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Influence of gut microbiota on the development and progression of nonalcoholic steatohepatitis

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Abstract

Introduction

Nonalcoholic steatohepatitis (NASH) is characterized by the presence of steatosis, inflammation, and ballooning degeneration of hepatocytes, with or without fibrosis. The prevalence of NASH has increased with the obesity epidemic, but its etiology is multifactorial. The current studies suggest the role of gut microbiota in the development and progression of NASH. The aim is to review the studies that investigate the relationship between gut microbiota and NASH. These review also discusses the pathophysiological mechanisms and the influence of diet on the gut–liver axis.

Result

The available literature has proposed mechanisms for an association between gut microbiota and NASH, such as: modification energy homeostasis, lipopolysaccharides (LPS)–endotoxemia, increased endogenous production of ethanol, and alteration in the metabolism of bile acid and choline. There is evidence to suggest that NASH patients have a higher prevalence of bacterial overgrowth in the small intestine and changes in the composition of the gut microbiota. However, there is still a controversy regarding the microbiome profile in this population. The abundance of Bacteroidetes phylum may be increased, decreased, or unaltered in NASH patients. There is an increase in the Escherichia and Bacteroides genus. There is depletion of certain taxa, such as Prevotella and Faecalibacterium.

Conclusion

Although few studies have evaluated the composition of the gut microbiota in patients with NASH, it is observed that these individuals have a distinct gut microbiota, compared to the control groups, which explains, at least in part, the genesis and progression of the disease through multiple mechanisms. Modulation of the gut microbiota through diet control offers new challenges for future studies.

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Acknowledgements

The authors gratefully acknowledge the combined support of the Brazilian government organizations (Comissão de Aperfeiçoamento de Pessoal do Nível Superior-CAPES and Fundação de Amparo à Pesquisa do Estado de Minas Gerais-FAPEMIG).

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Authors and Affiliations

  1. Universitary Hospital and School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil

    Fabiana de Faria Ghetti, Daiane Gonçalves Oliveira, Juliano Machado de Oliveira & Lincoln Eduardo Villela Vieira de Castro Ferreira

  2. Department of Biology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil

    Dionéia Evangelista Cesar

  3. Department of Nutrition, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil

    Ana Paula Boroni Moreira

  4. Unidade de Nutrição Clínica, Hospital Universitário, Rua Catulo Breviglieri, s/n, Bairro Santa Catarina, Juiz de Fora, Minas Gerais, CEP 36036-330, Brazil

    Fabiana de Faria Ghetti

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  2. Daiane Gonçalves Oliveira
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  3. Juliano Machado de Oliveira
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The author contributions were as follows: FFG and DGO designed the concept of the study, and all authors were involved in the literature search and review. FFG and DGO wrote the manuscript. APBM, JMO, DEC and LEVVCF were involved with editing the manuscript, and all authors read and approved the final manuscript.

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Correspondence to Fabiana de Faria Ghetti.

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de Faria Ghetti, F., Oliveira, D.G., de Oliveira, J.M. et al. Influence of gut microbiota on the development and progression of nonalcoholic steatohepatitis. Eur J Nutr 57, 861–876 (2018). https://doi.org/10.1007/s00394-017-1524-x

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