The fecal mycobiome in non-alcoholic fatty liver disease

Roles for the mycobiome in liver disease

“…Compositional changes in faecal mycobiome were analysed using ITS2 sequencing in a cross‐sectional study of subjects with NAFLD 23 . Beta diversity analysis captured more differences among non‐obese subjects than obese subjects.…”

“…One approach involves the use of antifungal agents to control overgrowth in the intestine. The antifungal drug amphotericin B, for example, was shown to prevent ethanol‐induced liver damage in mice 17 and western diet‐induced steatohepatitis in mice 23 . Mice that received the amphotericin B while on an ethanol diet did not develop intestinal fungal overgrowth and had lower levels of liver injury and hepatic steatosis.…”

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

“…In line with the observation of Lee et al that altered fecal bacterial microbiome represents a risk factor for disease progression in non obese NAFLD patients [ 7 ], the authors hypothesize that compositional changes in the fungal microbiome could similarly represent a prominent pathogenetic factor of advanced NAFLD in this group of patients [ 8 ]. In order to investigate specific compositional changes between groups, Demir et al performed differential multinomial regression analyses using the novel tool Songbird.…”

“…In the non-obese group, patients with NAFLD at advanced stages (NASH or F2–F4 fibrosis) had different fecal mycobiome compositions than patients with NAFLD at earlier stages (NAFLD or F0–F1 fibrosis). When assessing alpha-diversity (estimate of similarity or dissimilarity within a sample), apart from a lower fungal richness in non-obese patients with NAFLD and more severe liver disease, the authors did not observe significant differences among groups [ 8 ]. Pathophysiological mechanisms leading to the lean phenotype of NAFLD are not yet understood but may include apart from a different pattern of gut microbiota, a dysfunctional adipose tissue, altered body composition, genetic differences and epigenetic changes [ 3 ].…”

“…For non obese NAFLD patients with more severe fibrosis (F2–F4 stages), Mucor spp and Candida albicans were among others associated positively with F2–F4 fibrosis [ 8 ]. Mucor sp., which has been classified as an opportunistic pathogen in immunocompomised patients, particularly in hematologic patients under chemotherapy, and subjects with uncontrolled diabetes, was associated with high blood glucose levels in the study.…”