Alcoholic Liver Disease Aggravated by Intestinal Fungi

OVERGROWTH of intestinal fungi may exacerbate alcoholic liver disease (ALD), suggests a new study by researchers at the University of California, San Diego, California, USA and the J. Craig Venter Institute, Rockville, Maryland, USA. ALD, a term which encompasses a wide variety of liver diseases, including cirrhosis, has previously been linked with bacterial overgrowth in the intestines, but, until now, little research had been conducted on the role of intestinal fungi.

The study observed that intestinal fungi flourished in mice chronically exposed to alcohol and appeared to contribute to the worsening of the mice’s ALD. Researchers hypothesised that preventing the overgrowth of intestinal fungi could protect the mice from alcohol-induced disease, and thus some mice were treated with the anti-fungal agent amphotericin B. Results were promising, finding that mice treated with amphotericin B had lower levels of liver injury and fat accumulation compared to those left untreated.

Preliminary studies in humans were also conducted, examining the intestinal fungi of people who had alcohol use disorder and were at various stages of liver disease. The researchers recorded an overgrowth of specific fungal species within these subjects’ intestines, in addition to less fungal diversity when compared to the healthy control group. Importantly, it was also noted that the more prevalent the fungal overgrowth, the greater the risk of mortality in subjects with ALD.

The results of this study reveal a promising new direction for research into combatting ALD. Whilst further studies are required to confirm the role of intestinal fungi in the development of ALD, researchers are hopeful that, if such a connection is made, it may be possible to slow the progression of liver diseases by manipulating the composition of a patient’s intestinal fungi. Cirrhosis, one aspect of ALD, is the 12th leading cause of death internationally, with ~50% of those deaths attributed to alcohol misuse; thus, the ramifications of this discovery could have a great impact.

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