title: The role of intestinal bacteria overgrowth in obesity-related nonalcoholic fatty liver disease.
abstract: Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. It is a progressive disorder involving a spectrum of conditions that include pure steatosis without inflammation, nonalcoholic steatohepatitis (NASH), fibrosis and cirrhosis. The key factor in the pathophysiology of NAFLD is insulin resistance that determines lipid accumulation in the hepatocytes, which may be followed by lipid peroxidation, production of reactive oxygen species and consequent inflammation. Recent studies suggest that the characteristics of the gut microbiota are altered in NAFLD, and also, that small intestinal bacterial overgrowth (SIBO) contributes to the pathogenesis of this condition. This review presents the chief findings from all the controlled studies that evaluated SIBO, gut permeability and endotoxemia in human NAFLD. We also discuss the possible mechanisms involving SIBO, lipid accumulation and development of NASH. The understanding of these mechanisms may allow the development of new targets for NASH treatment in the future.
authors.affiliation: Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil. contato@silviaferolla.com.br.
authors.forename: Silvia M
authors.initials: SM
authors.lastname: Ferolla
authors.affiliation: Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil. geyzaarmiliato@hotmail.com.
authors.forename: Geyza N A
authors.initials: GN
authors.lastname: Armiliato
authors.affiliation: Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil. clacouto@hotmail.com.
authors.forename: Cláudia A
authors.initials: CA
authors.lastname: Couto
authors.affiliation: Departamento de Clínica Médica, Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil. tferrari@medicina.ufmg.br.
authors.forename: Teresa C A
authors.initials: TC
authors.lastname: Ferrari
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001419:Bacteria / Q000187:drug effects / Q000254:growth & development* / Q000378:metabolism; D018988:Bacterial Translocation; D054884:Host-Pathogen Interactions; D006801:Humans; D007421:Intestine, Small / Q000187:drug effects / Q000276:immunology / Q000382:microbiology* / Q000503:physiopathology; D064307:Microbiota; D065626:Non-alcoholic Fatty Liver Disease / Q000188:drug therapy / Q000209:etiology* / Q000276:immunology / Q000382:microbiology / Q000503:physiopathology; D009765:Obesity / Q000150:complications* / Q000276:immunology / Q000503:physiopathology; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents