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World J Hepatol. Mar 27, 2025; 17(3): 104167
Published online Mar 27, 2025. doi: 10.4254/wjh.v17.i3.104167
Gut microbiota in the development and progression of chronic liver diseases: Gut microbiota-liver axis
Aysun Yakut
Aysun Yakut, Department of Gastroenterology, İstanbul Medipol University Sefakoy Health Practice Research Center, İstanbul 38000, Türkiye
Author contributions: Yakut A designed the overall concept and outline of the manuscript, wrote and edited the manuscript, and performed the literature review.
Conflict-of-interest statement: The author reports no relevant conflicts of interest for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Aysun Yakut, MD, Department of Gastroenterology, İstanbul Medipol University Sefakoy Health Practice Research Center, Maslak Cesme Street, Tevfikbey District, Kucukcekmece, İstanbul 38000, Türkiye. aysun.yakut@istanbul.edu.tr
Received: December 12, 2024
Revised: January 28, 2025
Accepted: February 25, 2025
Published online: March 27, 2025
Processing time: 104 Days and 10.1 Hours
Abstract

The gut microbiota (GM) is a highly dynamic ecology whose density and composition can be influenced by a wide range of internal and external factors. Thus, “How do GM, which can have commensal, pathological, and mutualistic relationships with us, affect human health?” has become the most popular research issue in recent years. Numerous studies have demonstrated that the trillions of microorganisms that inhabit the human body can alter host physiology in a variety of systems, such as metabolism, immunology, cardiovascular health, and neurons. The GM may have a role in the development of a number of clinical disorders by producing bioactive peptides, including neurotransmitters, short-chain fatty acids, branched-chain amino acids, intestinal hormones, and secondary bile acid conversion. These bioactive peptides enter the portal circulatory system through the gut-liver axis and play a role in the development of chronic liver diseases, cirrhosis, and hepatic encephalopathy. This procedure is still unclear and quite complex. In this study, we aim to discuss the contribution of GM to the development of liver diseases, its effects on the progression of existing chronic liver disease, and to address the basic mechanisms of the intestinal microbiota-liver axis in the light of recent publications that may inspire the future.

Keywords: Gut microbiota; Gut microbiota-liver axis; Liver diseases; Treatment strategies and modeling; Chronic liver diseases

Core Tip: The gut microbiota (GM) plays an active role in both physiological and pathological processes for the host. These microbiomes and their metabolites living in the intestine interact with the host metabolism and reach the liver via portal flow. This interaction creates many defined and undefined mechanisms, forming the intestinal microbiota-liver axis. GM, together with the host interaction, can play a triggering role in the development of chronic diseases in the liver, and can also cause the existing chronic liver disease to complicate. GM, surprisingly, can also contribute to the progression of cirrhosis, cirrhosis complications and hepatocellular carcinoma.