About the role of intestinal microbiota in the pathogenesis and treatment of non-alcoholic fatty liver disease

Abstract

Objective. The article presented by the authors is devoted to new directions in the pathogenesis of non-alcoholic fatty liver disease. The relevance of this problem is high, since currently non-alcoholic fatty liver disease is the most common chronic liver disease in the world and affects from 25% to 40% of adults in developed countries such as the USA and Russia. Non-alcoholic fatty liver disease is a multidisciplinary problem. The pathogenesis of the pathology under consideration is complicated and includes a large number of different links. Recently, the connection between the gut microbiota and the development of non-alcoholic fatty liver disease has attracted enormous interest. In this review the authors focused in detailed analysis of reserches of this link in the pathogenesis of non-alcoholic fatty liver disease.Results. Based on the analysis of the literature, a correlation was obtained between the composition of the microbiota in healthy people and patients with non-alcoholic fatty liver disease. A large number of works has demonstrated without any doubt the connection between non-alcoholic fatty liver disease, small intestine bacterial overgrowth, and increased endotoxemia, it supports the hypothesis that patients with non-alcoholic fatty liver disease have weakening of intestinal barrier function and the formation of "leaky gut". Based on literature data, the need to complete non-alcoholic fatty liver disease therapy in order to stabilize the permeability of the intestinal epithelium and to increase the pool of butyrate-producing bacteria with butyrate preparations that can be introduced into the human body exogenously.Conclusion. Based on the analysis, carried out by the authors, the importance of studying the state of the intestinal microbiota of the body, as one of the most important links in the pathogenesis of non-alcoholic fatty liver disease, is emphasized. During the treatment of nonalcoholic fatty liver disease, along with existing treatment methods, additional pathogenetic therapy is required with drugs that restore normal intestinal flora: prebiotics, synbiotics, probiotics, bacterial metabolites.

Keywords

• non-alcoholic fatty liver disease
• intestinal microflora
• microbiota
• obesity
• farnesoid x-receptor
• bile acids
• bacterial overgrowth syndrome
• short-chain fatty acids
• endotoxinemia
• butyrate-producing bacteria