Manipulating the microbiota with supplemental Akkermansia muciniphila may offer hope for the global and hard-to-treat problem of alcoholic liver disease (ALD), a preliminary U.S.-European study in humans and mice suggested.
One modulator of ALD is the integrity of the intestinal barrier, and this integrity is supported by A. muciniphila, a Gram-negative intestinal commensal bacterium that enhances mucus production. In healthy people, this organism constitutes as much as 4% of fecal microbiota, according to Herbert Tilg, MD, of the Medical University in Innsbruck, Austria, and colleagues.
"We propose that depletion of A. muciniphilareflects an early event in the pathophysiology of ALD, probably by regulating gut barrier function. Recovery of ethanol-induced A. muciniphila depletion by oral supplementation could represent a novel treatment option for patients with ALD," they wrote in Gut.
ALD is the most common cause of liver-related deaths worldwide and is responsible for 5.9% of all global deaths. It encompasses simple steatosis, fibrosis, and cirrhosis, all of which can deteriorate toward acute alcoholic steatohepatitis (ASH) with its high mortality rates.
"Despite our increasing understanding of ALD pathogenesis, treatment strategies remain scarce," Tilg's group stated.
The degree of liver injury varies among individuals with ALD, and researchers increasingly believe that the microbiota plays a role in this variation. They are hopeful that appropriate probiotic supplementation may reduce hepatic injury.