Table 2.
Gut microbiota related strategies to manage chronic liver diseases.
| Strategies | Functional substance/Bacterial species | Mechanism of action | Ref. |
|---|---|---|---|
| Diet | Lactulose | acidify the intestinal cavity, inhibit urease producing bacteria, and limit the diffusion of ammonia into blood | (Phongsamran et al., 2010) |
| BCAA (leucine, isoleucine and valine) | promote protein synthesis, reduces nitrogen-containing products and prevents the formation of pseudo-neurotransmitters, reduce the progression of liver failure | (Fukushima et al., 2003) | |
| Thiamine; propose calcium, vitamin D |
restore the activity of PDH and KGDH, reducing ROS; reduce cholestasis |
(Francis, 2006; Atarashi et al., 2017; Satish and Shaik, 2021) | |
| SCFAs | activating G-protein coupled receptors or inhibiting histone deacetylase, anti-inflammatory properties of acetate and propionate, and their inhibitory effects on hepatic lipogenesis and lipid accumulation | (Jin et al., 2015; Sahuri-Arisoylu et al., 2016) | |
| Indole | enhance the tight junction of epithelial cells and mitigate inflammatory responses in the gut | (Beaumont et al., 2018) | |
| Choline | removing fat from hepatocytes | (Yu et al., 2016) | |
| Antibiotics |
Eubacteriaceae↑ Veillonellaceae↓ |
reduce the number of toxic metabolites produced by the GM and reduce serum pro-inflammatory cytokine | (Bajaj et al., 2013; Tang, 2014; Ponziani et al., 2016) |
| Probiotics | Lactobacillus rhamnosus | increase in intestinal FFAs concentration | (Shi et al., 2015) |
| Lactobacillus GG | reduction of alcohol-induced oxidative stress and restoration of barrier function | (Forsyth et al., 2009) | |
| Lactobacillus casei Shirota | may restore phagocytosis of neutrophils by changing IL-10 secretion and TLR4 expression | (Stadlbauer et al., 2008) | |
|
VSL# 3 (S. thermophilus, B.
breve, B. bacterium longum, B. infantis, L. acidophilus, L. plantarum, L. paracasei and L. delbrueckii subsp. Bulgarius) |
reduced the risk of hospitalization for HE as well as improved Child-Turcotte-Pugh (CTP) and model for end-stage liver disease scores (MELD) in patients with cirrhosis | (Dhiman et al., 2014) | |
| Prebiotics | pectin | restore the levels of Bacteroides | (Ferrere et al., 2017) |
| Fructooligosaccharide | promote fatty acid oxidation by up-regulating the expression of peroxidase, inhibit the expression of SREBP-2 in the liver and reduce the accumulation of cholesterol | (Matsumoto et al., 2017) | |
| Synbiotics | Bifidobacterium longum and FOS | protect against inflammation and hepatocyte damage | (Malaguarnera et al., 2012) |
| Fecal microbiota transplant (FMT) | feces bacteria from alcohol resistant mice | FMT prevented alcohol-induced intestinal disorders and fatty hepatitis | (Ferrere et al., 2017) |
| fecal bacteria transplantation from health control | improve intestinal flora disorder, enhance intestinal barrier function and reduce liver steatosis | (Zhou et al., 2017) | |
| fecal bacteria transplantation from health control | effectively reduce alkaline phosphatase in some patients, the ALP level of some patients (30%) decreased, fecal flora diversity of all patients increased | (Allegretti et al., 2019) | |
| FMT from the donor enriched in Lachnospiraceae and Ruminococcaceae | serum IL-6 and LPS binding protein were decreased and butyrate/isobutyrate was increased in the FMT group compared with baseline | (Bajaj et al., 2020) |
↑ means the abundance of bacteria increase; ↓ means the abundance of bacteria decrease.