Current Concepts, Opportunities, and Challenges of Gut Microbiome-Based Personalized Medicine in Nonalcoholic Fatty Liver Disease

S R Sharpton; B Schnabl; R Knight; R Loomba

doi:10.1016/j.cmet.2020.11.010

Current Concepts, Opportunities, and Challenges of Gut Microbiome-Based Personalized Medicine in Nonalcoholic Fatty Liver Disease

Cell Metab. 2021 Jan 5;33(1):21-32. doi: 10.1016/j.cmet.2020.11.010. Epub 2020 Dec 8.

Authors

S R Sharpton¹, B Schnabl², R Knight³, R Loomba⁴

Affiliations

¹ Division of Gastroenterology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA; NAFLD Research Center, Division of Gastroenterology, University of California, San Diego, La Jolla, CA, USA.
² Division of Gastroenterology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA; Department of Medicine, VA San Diego Healthcare System, San Diego, CA, USA; Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA, USA.
³ Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA, USA; Department of Computer Science & Engineering, Jacobs School of Engineering, University of California, San Diego, La Jolla, CA, USA; Department of Bioengineering, Jacobs School of Engineering, University of California, San Diego, La Jolla, CA, USA; Department of Pediatrics, University of California, San Diego, La Jolla, CA, USA.
⁴ Division of Gastroenterology, Department of Medicine, University of California, San Diego, La Jolla, CA, USA; NAFLD Research Center, Division of Gastroenterology, University of California, San Diego, La Jolla, CA, USA; Center for Microbiome Innovation, University of California, San Diego, La Jolla, CA, USA. Electronic address: roloomba@ucsd.edu.

Abstract

Nonalcoholic fatty liver disease (NALFD) is now a leading cause of chronic liver disease worldwide, in part, as a consequence of rapidly rising levels of obesity and metabolic syndrome and is a major risk factor for cirrhosis, hepatocellular carcinoma, and liver-related mortality. From NAFLD stems a myriad of clinical challenges related to both diagnosis and management. A growing body of evidence suggests an intricate linkage between the gut microbiome and the pathogenesis of NAFLD. We highlight how our current knowledge of the gut-liver axis in NAFLD may be leveraged to develop gut microbiome-based personalized approaches for disease management, including its use as a non-invasive biomarker for diagnosis and staging, as a target for therapeutic modulation, and as a marker of drug response. We will also discuss current limitations of these microbiome-based approaches. Ultimately, a better understanding of microbiota-host interactions in NAFLD will inform the development of novel preventative strategies and precise therapeutic targets.

Keywords: biomarker; cirrhosis; fibrosis; microbiota; nonalcoholic steatohepatitis.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Review

MeSH terms

Animals
Gastrointestinal Microbiome*
Host Microbial Interactions
Humans
Non-alcoholic Fatty Liver Disease / metabolism*
Non-alcoholic Fatty Liver Disease / pathology
Precision Medicine*

Abstract

Publication types

MeSH terms

Grants and funding