Could gut mycobiome play a role in NAFLD pathogenesis? Insights and therapeutic perspectives

Fotis, Dimitrios

doi:10.1016/j.metop.2022.100178

Cited by 14 publications

(9 citation statements)

References 38 publications

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“…It is noted that as the degree of liver damage (fibrosis/cirrhosis) increases in patients with NAFLD and microbiota changes grow too [19]. Also, in patients with NAFLD, changes in the gut microbiome and in the number of Candida albicans are found [20]. In a Ukrainian study, patients with NAFLD had a decreased number of Lactobacillus spp.…”

Section: Discussionmentioning

confidence: 99%

State of the Gut Microbiota in Patients With Metabolic-Associated Fatty Liver Disease With Type 2 Diabetes Mellitus

Dorofeev

Rudenko²,

Cheverda³

2022

Proc Shevchenko Sci Soc Med Sci

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Introduction. One of the frequent complications of the type 2 diabetes mellitus (T2DM) is a metabolic-associated fatty liver disease (MAFLD). Aim. To study the composition of gut microbiota in patients with a combination of T2DM and MAFLD and to compare it with the microbiota in isolated T2DM and MAFLD. Methods. 111 patients were studied. The main group consisted of 56 patients with a combination of MAFLD and T2DM; the 1st group included 28 patients with MAFLD and the 2nd - 27 patients with T2DM. The control group consisted of 30 practically healthy people. Diagnosis was made by steatometry, shear wave elastography, lactulose H2 breath test, qPCR of feces using primers targeting the 16S rRNA gene, and stool culture. Results. In the the main group SIBO was found in 48.2%, in 1st – 35.7%, in 2nd – 33.3%, compared to 10% in the control group. When compared with healthy people, the number of "other" microorganisms significantly increased in the group with isolated T2DM and Clostridium, Proteus and Candida were cultured; in the case of isolated MAFLD, a decrease in Bacteroidetes and an increase in the Firmicutes/Bacteroidetes ratio, as well as an increase in Klebsiella and Clostridium. In the main group, an increase in Actinobacteria, "other" microorganisms, a ratio of Firmicutes/Bacteroidetes and a decrease in Bacteroidetes were found, when cultured - an increase in Clostridium, Klebsiella and Candida. Conclusions. Only the group of MAFLD with T2DM was characterized by increased Actinobacteria; decreased absolute number of Bifidobacterium and Lactobacillus and increased Escherichia, including with altered enzymatic properties in the stool culture.

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Section: Discussionmentioning

confidence: 99%

State of the Gut Microbiota in Patients With Metabolic-Associated Fatty Liver Disease With Type 2 Diabetes Mellitus

Dorofeev

Rudenko²,

Cheverda³

2022

Proc Shevchenko Sci Soc Med Sci

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“…Effects on hepatic function and NAFLD Nowadays, NAFLD has been assessed to affect almost 70% to 80% of patients with T2DM [75,76], while in obesity its prevalence ranges from 50% to 90%, depending on the degree of excess adiposity [77]. NAFLD, which is characterized by excess fat accumulation in the hepatocyte, may be associated with non-alcoholic steatohepatitis (NASH), cirrhosis and even hepatocellular carcinoma [78,79]. Apart from these severe liver consequences, NAFLD, especially in a patient with obesity and T2DM, calls for action in terms of CVD, as it is related to increased cardiovascular adverse effects [80,81].…”

Section: Cardiovascular Effectsmentioning

confidence: 99%

SGLT-2 inhibitors in obesity and its associated cardiometabolic disorders: where do we stand?

