Probiotics and Liver Disease: Where Are We Now and Where Are We Going?

Probiotics are live, nonpathogenic bacteria capable of colonizing the colonic mucosa. The most common probiotics include strains of Lactobacillus or Bifidobacteria, which are part of the normal gastrointestinal microbiota. Initial studies of selected probiotic species have suggested potential efficacy in several gastrointestinal diseases including inflammatory bowel diseases (particularly pouchitis), antibiotic-related diarrhea, Clostridium difficile toxin-induced colitis, infectious diarrhea, irritable bowel syndrome, and allergy. The so-called "gut-liver axis" involves complex interaction between the liver parenchyma and gut microbiota. There is growing evidence to suggest that alteration in gut microbial components may affect the liver and can be a precipitating cofactor in development and modulating of chronic liver damage through ethanol, production of ammonia and endotoxin. This may allow for a better understanding of its role in the pathogenesis of verities of liver diseases and help to identify a microbial target for prevention and treatment of such diseases. This paper discusses the growing evidence that highlights the relationship between gut microbiota and development, prevention and treatment of numbers of liver diseases.