The Role of Microbiota in Chronic Liver Disease

Amir Avan

The intestinal microflora plays a role in local immunity, providing a barrier against harmful microbes, as well as the digestion of nutrients. Microbial translocation is the movement of live microorganisms or bacterial products (such LPS, lipopeptides) from the intestinal lumen to the mesenteric lymph nodes and other extra intestinal locations as a result of disturbed gut flora. Recent research indicates that microbial translocation (MT) may also occur in the early stages of other liver disorders, such as alcoholic hepatopathy and nonalcoholic fatty liver disease, in addition to cirrhosis. Different factors that may favour MT include decreased immunity, greater permeability of the intestinal mucosa, and small intestinal bacterial overgrowth. Additionally, MT has been linked to the aetiology of cirrhosis complications, a major source of morbidity and mortality in cirrhotic individuals. Prokinetics and probiotics are two non-antibiotic-based therapeutic approaches that have been employed to modulate the gut flora and lower MT. Selective intestinal decontamination is an antibiotic-based therapeutic approach. Probiotics in particular can be a tempting tactic, even if bigger randomised trials are required to confirm the encouraging outcomes of animal models and small clinical investigations.