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| Compromised nutritional status in patients with end-stage liver disease: Role of gut microbiota |
| Maria Vasco a , Rossella Paolillo a , Concetta Schiano b , Linda Sommese a , c , *, Oreste Cuomo d , Claudio Napoli a , b , e |
a U.O.C. Division of Clinical Immunology, Immunohematology, Transfusion Medicine and Transplant Immunology, Regional Reference Laboratory of Transplant Immunology, Department of Internal and Specialty Medicine, Azienda Ospedaliera Universitaria, Universitàdegli Studi della Campania “Luigi Vanvitelli”, Naples 80138, Italy
b IRCCS SDN, Naples, Italy
c Department of Experimental Medicine, Universitàdegli Studi della Campania “Luigi Vanvitelli”, Napoli 80138, Italy
d Department of Liver Transplant, AORN A. Cardarelli, Naples, Italy
e Department of Medical, Surgical, Neurological, Metabolic and Geriatric Sciences, Universitàdegli Studi della Campania “Luigi Vanvitelli”, Naples, Italy
*Corresponding author.
E-mail address: linda.sommese@unicampania.it (L. Sommese). |
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Abstract BACKGROUND:
Patients with end-stage liver disease (ESLD) have a compromised nutritional status because of the liver crucial role in regulating metabolic homeostasis and energy balance.
DATA SOURCES:
A systematic review of literature based on extensive relevant articles published from 2001 to 2017 in English in PubMed database was performed by searching keywords such as liver disease, non-alcoholic liver disease, alcoholic liver disease, malnutrition, epigenetics, gut microbiota, and probiotics.
RESULTS:
Liver transplantation would be one eligible therapy for ESLD patients, even if, the clinical outcome is negatively influenced by malnutrition and/or infections. The malnutrition is a condition of nutrient imbalance with a high incidence in ESLD patients. An accurate evaluation of nutritional status could be fundamental for reducing complications and prolonging the survival of ESLD patients including those undergoing liver transplantation. In addition, the interaction among nutrients, diet and genes via epigenetics has emerged as a potential target to reduce the morbidity and mortality in ESLD patients. The malnutrition induces changes in gut microbiota causing dysbiosis with a probable translocation of bacteria and/or pathogen-derived factors from the intestine to the liver. Gut microbiota contribute to the progression of chronic liver diseases as well as hepatocellular carcinoma. The administration of probiotics modulating gut microbiota could improve all chronic liver diseases.
CONCLUSIONS:
This review provides an update on malnutrition status linked to epigenetics and the potential benefit of some probiotics on the management of ESLD patients. In support of this view and to reveal the constant and growing interest in this field, some clinical trials are reported.
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2018, Vol. 17 
