The microbiome and metabolic fatty liver disease (MeFLD)

Abstract

Background: Despite intensive research, both the pathogenesis and the pathophysiology of metabolic fatty liver disease (MeFLD) and its hepatic complications are poorly understood. Dyslipidemias and glucose metabolism disorders are among the well-studied pathomechanisms. In addition, the intestinal microbiome is increasingly suspected to be significantly involved in the occurrence and progression of MeFLD, via the regulation of the metabolism and the immune system. Objectives: The work focuses on the importance of the microbiome in the context of pathogenesis and pathophysiology in MeFLD. Mechanisms of how the microbiome potentially contributes to the development of MeFLD will be highlighted. Materials and methods: A systematic literature search was undertaken using PubMed and forms the basis of this work. Results: The microbiome is involved in the development of MeFLD via numerous mechanisms and signaling pathways. While animal studies show clear evidence for this link, clinical evidence is lacking despite overall promising results. Human intervention studies with prebiotics, probiotics, or synbiotics, as well as fecal microbiome transfer suggest that modulation of the microbiome may be a promising therapeutic option in patients with MeFLD. Conclusion: As our understanding of the influence of the microbiome on the pathogenesis of MeFLD progresses, targeted interventions for prevention and therapy of MeFLD may be adopted in the future.