How Diet-Induced Changes in the “Gut-Liver” Axis Affect Chronic Liver Disease Outcome?

Abstract

Hepatocellular carcinoma (HCC) occurs in patients with chronic liver damage, inflammation and cirrhosis. The facilitators involved in increasing the HCC risk in the damaged liver are yet to be discovered. Diet and lifestyle have a profound effect on the liver inflammation and HCC. The term “gut liver axis” describes the bidirectional relationship between the liver and the gut, which are both anatomically and functionally related. Chronic liver damage is characterised by increased intestinal permeability that allows the translocation of various components and metabolites from the gut microbiota to the liver, resulting in liver inflammation and fibrosis. In this review, we discuss how diet-induced changes in gut microbiome composition, such as lipopolysaccharide and lipoteichoic acid, and its metabolites, such as bile acids, play a role in the pathogenesis of liver fibrosis and HCC.

Non-alcoholic fatty liver disease-related hepatocellular carcinoma

“… 37 Weight loss not only reduces and reverses NAFLD, but also alters the “liver-gut” axis rendering the gut microbiome less implicated in liver fibrosis and HCC development. 38 A propensity matched study revealed that bariatric surgery among obese patients was associated with lower incidence of NASH and HCC in a 7-year follow-up period. 39 However, there are no data on weight loss leading to HCC risk reduction among NASH patients specifically.…”

Obesity Management in the Primary Prevention of Hepatocellular Carcinoma

“…In pre-clinical models, induction of a chronic negative energy balance via calorie restriction [ 87 , 88 ], intermittent fasting [ 89 ], and/or time-restricted feeding [ 90 ] decreases the incidence and multiplicity of liver cancer. Mechanistically, prevention appears to be driven by metabolic improvements, the resolution of pre-existing liver disease, and the restoration of immune function [ 88 , 89 , 91 ]. Additionally, dietary intake impacts the composition of the gut microbiome, the type and concentration of circulating bile acids, and the integrity of the gut barrier permeability, all of which affect HCC development [ 91 ].…”

“…Mechanistically, prevention appears to be driven by metabolic improvements, the resolution of pre-existing liver disease, and the restoration of immune function [ 88 , 89 , 91 ]. Additionally, dietary intake impacts the composition of the gut microbiome, the type and concentration of circulating bile acids, and the integrity of the gut barrier permeability, all of which affect HCC development [ 91 ]. Overall, there is a need for improved investigation using the gold-standard controlled feeding studies to assess specific dietary interventions for the prevention of HCC and whether they require weight loss.…”

Reducing Liver Cancer Risk through Dietary Change: Positive Results from a Community-Based Educational Initiative in Three Racial/Ethnic Groups

“…Specifically, higher intake of whole grain and dietary fiber have been linked to lower risks of liver cancer and liver disease mortality [32]. In addition, food groups such as red and processed meats that include saturated fats, as well as high sodium consumption, were found to be positively correlated with HCC occurrence whereas high consumption of white meat, fish, fiber, vegetables, and fruits were associated with lower HCC risks [33][34][35][36][37]. Alcohol has been a confirmed risk factor of liver cancer [29].…”