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Nonalcoholic Fatty Liver Disease and the Gut Microbiota: Exploring the Connection

Edward C. Oldfield, Ray Z. Dong and David A. Johnson

As the gut microbiota continues to be implicated in an increasing number of disease processes, a plethora of new literature surrounding its complexity and role in the maintenance of intestinal homeostasis has become available. Nonalcoholic fatty liver disease (NAFLD) has become the most common nonviral liver disease worldwide and a number of predisposing risk factors for NAFLD have been identified, including obesity and insulin resistance. Recent evidence supports a role for the gut microbiota in the pathogenesis of these risk factors and NAFLD itself. Additionally changes in the gut microbiota can lead to activation of immune responses that have the potential to promote progression of NAFLD to the more severe nonalcoholic steatohepatitis (NASH). Furthermore, the gut microbiota may serve as a potential target for therapeutic options to treat NAFLD. This review seeks to explain the role of the gut microbiota in the pathogenesis of NAFLD and its risk factors, while also discussing potential future treatment options directed at correcting imbalances with in the gut microbiota.