Gut-pancreas-liver axis as a target for treatment of nafld/nash

Gianluca Svegliati-Baroni, Bárbara Patrício, Gessica Lioci, Maria Paula Macedo, Amalia Gastaldelli

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Abstract

Non-alcoholic fatty liver disease (NAFLD) represents the most common form of chronic liver disease worldwide. Due to its association with obesity and diabetes and the fall in hepatitis C virus morbidity, cirrhosis in NAFLD is becoming the most frequent indication to liver transplantation, but the pathogenetic mechanisms are still not completely understood. The so-called gut-liver axis has gained enormous interest when data showed that its alteration can lead to NAFLD development and might favor the occurrence of non-alcoholic steatohepatitis (NASH). Moreover, several therapeutic approaches targeting the gut-pancreas-liver axis, e.g., incretins, showed promising results in NASH treatment. In this review, we describe the role of incretin hormones in NAFLD/NASH pathogenesis and treatment and how metagenomic/metabolomic alterations in the gut microbiota can lead to NASH in the presence of gut barrier modifications favoring the passage of bacteria or bacterial products in the portal circulation, i.e., bacterial translocation.

Original languageEnglish
Article number5820
Pages (from-to)1-39
Number of pages39
JournalInternational Journal of Molecular Sciences
Volume21
Issue number16
DOIs
Publication statusPublished - 2 Aug 2020

Keywords

  • Glucose metabolism
  • Gut-pancreas-liver axis
  • Incretins
  • Lipid metabolism
  • Non-alcoholic fatty liver disease
  • Non-alcoholic steatohepatitis
  • Type-2 diabetes

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