Gut-Liver-Brain Axis and Alcohol Use Disorder: Treatment Potential of Fecal Microbiota Transplantation.
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
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
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 |
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.