Nonalcoholic fatty liver disease (NAFLD) has emerged as the most common cause of liver disease among children and adolescents in industrialized countries due to increasing prevalence of obesity. It is generally recognized that both genetic and environmental risk factors contribute to the pathogenesis of NAFLD. Convincing evidences have shown that gut microbiota alteration is associated with NAFLD pathogenesis both in patients and animal models. Bacterial overgrowth and increased intestinal permeability are evident in NAFLD patients and lead to increased delivery of gut-derived bacterial products, such as lipopolysaccharide and bacterial DNA, to the liver through portal vein and then activation of toll-like receptors (TLRs), mainly TLR4 and TLR9, and their downstream cytokines and chemokines, resulting in hepatic inflammation. Currently, the role of gut microbiota in the pathogenesis of NAFLD is still the focus of many active clinical/basic researches. Modulation of gut microbiota with probiotics or prebiotics has been targeted as a preventive or therapeutic strategy on this pathological condition. Their beneficial effects on the NAFLD have been demonstrated in animal models and limited human studies.
Part of the book: The Gut Microbiome