European Journal of Biomedical and Pharmaceutical Sciences

ROLE OF GUT MICROBIOTA IN ALCOHOL-RELATED LIVER DISEASE: FROM PATHOGENESIS TO MICROBIOME-BASED THERAPEUTIC APPROACHES

Shruti Kadam*, Aditya Gawad, Kirti Jamkar, Shriyash Jangavali, Priti Dakh, Shraddha Papade

ABSTRACT

Alcohol-related liver disease (ALD) is a major cause of chronic liver injury, ranging from hepatic steatosis and alcoholic hepatitis to cirrhosis and liver failure. Increasing evidence indicates that disruption of the gut–liver axis is an important contributor to ALD pathogenesis. Chronic alcohol exposure alters gut microbial composition, promotes intestinal permeability, facilitates bacterial translocation, and increases exposure to microbial products such as lipopolysaccharide. These changes activate hepatic immune pathways, oxidative stress, and inflammatory responses, thereby contributing to disease progression. Gut microbiota alterations may also influence intestinal metabolites, bile acid metabolism, and immune regulation. Consequently, microbiome-directed interventions have emerged as potential therapeutic strategies. Dietary modification, prebiotics, probiotics, synbiotics, antibiotics, and faecal microbiota transplantation have demonstrated varying degrees of benefit in experimental and clinical studies. This review summarizes the role of gut microbiota in ALD pathogenesis and evaluates emerging microbiome-based approaches for restoring intestinal homeostasis and improving liver outcomes.

Keywords: Alcohol-related liver disease, Gut microbiota, Gut–liver axis, Dysbiosis and Microbiome-based therapy.