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Gut microbiome-brain-cirrhosis axis.

Maren L Smith1,2, James B Wade3, Jennifer Wolstenholme1,2

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Cirrhosis disrupts the gut microbiome, impacting the gut-liver-brain axis and leading to neuropsychiatric issues like cognitive decline and mood disorders. Modulating the gut microbiome shows promise for treating these conditions.

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Area of Science:

  • Hepatology
  • Neuroscience
  • Microbiology

Background:

  • Cirrhosis involves liver inflammation, fibrosis, and failure, increasing risks for neuropsychiatric conditions like hepatic encephalopathy (HE), Alzheimer's, Parkinson's, anxiety, and depression.
  • The gut-liver-brain axis describes bidirectional communication between the gut, liver, and central nervous system, influencing organ function.
  • Gut dysbiosis, an imbalance in gut bacteria, is prevalent in cirrhosis and linked to cognitive and mood disturbances.

Purpose of the Study:

  • To review the pathophysiological and cognitive effects of cirrhosis.
  • To explore the link between cirrhosis and gut microbiome disruption.
  • To summarize evidence for gut microbiome modulation as a treatment for cirrhosis and associated neuropsychiatric conditions.

Main Methods:

  • Literature review of clinical studies and animal models.
  • Analysis of pathophysiological mechanisms.
  • Examination of gut microbiome alterations in cirrhosis patients.

Main Results:

  • Cirrhosis is associated with significant gut dysbiosis, even in the absence of alcohol use disorder.
  • Gut dysbiosis demonstrably influences cognitive and mood-related behaviors in cirrhosis.
  • The gut microbiome plays a critical role in gut-liver and gut-brain communication.

Conclusions:

  • The gut microbiome is a key factor in the pathophysiology of cirrhosis-associated neuropsychiatric conditions.
  • Targeting the gut microbiome offers a potential therapeutic strategy for managing cirrhosis complications.
  • Further research into the gut-liver-brain axis is crucial for developing effective treatments.