Vallianou Natalia G, Kounatidis Dimitris, Psallida Sotiria, Vythoulkas-Biotis Nikolaos, Adamou Andreas, Zachariadou Tatiana, Kargioti Sofia, Karampela Irene, Dalamaga Maria
First Department of Internal Medicine, Sismanogleio General Hospital, Sismanogliou 1 Str., 15126 Athens, Greece.
Department of Internal Medicine, Hippokration General Hospital, 114 Vassilissis Sofias Str., 11527 Athens, Greece.
Metabolites. 2024 Jun 28;14(7):366. doi: 10.3390/metabo14070366.
Nonalcoholic fatty liver disease (NAFLD) poses an emerging threat topublic health. Nonalcoholic steatohepatitis (NASH) is reported to be the most rapidly rising cause of hepatocellular carcinoma in the western world. Recently, a new term has been proposed: metabolic dysfunction-associated steatotic liver disease (MASLD). The introduction of this new terminology has sparked a debate about the interchangeability of these terms. The pathogenesis of NAFLD/MASLD is thought to be multifactorial, involving both genetic and environmental factors. Among these factors, alterations in gut microbiota and gut dysbiosis have recently garnered significant attention. In this context, this review will further discuss the gut-liver axis, which refers to the bidirectional interaction between the human gut microbiota and the liver. Additionally, the therapeutic potential of probiotics, particularly next-generation probiotics and genetically engineered bacteria, will be explored. Moreover, the role of prebiotics, synbiotics, postbiotics, and phages as well as fecal microbiota transplantation will be analyzed. Particularly for lean patients with NAFLD/MASLD, who have limited treatment options, approaches that modify the diversity and composition of the gut microbiota may hold promise. However, due to ongoing safety concerns with approaches that modulate gut microbiota, further large-scale studies are necessary to better assess their efficacy and safety in treating NAFLD/MASLD.
非酒精性脂肪性肝病（NAFLD）对公众健康构成了新出现的威胁。据报道，非酒精性脂肪性肝炎（NASH）是西方世界肝细胞癌最快速上升的病因。最近，提出了一个新术语：代谢功能障碍相关脂肪性肝病（MASLD）。这一新术语的引入引发了关于这些术语可互换性的争论。NAFLD/MASLD的发病机制被认为是多因素的，涉及遗传和环境因素。在这些因素中，肠道微生物群的改变和肠道生态失调最近受到了极大关注。在此背景下，本综述将进一步讨论肠-肝轴，其指的是人类肠道微生物群与肝脏之间的双向相互作用。此外，还将探讨益生菌，特别是下一代益生菌和基因工程菌的治疗潜力。此外，还将分析益生元、合生元、后生元和噬菌体以及粪便微生物群移植的作用。特别是对于治疗选择有限的NAFLD/MASLD瘦患者，改变肠道微生物群多样性和组成的方法可能具有前景。然而，由于对调节肠道微生物群方法的安全性担忧仍在持续，需要进一步的大规模研究以更好地评估其在治疗NAFLD/MASLD中的疗效和安全性。
