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Gut-Liver-Brain Axis and Alcohol Use Disorder: Treatment Potential of Fecal Microbiota Transplantation.

Alcohol research : current reviews
January 1, 2024
Jennifer T Wolstenholme et al. (4 authors)
Journal ArticleReviewResearch Support, N.I.H., ExtramuralResearch Support, Non-U.S. Gov'tResearch Support, U.S. Gov't, Non-P.H.S.Human Study
Study Details

Study Goal

The researchers aimed to review the role of fecal microbiota transplantation (FMT) in mitigating alcohol-associated alterations to the liver, gut, and brain, and to assess its therapeutic potential for alcohol use disorder (AUD) and alcohol-associated liver disease (ALD).

Results Summary

The review found limited but promising evidence that FMT and probiotic supplementation can alleviate some symptoms of ALD and influence behaviors linked to increased alcohol use, though the therapeutic application of FMT remains investigatory.

Population

Human and preclinical (rodent) studies focusing on alcohol use disorder and alcohol-associated liver disease.

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (9)
InterventionDirectionEndpointPopulationDosageImpactClaim #
alcohol consumption
neutral
gut microbiota
-
-
has direct effects on
#1
alcohol consumption
neutral
diversity of bacteria
-
-
altering
#2
alcohol consumption
increase
bacterial overgrowth
-
-
leading to
#3
alcohol
increase
alcohol consumption
-
-
may contribute to increased
#4
alcohol
neutral
alcohol-associated liver disease (ALD)
-
-
may contribute to progression of
#5
fecal microbiota transplantation (FMT)
decrease
alcohol-associated alterations to the liver, gut, and brain
-
-
ameliorating
#6
alcohol
neutral
gut microbiome
-
-
can alter
#7
microbiome
neutral
affective behaviors frequently associated with increased alcohol use
humans and rodents
-
can be transferred between humans and rodents to alter
#8
FMT or other probiotic supplementation
decrease
some of the symptoms associated with ALD and drinking
-
-
have shown promise in alleviating
#9
Abstract

PURPOSE: Chronic alcohol use is a major cause of liver damage and death. In the United States, multiple factors have led to low utilization of pharmacotherapy for alcohol use disorder (AUD), including lack of provider knowledge and comfort in prescribing medications for AUD. Alcohol consumption has direct effects on the gut microbiota, altering the diversity of bacteria and leading to bacterial overgrowth. Growing evidence suggests that alcohol's effects on the gut microbiome may contribute to increased alcohol consumption and progression of alcohol-associated liver disease (ALD). This article reviews human and preclinical studies investigating the role of fecal microbiota transplantation (FMT) in ameliorating alcohol-associated alterations to the liver, gut, and brain resulting in altered behavior; it also discusses the therapeutic potential of FMT. SEARCH METHODS: For this narrative review, a literature search was conducted in September 2022 of PubMed, Web of Science Core Collection, and Google Scholar to identify studies published between January 2012 and September 2022. Search terms used included "fecal microbiota transplantation" and "alcohol." SEARCH RESULTS: Most results of the literature search were review articles or articles on nonalcoholic fatty liver disease; these were excluded. Of the remaining empirical manuscripts, very few described clinical or preclinical studies that were directly investigating the effects of FMT on alcohol drinking or related behaviors. Ultimately, 16 studies were included in the review. DISCUSSION AND CONCLUSIONS: The literature search identified only a few studies that were directly investigating the effect of FMT on ALD or alcohol drinking and related behaviors. Largely proof-of-concept studies, these findings demonstrate that alcohol can alter the gut microbiome and that the microbiome can be transferred between humans and rodents to alter affective behaviors frequently associated with increased alcohol use. Other studies have shown promise of FMT or other probiotic supplementation in alleviating some of the symptoms associated with ALD and drinking. These results show that the implementation of FMT as a therapeutic approach is still in the investigatory stages.

Medical Subject Headings (MeSH)
HumansFecal Microbiota TransplantationAlcoholismNon-alcoholic Fatty Liver DiseaseLiver Diseases, AlcoholicAlcohol Drinking
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality70/10
Citation Metrics
Total Citations13
Citations/Year13.0
Relative Citation Ratio4.88
Research Impact Scores
APT Score0.95
Weight Score2.84
Normalized Score0.60
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