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FROM GUT TO LIVER: MICROBIOTA-BASED INTERVENTIONS FOR NAFLD

Khrystyna Kvit 1, Vasyl Prysyazhnyuk 2, Nataliia Kharchenko 3, Viacheslav Kharchenko 4

Affiliations

1 Danylo Halytsky Lviv National Medical University, Lviv, Ukraine

2 Bukovinian State Medical University, Chernivtsi, Ukraine

3 Shupyk National Healthcare University of Ukraine, Kyiv, Ukraine

4 National Medical Academy of Postgraduate Education by P.Shupyk, Kyiv, Ukraine

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Abstract

Introduction

Nonalcoholic fatty liver disease (NAFLD) is a widespread metabolic disorder associated with intestinal dysbiosis, low-grade systemic inflammation, and small intestinal bacterial overgrowth (SIBO). Targeting the gut-liver axis through microbiome-modulating therapies may represent a promising approach to disease management.

Aims & Methods

The aim was to investigate gut microbiota alterations in NAFLD patients and assess the efficacy of microbiota-based therapy on metabolic, inflammatory, and structural liver parameters. The study included 152 NAFLD patients and 47 controls. Gut microbiota composition was evaluated using qRT-PCR, and SIBO was diagnosed via hydrogen breath testing. The therapeutic protocol included rifaximin (200 mg TID for 14 days), Saccharomyces boulardii CNCM I-745 (1 capsule BID for 30 days), and essential phospholipids (600 mg TID for 30 days). Liver function tests, inflammatory markers, and steatometry were assessed before and after treatment.

Results

Alterations in gut microbiota composition indicative of dysbiosis—including increased Firmicutes/Bacteroides ratio and Actinobacteria abundance—were identified in NAFLD. Strong correlations emerged between the F/B index and triglycerides (r = 0.78), TNF-α (r = 0.77), and between Actinobacteria and hsCRP (r = 0.66). SIBO rates declined significantly post-treatment (51% → 17%). Liver enzymes, inflammatory markers, and steatometric parameters improved substantially (p<0.05).

Conclusion

Microbiota-targeted therapy combining rifaximin, S. boulardii, and phospholipids effectively corrected dysbiosis, reduced inflammation, improved metabolic parameters, and promoted liver structural recovery in NAFLD patients. These findings support incorporating microbiome-focused interventions into routine clinical practice for NAFLD.

Conference

UEG Week Berlin 2025

Topics

Hepatobiliary

Submission format

Abstract

Session

LIVER (Posters)

Citation

United European Gastroenterology Journal 2025; 13 (Supplement 8)

Published

2025

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ESOPHAGEAL MOTILITY AND GASTROESOPHAGEAL REFLUX DISEASE IN PATIENTS WITH TYPE 2 DIABETES OPERATED WITH GASTRIC BYPASS OR SLEEVE GASTRECTOMY, 5-YEAR RESULTS FROM THE OSEBERG STUDY

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