title: Gut microbiota in alcoholic liver disease: pathogenetic role and therapeutic perspectives.
abstract: Alcoholic liver disease (ALD) is the commonest cause of cirrhosis in many Western countries and it has a high rate of morbidity and mortality. The pathogenesis is characterized by complex interactions between metabolic intermediates of alcohol. Bacterial intestinal flora is itself responsible for production of endogenous ethanol through the fermentation of carbohydrates. The intestinal metabolism of alcohol produces a high concentration of toxic acetaldehyde that modifies gut permeability and microbiota equilibrium. Furthermore it causes direct hepatocyte damage. In patients who consume alcohol over a long period, there is a modification of gut microbiota and, in particular, an increment of Gram negative bacteria. This causes endotoxemia and hyperactivation of the immune system. Endotoxin is a constituent of Gram negative bacteria cell walls. Two types of receptors, cluster of differentiation 14 and Toll-like receptors-4, present on Kupffer cells, recognize endotoxins. Several studies have demonstrated the importance of gut-liver axis and new treatments have been studied in recent years to reduce progression of ALD modifying gut microbiota. It has focused attention on antibiotics, prebiotics, probiotics and synbiotics.
authors.affiliation: Giulia Malaguarnera, Michele Malaguarnera, Department of Clinical and Molecular Biomedicine, Section of Pharmacology and Biochemistry, 95100 Catania, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Malaguarnera
authors.affiliation: Giulia Malaguarnera, Michele Malaguarnera, Department of Clinical and Molecular Biomedicine, Section of Pharmacology and Biochemistry, 95100 Catania, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Giordano
authors.affiliation: Giulia Malaguarnera, Michele Malaguarnera, Department of Clinical and Molecular Biomedicine, Section of Pharmacology and Biochemistry, 95100 Catania, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Nunnari
authors.affiliation: Giulia Malaguarnera, Michele Malaguarnera, Department of Clinical and Molecular Biomedicine, Section of Pharmacology and Biochemistry, 95100 Catania, Italy.
authors.forename: Gaetano
authors.initials: G
authors.lastname: Bertino
authors.affiliation: Giulia Malaguarnera, Michele Malaguarnera, Department of Clinical and Molecular Biomedicine, Section of Pharmacology and Biochemistry, 95100 Catania, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Malaguarnera
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D006090:Gram-Negative Bacteria / Q000187:drug effects / Q000276:immunology / Q000472:pathogenicity*; D054884:Host-Pathogen Interactions; D006801:Humans; D007422:Intestines / Q000187:drug effects / Q000276:immunology / Q000382:microbiology*; D008099:Liver / Q000187:drug effects / Q000276:immunology / Q000382:microbiology*; D008108:Liver Diseases, Alcoholic / Q000276:immunology / Q000382:microbiology* / Q000628:therapy*; D056692:Prebiotics; D019936:Probiotics / Q000627:therapeutic use; D058616:Synbiotics
chemical_list: D000900:Anti-Bacterial Agents; D056692:Prebiotics
keywords: Alcoholic liver disease; Bacterial translocation; Dysbiosis; Endotoxin; Gut microbiota; Prebiotics; Probiotics; Synbiotic