The role of gut microbiota in liver and biliary system disorders
Kostyukevich O.I., Bylova N.A., Simbirtseva A.S.

N.I. Pirogov Russian National Research Medical University, Moscow, Russia

Recent studies revolutionized traditional views on the pathogenesis of many disorders. To date, the role of gut microbiota in atherosclerosis, obesity, diabetes, hypertension etc. was clearly demonstrated. In recent years, the role of gut microflora in liver diseases presents a wide field of speculations. It was shown that long-term gut dysbiosis and, in particular, small intenstinal overgrowth syndrome (SIBO) result in nonalcoholic fatty liver disease (NAFLD), i.e., steatosis and steatohepatitis, intrahepatic intralobular cholestasis, and extrahepatic biliary tract dysfunction. Gut microflora is implicated in liver damage by a number of mechanisms, i.e., induction of fatty liver changes, endogenous ethanol production, activation of systemic inflammatory reaction, changes in choline metabolism etc. Modern investigational tools revealed reliable differences in gut microbiota composition in patients with and without liver diseases. There is increasing evidence that NAFLD occurs in patients without obesity, diabetes or dyslipidemia. In these cases, qualitative and quantitative abnormalities of gut microflora are assumed as a key pathogenic factor of liver damage. The paper addresses probable pathogenic mechanisms of liver damage in gut microbiota abnormalities as well as management strategies and perspective complex therapeutic approaches.

Key words: nonalcoholic fatty liver disease, steatohepatitis, gut microflora, microbiome, complex therapy.

For citation: Kostyukevich O.I., Bylova N.A., Simbirtseva A.S. The role of gut microbiota in liver and biliary system disorders // RMJ. Gastroenterology. 2016. № 11. P. 713–720.