Gut Microbiota Might Be the Key to Fight Against Fatty Liver

Manipulate Intestinal Bacteria to Avoid Obesity-related Hepatic Complications

Non-alcoholic Fatty Liver Disease
Non-alcoholic fatty liver disease (NAFLD) is a chronic liver disorder that is increasing rapidly due to staggering obesity rates. Almost 70-80% of individuals with obesity and type 2 diabetes have ‘fatty liver.’ NAFDL is the accumulation of excess fat in liver cells that is not due to alcohol. Normally any liver can contain fat but when the fat is more than 5-10% of the liver’s weight, then it is termed as fatty liver (steatosis).
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NAFLD is generally seen in overweight/obese people and in those who have diabetes, high cholesterol and high triglycerides. Rapid weight loss and poor eating habits may also lead to the development of non-alcoholic fatty liver disease. Often present with no symptoms, when symptoms do occur they manifest in the form of fatigue, weakness, weight loss, loss of appetite, nausea, abdominal pain, spider-like blood vessels, skin and eyes (jaundice) turning yellow, itching, fluid buildup, mind confusion and swelling of the legs (edema) and abdomen (ascites). Fatty liver disease is increasingly seen in childhood and adolescent obesity and exists as the most common form of chronic liver disease in these age groups.

Gut Microbiota
The gut microbiota acts just like an Akshaya Patra (meaning an inexhaustible vessel according to Hindu mythology that keeps supplying food indefinitely) surprising us with a continuous rendering of news and facts that are decoded while exploring it. There is a plethora of information available about the gut microbiota in the website www.firsteatright.com.

The human gut consists of a large number of microbiota that play important roles right from absorbing nutrients to energy homeostasis. The liver exists as the first point of contact for bacterial and microbial components, endogenous and exogenous toxins present in the portal blood and acts as the first one to trigger an immunological response to these molecules.

A new study published in the journal ‘Nature Medicine’ shows how certain gut bacteria cause the accumulation of fat in the liver and play a crucial role in fatty liver disease (hepatic steatosis). The research could make way for the availability of biomarkers to predict the disease and suggest solutions based on nutritional and pharmacological approaches along with the use of probiotics.

Fat accumulation in the liver is associated with inflammation, chances of liver failure and a diminished ability to filter environmental and dietary toxins enhancing the risk of cancer. Fatty liver is a cunning disease, in the sense that there is no medical treatment as such available till date. The only treatment options exist in the form of diet modifications and liver transplant.

The Study
The study split 800 obese men and women into two groups depending on the presence or absence of fatty liver noting down a huge set of medical data. In a small group of 100 obese women, molecular analysis was done on liver biopsies and urine, fecal and plasma samples. The main concern of the researchers was to find out whether the microbiota was majorly involved in the onset of fatty liver due to obesity and type 2 diabetes. The researchers used a big data approach to get an answer to their queries. A huge database comprising of various molecular details of the microbiota, liver genes, plasma proteins and urine proteins were created and the information collected on female patients’ biopsies and clinical data was used. Algorithms were later developed to catch hold of any link between these data sets.

The algorithm scanned through three million bacterial genes and the researchers found two things of primary importance:

1. Greater the disease progression, greater the fall in microbial gene diversity which might lead to diminished microbiota composition even before any symptoms start appearing
2. A compound of the microbiota, phenylacetic acid, initiates fat accumulation in the liver while lipopolysaccharides trigger inflammation
   
   

These results motivate the researchers to think positively that in the long run, it might be possible to prevent hepatic complications of obesity by manipulating intestinal bacteria. There also exists the chances of developing a new generation of probiotics, food supplements and medicines that can dissuade the bacterial mechanisms that cause liver disease.