Intestinal permeability in the pathogenesis of liver damage: From non-alcoholic fatty liver disease to liver transplantation.
Bacterial translocation
Cirrhosis
Gut microbiota
Gut-liver axis
Liver disease
Mediterranean diet
Personalized medicine
Journal
World journal of gastroenterology
ISSN: 2219-2840
Titre abrégé: World J Gastroenterol
Pays: United States
ID NLM: 100883448
Informations de publication
Date de publication:
07 Sep 2019
07 Sep 2019
Historique:
received:
21
05
2019
revised:
04
07
2019
accepted:
19
07
2019
entrez:
24
9
2019
pubmed:
24
9
2019
medline:
18
2
2020
Statut:
ppublish
Résumé
The intimate connection and the strict mutual cooperation between the gut and the liver realizes a functional entity called gut-liver axis. The integrity of intestinal barrier is crucial for the maintenance of liver homeostasis. In this mutual relationship, the liver acts as a second firewall towards potentially harmful substances translocated from the gut, and is, in turn, is implicated in the regulation of the barrier. Increasing evidence has highlighted the relevance of increased intestinal permeability and consequent bacterial translocation in the development of liver damage. In particular, in patients with non-alcoholic fatty liver disease recent hypotheses are considering intestinal permeability impairment, diet and gut dysbiosis as the primary pathogenic trigger. In advanced liver disease, intestinal permeability is enhanced by portal hypertension. The clinical consequence is an increased bacterial translocation that further worsens liver damage. Furthermore, this pathogenic mechanism is implicated in most of liver cirrhosis complications, such as spontaneous bacterial peritonitis, hepatorenal syndrome, portal vein thrombosis, hepatic encephalopathy, and hepatocellular carcinoma. After liver transplantation, the decrease in portal pressure should determine beneficial effects on the gut-liver axis, although are incompletely understood data on the modifications of the intestinal permeability and gut microbiota composition are still lacking. How the modulation of the intestinal permeability could prevent the initiation and progression of liver disease is still an uncovered area, which deserves further attention.
Identifiants
pubmed: 31543676
doi: 10.3748/wjg.v25.i33.4814
pmc: PMC6737313
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
4814-4834Déclaration de conflit d'intérêts
Conflict-of-interest statement: Nothing to declare.
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