Biomedicines (Apr 2023)

Gut Dysbiosis and Blood-Brain Barrier Alteration in Hepatic Encephalopathy: From Gut to Brain

  • Ali Shahbazi,
  • Ali Sepehrinezhad,
  • Edris Vahdani,
  • Raika Jamali,
  • Monireh Ghasempour,
  • Shirin Massoudian,
  • Sajad Sahab Negah,
  • Fin Stolze Larsen

DOI
https://doi.org/10.3390/biomedicines11051272
Journal volume & issue
Vol. 11, no. 5
p. 1272

Abstract

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A common neuropsychiatric complication of advanced liver disease, hepatic encephalopathy (HE), impacts the quality of life and length of hospital stays. There is new evidence that gut microbiota plays a significant role in brain development and cerebral homeostasis. Microbiota metabolites are providing a new avenue of therapeutic options for several neurological-related disorders. For instance, the gut microbiota composition and blood-brain barrier (BBB) integrity are altered in HE in a variety of clinical and experimental studies. Furthermore, probiotics, prebiotics, antibiotics, and fecal microbiota transplantation have been shown to positively affect BBB integrity in disease models that are potentially extendable to HE by targeting gut microbiota. However, the mechanisms that underlie microbiota dysbiosis and its effects on the BBB are still unclear in HE. To this end, the aim of this review was to summarize the clinical and experimental evidence of gut dysbiosis and BBB disruption in HE and a possible mechanism.

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