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Abstract Details
Current Concepts, Opportunities, and Challenges of Gut Microbiome-Based Personalized Medicine in Nonalcoholic Fatty Liver Disease
Cell Metab. 2020 Dec 3;S1550-4131(20)30605-7. doi: 10.1016/j.cmet.2020.11.010.Online ahead of print.
S R Sharpton1, B Schnabl2, R Knight3, R Loomba4
Author information
1Division 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.
2Division 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.
3Center 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.
4Division 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.