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Microbiota and nonalcoholic fatty liver disease

promising prospects for clinical interventions?

Knudsen, Christellea,b; Neyrinck, Audrey M.a; Lanthier, Nicolasc,d; Delzenne, Nathalie M.a

Current Opinion in Clinical Nutrition & Metabolic Care: September 2019 - Volume 22 - Issue 5 - p 393–400
doi: 10.1097/MCO.0000000000000584
NUTRITION AND THE GASTROINTESTINAL TRACT: Edited by M. Isabel T.D. Correia and André Van Gossum

Purpose of review Nonalcoholic fatty liver disease (NAFLD) is becoming the most important cause of chronic liver disease in Western countries but no pharmacological therapy is currently available. Growing evidence suggests that the microbiota plays a role in the occurrence and evolution of this disease, namely through the production of bioactive metabolites.

Recent findings Omics technologies (metagenomic, metabolomic, and phenomic data) allow providing a robust prediction of steatosis. More than just correlations, causative effects of certain bacterial metabolites have been evidenced in vitro and in rodent models. Butyrate has been shown to be a potent metabolic and inflammatory modulator in the liver. Several aromatic amino-acids such as phenylacetic acid, imidazole propionate, and 3-(4-hydroxyphenyl)lactate have been identified as potential inducers of steatosis and hepatic inflammation, whereas indolic compounds (indole and indole-3-acetate) seem to preserve liver integrity. Current clinical trials aim at evaluating the efficacy of novel approaches (functional foods, prebiotic and probiotics, and fecal microbial transplants).

Summary The microbiota brings new hopes in the management of nonalcoholic fatty liver diseases, including nonalcoholic steatohepatitis. Adequate intervention studies in targeted patients are needed to unravel the relevance of such approaches in the management of those liver diseases.

aMetabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université catholique de Louvain, Brussels, Belgium

bGenPhySE, Université de Toulouse, INRA, ENVT, Castanet Tolosan, France

cService d’Hépato-gastroentérologie, Cliniques universitaires Saint-Luc

dLaboratory of Gastroenterology and Hepatology, Institut de Recherche Expérimentale et Clinique, UCLouvain, Université catholique de Louvain, Brussels, Belgium

Correspondence to Nathalie M. Delzenne, PhD, Metabolism and Nutrition Research Group, Louvain Drug Research Institute, UCLouvain, Université catholique de Louvain, 73 av. E. Mounier Box B1.73.11, B-1200 Brussels, Belgium. Tel: +3227647369; e-mail:

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