Second Department of Internal Medicine, Osaka Medical Collegegrid.444883.7, Takatsuki, Japan.
Department of Microbiology and Infection Control, Osaka Medical Collegegrid.444883.7, Takatsuki, Japan.
mBio. 2021 Aug 31;12(4):e0115521. doi: 10.1128/mBio.01155-21. Epub 2021 Jul 6.
Nonalcoholic fatty liver disease (NAFLD), characterized by excessive fat deposition in the liver unrelated to alcohol consumption, is highly prevalent worldwide. However, effective therapeutic agents approved for NAFLD treatment are lacking. An ileal bile acid transporter inhibitor (IBATi), which represents a new mode of treatment of chronic idiopathic constipation, leads to increased delivery of bile acids to the colon. We investigated the effect of IBATi against NAFLD through modification of the gut microbiota in mice. IBATi treatment significantly suppressed body weight gain, liver dysfunction, and serum low-density lipoprotein levels and significantly decreased NAFLD activity scores in high-fat diet (HFD) mice. Treatment with IBATi ameliorated the decreased hepatic cholesterol 7-a-monooxygenase () and increased ileal fibroblast growth factor 15 () mRNA expression in HFD mice. Further, IBATi treatment changed the α-diversity in the gut microbiota reduced by HFD, which was analyzed in feces using 16S rRNA sequencing. To establish the mechanism underlying improvement in NAFLD induced by IBATi, we recolonized antibiotic solution-treated mice by fecal microbiome transplantation (FMT) using stool from HFD or HFD plus IBATi mice. This is the first report that fecally transplanted gut microbiota from HFD plus IBATi mice prevented hepatic steatosis caused by HFD. In conclusion, IBATi improved hepatic steatosis by ameliorating gut microbiota dysbiosis in NAFLD model mice, suggesting a potential therapeutic agent for NAFLD treatment. NAFLD is an increasingly recognized condition that may progress to liver cirrhosis and hepatocellular carcinoma, and community surveys have assessed that the prevalence is 14 to 32% worldwide. The first line of treatment for NAFLD is lifestyle modification to achieve weight reduction, particularly through diet and exercise. However, weight reduction is difficult to achieve and maintain, and pharmacological agents approved for the treatment of NAFLD are lacking. This study investigated the influence of the gut microbiota and the effect of an IBATi on NAFLD using a murine model. Treatment with IBATi significantly improved NAFLD in HFD mice. Further, fecal microbiome transplantation using stool from HFD plus IBATi mice prevented hepatic steatosis caused by HFD. Our study makes a significant contribution to the literature because the study findings suggest a potential treatment strategy for NAFLD patients by ameliorating gut microbiota dysbiosis.
非酒精性脂肪性肝病(NAFLD)是一种以肝脏内脂肪过度沉积为特征的疾病,与饮酒无关,在全球范围内广泛存在。然而,目前缺乏批准用于治疗 NAFLD 的有效治疗药物。回肠胆汁酸转运蛋白抑制剂(IBATi)是一种治疗慢性特发性便秘的新方法,可增加胆汁酸向结肠的输送。我们通过改变小鼠的肠道微生物群来研究 IBATi 对 NAFLD 的影响。IBATi 治疗显著抑制了高脂肪饮食(HFD)小鼠的体重增加、肝功能障碍和血清低密度脂蛋白水平,并显著降低了 HFD 小鼠的非酒精性脂肪性肝病活动评分。在 HFD 小鼠中,IBATi 治疗改善了肝脏胆固醇 7-α-单加氧酶()的降低和回肠成纤维细胞生长因子 15()mRNA 表达的增加。此外,IBATi 治疗改变了高脂肪饮食引起的肠道微生物群的 α-多样性,使用 16S rRNA 测序分析粪便。为了确定 IBATi 改善非酒精性脂肪性肝病的机制,我们使用来自高脂肪饮食或高脂肪饮食加 IBATi 小鼠的粪便通过粪便微生物群移植(FMT)来重新定植抗生素处理的小鼠。这是第一个报道来自高脂肪饮食加 IBATi 小鼠的粪便移植的肠道微生物群可预防高脂肪饮食引起的肝脂肪变性的报告。总之,IBATi 通过改善 NAFLD 模型小鼠的肠道微生物群失调来改善肝脂肪变性,提示其可能成为治疗非酒精性脂肪性肝病的潜在治疗药物。非酒精性脂肪性肝病(NAFLD)是一种日益被认识的疾病,可能进展为肝硬化和肝细胞癌,社区调查评估全球患病率为 14%至 32%。NAFLD 的一线治疗方法是生活方式改变以实现体重减轻,特别是通过饮食和运动。然而,体重减轻很难实现和维持,并且缺乏批准用于治疗 NAFLD 的药物。本研究使用小鼠模型研究了肠道微生物群的影响和 IBATi 的作用。IBATi 治疗显著改善了 HFD 小鼠的非酒精性脂肪性肝病。此外,使用来自高脂肪饮食加 IBATi 小鼠的粪便进行粪便微生物群移植可预防高脂肪饮食引起的肝脂肪变性。我们的研究对文献做出了重要贡献,因为研究结果表明通过改善肠道微生物群失调可以为 NAFLD 患者提供一种潜在的治疗策略。
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