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Open AccessReview

The Role of Probiotics in Nonalcoholic Fatty Liver Disease: A New Insight into Therapeutic Strategies

by Marica Meroni 1,2,†, Miriam Longo 1,3,† and Paola Dongiovanni 1,*
1
General Medicine and Metabolic Diseases, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Pad. Granelli, via F Sforza 35, 20122 Milan, Italy
2
Department of Pathophysiology and Transplantation, Università degli Studi di Milano, 20122 Milano, Italy
3
Department of Clinical Sciences and Community Health, Università degli Studi di Milano, 20122 Milano, Italy
*
Author to whom correspondence should be addressed.
These authors equally contributed to the manuscript.
Nutrients 2019, 11(11), 2642; https://doi.org/10.3390/nu11112642
Received: 10 October 2019 / Revised: 25 October 2019 / Accepted: 28 October 2019 / Published: 4 November 2019
Nonalcoholic fatty liver disease (NAFLD) encompasses a broad spectrum of pathological hepatic conditions ranging from simple steatosis to nonalcoholic steatohepatitis (NASH), which may predispose to liver cirrhosis and hepatocellular carcinoma (HCC). Due to the epidemic obesity, NAFLD is representing a global health issue and the leading cause of liver damage worldwide. The pathogenesis of NAFLD is closely related to insulin resistance (IR), adiposity and physical inactivity as well as genetic and epigenetic factors corroborate to the development and progression of hepatic steatosis and liver injury. Emerging evidence has outlined the implication of gut microbiota and gut-derived endotoxins as actively contributors to NAFLD pathophysiology probably due to the tight anatomo-functional crosstalk between the gut and the liver. Obesity, nutrition and environmental factors might alter intestinal permeability producing a favorable micro-environment for bacterial overgrowth, mucosal inflammation and translocation of both invasive pathogens and harmful byproducts, which, in turn, influence hepatic fat composition and exacerbated pro-inflammatory and fibrotic processes. To date, no therapeutic interventions are available for NAFLD prevention and management, except for modifications in lifestyle, diet and physical exercise even though they show discouraging results due to the poor compliance of patients. The premise of this review is to discuss the role of gut–liver axis in NAFLD and emphasize the beneficial effects of probiotics on gut microbiota composition as a novel attractive therapeutic strategy to introduce in clinical practice. View Full-Text
Keywords: nonalcoholic fatty liver disease; gut microbiota; gut–liver axis; leaky gut; intestinal permeability; tight junctions; endotoxemia; probiotics nonalcoholic fatty liver disease; gut microbiota; gut–liver axis; leaky gut; intestinal permeability; tight junctions; endotoxemia; probiotics
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Meroni, M.; Longo, M.; Dongiovanni, P. The Role of Probiotics in Nonalcoholic Fatty Liver Disease: A New Insight into Therapeutic Strategies. Nutrients 2019, 11, 2642.

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