Interactions between the intestinal microbiome and liver diseases

Gastroenterology. 2014 May;146(6):1513-24. doi: 10.1053/j.gastro.2014.01.020. Epub 2014 Jan 15.


The human intestine harbors a diverse community of microbes that promote metabolism and digestion in their symbiotic relationship with the host. Disturbance of its homeostasis can result in disease. We review factors that disrupt intestinal homeostasis and contribute to nonalcoholic fatty liver disease, steatohepatitis, alcoholic liver disease, and cirrhosis. Liver disease has long been associated with qualitative and quantitative (overgrowth) dysbiotic changes in the intestinal microbiota. Extrinsic factors, such as the Western diet and alcohol, contribute to these changes. Dysbiosis results in intestinal inflammation, a breakdown of the intestinal barrier, and translocation of microbial products in animal models. However, the contribution of the intestinal microbiome to liver disease goes beyond simple translocation of bacterial products that promote hepatic injury and inflammation. Microbial metabolites produced in a dysbiotic intestinal environment and host factors are equally important in the pathogenesis of liver disease. We review how the combination of liver insult and disruptions in intestinal homeostasis contribute to liver disease.

Keywords: Alcoholic Steatohepatitis; Endotoxin; Microbiota.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Bacteria / classification
  • Bacteria / metabolism*
  • Bile Acids and Salts / metabolism
  • Dysbiosis
  • Fatty Liver / metabolism
  • Fatty Liver / microbiology
  • Host-Pathogen Interactions
  • Humans
  • Intestines / microbiology*
  • Liver Cirrhosis / metabolism
  • Liver Cirrhosis / microbiology
  • Liver Diseases / metabolism
  • Liver Diseases / microbiology*
  • Liver Diseases, Alcoholic / metabolism
  • Liver Diseases, Alcoholic / microbiology
  • Microbiota*
  • Non-alcoholic Fatty Liver Disease
  • Risk Factors


  • Bile Acids and Salts