Tsilingiris¹,

Kounatidis²,

Lempesis³

et al. 2022

Polish Archives of Internal Medicine

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As the tide of obesity and its complications is on the rise, there is an urgent need for new drugs with weight-lowering and beneficial metabolic properties. Obesity-related disorders, such as metabolic syndrome, prediabetes, type 2 diabetes mellitus (T2DM), cardiovascular disease and non-alcoholic fatty liver disease (NAFLD) make this need more than mandatory. Sodium-Glucose Co-Transporter-2 (SGLT-2) inhibitors (empagliflozin, canagliflozin, dapagliflozin, and ertugliflozin) are the latest class of agents to receive approval for the treatment of T2DM. Not long after their marketing, a wide spectrum of target organ-protective and overall beneficial health effects associated with their use began to unveil. An increasing bulk of evidence points towards that these actions are to a great degree independent of glucose lowering, which has led to the broadening of the indications of SGLT-12 inhibitors outside the frame of antihyperglycemic therapy. Additionally, their unique mode of action including an increased renal glucose excretion and hence, net energy loss could render SGLT-2 inhibitors attractive candidates for the treatment of obesity. Very few reviews in the literature have appraised holistically the therapeutic potential of SGLT-2 inhibitors in obesity and its associated complications. Herein, we synopsize the currently available evidence regarding the effects of drugs of this class on body adiposity, together with considerations which accompany their potential use with the aim of weight loss. Furthermore, we attempt an overview of their actions and future perspectives of their use with respect to a range of obesity-related disorders, which include cardiovascular, renal, as well as NAFLD, malignancy, and ovarian dysfunction.

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“…For example, lean versus obese NAFLD is associated with decreased Lactobacillus abundance [182,183] . Furthermore, non-obese steatohepatitis is associated with a different mycobiome, with a lower fungal richness, increased abundance of Candida albicans and Mucor spp, and decreased Saccharomyces cerevisiae [184] . C. albicans is known to induce a Th17 proinflammatory response [185] , and its richness is associated more with hepatic inflammation than steatosis [184] .…”

Section: Gut Microbiota and Mafldmentioning

confidence: 99%

“…Besides bacteria, the virome in patients with advanced fibrosis is different, with a decreased variability and a decreased relative abundance of bacteriophages, which may have a direct impact on modulating the taxonomic composition of the bacterial microbiota [198] . In addition, regarding mycobiome, Candida albicans relative abundance and immunogenicity seem to increase in patients with advanced fibrosis [184] .…”

Section: Gut Microbiota and Progression Of Mafldmentioning

confidence: 99%

MAFLD under the lens: the role of gut microbiota

Sousa¹,

Machado²

2022

Metab Target Organ Damage

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Obesity, the metabolic syndrome, and metabolic dysfunction-associated fatty liver disease (MAFLD) can be portrayed as transmissible diseases. Indeed, they can be induced, in animal models, by cohabitation or by transplantation of fecal microbiota from other animals or humans with those diseases. As such, to get a 10,000-foot view, we need to see under the lens the microbes that populate our gut. Gut microbiota participates in the harvesting of energy from nutrients, it allows the digestion of otherwise indigestible nutrients such as fibers, and it also produces short chain fatty acids and some vitamins while emitting different compounds that can regulate whole-body metabolism and elicit proinflammatory responses. The metabolic syndrome and MAFLD share physiopathology and also patterns of gut dysbiota. Moreover, MAFLD also correlates with dysbiota patterns that are associated with direct steatogenic or fibrogenic effects. In the last decade, a tremendous effort has allowed a fair understanding of the dysbiota patterns associated with MAFLD. More recently, research is moving towards the delineation of microbiota-targeted therapies to manage metabolic dysfunction and MAFLD. This review provides in-depth insight into the state-of-the-art of gut dysbiosis in MAFLD, targeting clinical hepatologists.

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Could gut mycobiome play a role in NAFLD pathogenesis? Insights and therapeutic perspectives

Cited by 14 publications

References 38 publications

State of the Gut Microbiota in Patients With Metabolic-Associated Fatty Liver Disease With Type 2 Diabetes Mellitus

State of the Gut Microbiota in Patients With Metabolic-Associated Fatty Liver Disease With Type 2 Diabetes Mellitus

SGLT-2 inhibitors in obesity and its associated cardiometabolic disorders: where do we stand?

MAFLD under the lens: the role of gut microbiota

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