Chapter 8 : Microbiota, Liver Diseases, and Alcohol

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Excessive alcohol consumption and being obese/overweight are the leading causes of chronic liver disease in Western countries. Nonalcoholic fatty liver disease (NAFLD) encompasses all liver lesions that can be observed in overweight/obese patients, ranging from pure steatosis to steatohepatitis (nonalcoholic steatohepatitis [NASH]), fibrosis, cirrhosis, and even hepatocellular carcinoma (HCC). Alcoholic liver disease (ALD) defines liver lesions observed in patients with alcohol abuse and includes steatosis, hepatitis, fibrosis, cirrhosis, and HCC. It usually occurs when alcohol consumption is higher than 70 g/day in men and 60 g/day in women. However, only some chronic alcohol consumers develop liver injury, suggesting that factors other than excessive alcohol consumption play a role in ALD. Moreover, some patients with other liver diseases, such as chronic hepatitis C or NAFLD, also consume alcohol. Alcohol may lead to liver injury at a lower level of consumption in these patients with another underlying liver disease.

Citation: Cassard A, Gérard P, Perlemuter G. 2018. Microbiota, Liver Diseases, and Alcohol, p 187-212. In Britton R, Cani P (ed), Bugs as Drugs. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.BAD-0007-2016
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Figure 1

Histology of the liver. Paraffin sections (4 μm thick) were stained with hematoxylin and eosin. Images were obtained using a Hamamatsu scanning module (Hamamatsu LX2000) and appropriate software (magnification, ×100). (A) Healthy tissue; (B) steatosis; (C) steatosis with inflammation; (D) fibrosis.

Citation: Cassard A, Gérard P, Perlemuter G. 2018. Microbiota, Liver Diseases, and Alcohol, p 187-212. In Britton R, Cani P (ed), Bugs as Drugs. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.BAD-0007-2016
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Figure 2

Intestinal microbiota in liver disease. Diet and alcohol influence the composition of the gut bacteria. Dysbiosis is associated with changes in bacterial metabolites such as SCFA and BAs. The gut barrier is also altered, leading to increased endotoxemia (LPS). Acetaldehyde is specifically produced by the gut bacteria in ALD. Modifications of BAs and activation of their receptors, FXR and TGR5, participate in the development of liver lesions.

Citation: Cassard A, Gérard P, Perlemuter G. 2018. Microbiota, Liver Diseases, and Alcohol, p 187-212. In Britton R, Cani P (ed), Bugs as Drugs. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.BAD-0007-2016
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Main differences between ALD and NAFLD

Citation: Cassard A, Gérard P, Perlemuter G. 2018. Microbiota, Liver Diseases, and Alcohol, p 187-212. In Britton R, Cani P (ed), Bugs as Drugs. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.BAD-0007-2016
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Microbiotas associated with different stages of NAFLD

Citation: Cassard A, Gérard P, Perlemuter G. 2018. Microbiota, Liver Diseases, and Alcohol, p 187-212. In Britton R, Cani P (ed), Bugs as Drugs. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.BAD-0007-2016
Generic image for table

Comparison of healthy microbiotas and microbiotas associated with cirrhosis

Citation: Cassard A, Gérard P, Perlemuter G. 2018. Microbiota, Liver Diseases, and Alcohol, p 187-212. In Britton R, Cani P (ed), Bugs as Drugs. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.BAD-0007-2016

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