A story of liver and gut microbes: how does the intestinal flora affect liver disease? A review of the literature

Giuffrè, Mauro; Campigotto, Michele; Campisciano, Giuseppina; Comar, Manola; Crocè, Lory Saveria

doi:10.1152/ajpgi.00161.2019

Cited by 97 publications

(83 citation statements)

References 213 publications

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“…Obesity is directly related to the development of non-alcoholic fatty liver disease (NAFLD) [ 2 ]. NAFLD is characterized by a disease spectrum ranging from simple hepatic steatosis (i.e., non-alcoholic fatty liver, NAFL) to non-alcoholic steatohepatitis (NASH) in as many as 40% of patients [ 3 , 4 , 5 ]. Over time, NASH can further promote liver injury, causing fibrosis and, potentially, cirrhosis [ 3 ].…”

Section: Introductionmentioning

confidence: 99%

Optimization of Point-Shear Wave Elastography by Skin-to-Liver Distance to Assess Liver Fibrosis in Patients Undergoing Bariatric Surgery

et al. 2020

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Background: Obesity is a primary limiting factor in liver stiffness measurement (LSM). The impact of obesity has always been evaluated in terms of body mass index (BMI), without studying the effects of skin-to-liver distance (SLD) on LSM. We studied the impact of SLD on LSM in a cohort of obese patients undergoing bariatric surgery and intra-operatory liver biopsy. Materials and Methods: 299 patients underwent LSM by point-shear wave elastography (ElastPQ protocol), with two different ultrasound machines. SLD was measured as the distance between the skin and the liver capsule, perpendicular to where the region of interest (ROI) was positioned. We used the following arbitrary cut-offs: <5.7 kPa, F0–1; 5.7–7.99 kPa, F2; ≥8 kPa, F3–4. Results: We developed two logistic regression models using elastography–histology agreement (EHA) as the dependent variable and SLD as the independent variable. The model based on the second machine showed strongly more performant discriminative and calibration metrics (AIC 38.5, BIC 44.2, Nagelkerke Pseudo-R2 0.894, AUROC 0.90). The SLD cut-off value of 34.5 mm allowed a correct EHA with a sensitivity of 100%, a specificity of 93%, negative predictive value of 100%, positive predictive value of 87%, an accuracy of 96%, and positive likelihood ratio of 3.56. Conclusion: The impact of SLD is machine-dependent and should be taken into consideration when interpreting LSM. We believe that our findings may serve as a reference point for appropriate fibrosis stratification by liver elastography in obese patients.

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Section: Introductionmentioning

confidence: 99%

Optimization of Point-Shear Wave Elastography by Skin-to-Liver Distance to Assess Liver Fibrosis in Patients Undergoing Bariatric Surgery

et al. 2020

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“…The gut microbiota is a huge and complex system that is influenced by numerous factors, and is associated with host immunity. It has been reported that gut microbiota and host immunity are associated via diet, intestinal absorption and enterohepatic circulation ( 77 , 78 ). Therefore, it may be a promising research direction to determine the association between gut microbiota and immunotherapy.…”

Section: Discussionmentioning

confidence: 99%

Association between the gut microbiota and patient responses to cancer immune checkpoint inhibitors (Review)

et al. 2020

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Studies are increasingly investigating the association between the gut microbiota and the outcomes of immunotherapy in patients with cancer. Notably, certain studies have demonstrated that the gut microbiota serves a key role in regulating a patient's response to immunotherapy. In the present review, the potential associations between the gut microbiota, and cancer, host immunity and cancer immunotherapy are reviewed. Furthermore, the effects of fecal microbiota transplantation, antibiotics, probiotics, prebiotics, synbiotics, components of traditional Chinese medicine and various lifestyle factors on the gut microbiota and cancer immunotherapy outcomes are discussed. Certain dominant bacterial groups in the context of cancer immunotherapy and certain effective methods for optimizing immunotherapy by regulating the gut microbiota have been identified. Further investigation may enable the rapid conversion of these discoveries into practical products and clinically applicable methods.

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“…Most of the microorganisms that arrive in the liver are eliminated due to the balance between tolerance and inflammation of the hepatic microenvironment [ 3 , 20 , 21 ]. Brucella has a panoply of defensive strategies to evade immune response, including intracellular lifestyle and the prevention of the development of an appropriate adaptive immune response [ 22 , 23 ].…”

Section: Discussionmentioning

confidence: 99%

Hepatic Stellate Cells and Hepatocytes as Liver Antigen-Presenting Cells during B. abortus Infection

et al. 2020

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In Brucellosis, the role of hepatic stellate cells (HSCs) in the induction of liver fibrosis has been elucidated recently. Here, we study how the infection modulates the antigen-presenting capacity of LX-2 cells. Brucella abortus infection induces the upregulation of class II transactivator protein (CIITA) with concomitant MHC-I and -II expression in LX-2 cells in a manner that is independent from the expression of the type 4 secretion system (T4SS). In concordance, B. abortus infection increases the phagocytic ability of LX-2 cells and induces MHC-II-restricted antigen processing and presentation. In view of the ability of B. abortus-infected LX-2 cells to produce monocyte-attracting factors, we tested the capacity of culture supernatants from B. abortus-infected monocytes on MHC-I and –II expression in LX-2 cells. Culture supernatants from B. abortus-infected monocytes do not induce MHC-I and -II expression. However, these supernatants inhibit MHC-II expression induced by IFN-γ in an IL-10 dependent mechanism. Since hepatocytes constitute the most abundant epithelial cell in the liver, experiments were conducted to determine the contribution of these cells in antigen presentation in the context of B. abortus infection. Our results indicated that B. abortus-infected hepatocytes have an increased MHC-I expression, but MHC-II levels remain at basal levels. Overall, B. abortus infection induces MHC-I and -II expression in LX-2 cells, increasing the antigen presentation. Nevertheless, this response could be modulated by resident or infiltrating monocytes/macrophages.

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A story of liver and gut microbes: how does the intestinal flora affect liver disease? A review of the literature

Cited by 97 publications

References 213 publications

Optimization of Point-Shear Wave Elastography by Skin-to-Liver Distance to Assess Liver Fibrosis in Patients Undergoing Bariatric Surgery

Optimization of Point-Shear Wave Elastography by Skin-to-Liver Distance to Assess Liver Fibrosis in Patients Undergoing Bariatric Surgery

Association between the gut microbiota and patient responses to cancer immune checkpoint inhibitors (Review)

Hepatic Stellate Cells and Hepatocytes as Liver Antigen-Presenting Cells during B. abortus Infection

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