells, contributing to the inflammation observed in ALD. Recently, probiotics have been shown to be effective in reducing or preventing the progression of ALD. A potential mechanism is that the probiotics transforms the composition of intestinal microbiota, which leads to reductions in alcohol-induced dysbiosis, intestinal permeability, bacterial translocation, endotoxemia, and consequently, the development of ALD. While transformation of intestinal microbiota by probiotics appears to be a promising therapeutic strategy for the treatment of intestinal barrier dysfunction, there is a scarcity of research that studies probiotics in the context of ALD. In this review, we discuss the potential therapeutic applications of probiotics in the treatment of ALD.

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Fig. 1

Abbreviations

ALD:

alcoholic liver disease

LPS:

lipopolysaccharide

TLR:

Toll-like receptor

TNF:

tumor necrosis factor

IL:

interleukin

FMT:

fecal microbiota transplantation

GG:

Gorbach-Goldin

CDI:

Clostridium difficile infection

CRP:

C-reactive protein

AST:

aspartate aminotransferase

ALT:

alanine aminotransferase

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Funding

This research was supported by Hallym University Research Fund, Korea National Research Foundation (NRF-2015R1C1A1A01053232 and NRF-2018M3A9F3020956), and Hallym University Research Fund 2016 (HURF-2016-60).

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Meegun Hong: analysis and interpretation of the data, collection and assembly of data, drafting of the article. Ki Tae Suk: conception and design, critical revision of the article for important intellectual content, final approval of the article. Dae Hee Han and Jitaek Hong: critical revision of the article for important intellectual content. Dong Joon Kim: provision of study materials.

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Correspondence to Ki Tae Suk.

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The authors declare that they have no conflict of interest.

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Meegun Hong, Dae Hee Han, and Jitaek Hong share co-first author.

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Hong, M., Han, D.H., Hong, J. et al. Are Probiotics Effective in Targeting Alcoholic Liver Diseases?. Probiotics & Antimicro. Prot. 11, 335–347 (2019). https://doi.org/10.1007/s12602-018-9419-6

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Keywords

  • Alcoholic liver disease
  • Microbiota
  • Probiotics
  • Dysbiosis
  • Gut