Microbiome as a therapeutic target in alcohol-related liver disease.
Sarin SK, Pande A, Schnabl B
J Hepatol. Feb 2019
COMMENT: Modulation of gut microbial composition by faecal microbiota transplantation or precision microbiome therapies are the new therapeutic options which are currently being evaluated for patients with alcohol-related liver disease.
In this review the authors discuss about the contribution of the gut microbiota to alcohol-related liver disease via different mechanisms such as, suppression of the immune system, intestinal inflammation and changes in microbial metabolites. They summarize the effects of untargeted treatment approaches on the gut microbiota, such as diet, probiotics, antibiotics and faecal microbial transplantation in alcohol-related liver disease and discuss targeted approaches that can restore intestinal homeostasis and improve alcohol-related liver disease.
Alterations in the intestinal microbiota contributes to the development of alcohol-related liver disease. A better characterization of the gut microbiome, metabolome and host response will allow to determine groups of patients that would benefit most from therapies targeting the gut microbiota. Microbiome and metabolome analysis in patients with alcohol-related liver disease might become a routine diagnostic test to stratify patients for tailored microbiome treatment. Untargeted therapies using antibiotics, probiotics, or faecal microbiota transplantation will be replaced by personalized and precision medicine approaches, such as bio-engineered bacterial strains or drugs that modulate specific bacterial enzymes and metabolic pathways.