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Candida overgrowth accompanied by an increased systemic exposure and immune response to fungi which
correlated to mortality. Also, findings from the ethanol-treated mouse model supported the role of fungi in
ALD as the treatment with an antifungal drug, amphotericin B, protected mice from intestinal fungal overgrowth, reduced beta-glucan translocation and
ameliorated ethanol-induced liver disease.108 So, it
seems that chronic exposure to ethanol resulting in
fungal overgrowth and translocation of fungal products
into the liver may lead to liver inflammation and cirrhosis. To sum up, the manipulation of both microbial
and fungal components of the gut microbiome might be
a promising strategy in the treatment of ALD.

including, among others, lack of physical activity,
stress, dietary changes, xenobiotics and medication.
The altered, that is, dysbiotic, microbiota is associated
with multiple chronic inflammatory diseases. Whether
dysbiosis is a direct cause or a consequence of the disease remains unclear, but animal models, especially
gnotobiotic models, prove to be a tremendously
useful tool when addressing these questions.
Undoubtably, gut microbiota is a central player in the
pathogenesis of chronic inflammatory diseases.
However, further well-designed studies are needed to
increase our knowledge of host-microbiome physiology
to enable us to create new diagnostic, preventative and
therapeutic strategies.

Microbiota and cirrhosis

Acknowledgements

Cirrhosis, a final stage of many chronic liver diseases
including NAFLD, ALD, cholestatic liver diseases and
viral hepatitis, is characterised by replacement of
healthy liver tissue with non-functional fibrous tissue.
Cirrhosis, as well as NAFLD and ALD, is associated
with gut microbiota alterations, including dysbiosis and
SIBO. Qin et al. showed that the intestinal tract of cirrhosis patients is massively colonised by microorganisms usually associated with the oral cavity, such as
Veillonela and Streptococcus.109 The overrepresentation
of oral microbiota in the small intestines of cirrhosis
patients was also confirmed by Chen et al.110 Like
ALD patients, the cirrhosis patients demonstrate a significant fungal dysbiosis. Also, a bacterial-fungal ratio,
specifically the Bacteroidetes/Ascomycota ratio, was
shown to reliably predict the length of hospitalisation
of these patients.111
The treatment of cirrhosis and its complications
include reduction of the gut microbiota load with
non-absorbable antibiotics.112 In animal models, therapeutic strategies based on the blocking of microbiota
sensing receptors, such as TLRs or NLRP3 proved also
to be effective in decreasing liver inflammation and
fibrogenesis.113,114
To conclude, gut microbiota is a critical player in
liver disease pathogenesis and it should be given the
highest attention. However, further research is needed
to fully expand our knowledge of the interactions
among diet, microbiota and host in the prevention
and treatment of liver diseases.

Conclusions
In this review, we have summarised available data from
both human and animal studies on the role of gut
microbiota in the pathogenesis of selected intestinal
and hepatic diseases. Human gut microbiota is being
altered primarily by lifestyle and environmental factors

The authors thank James Rizzo for editing and proofreading
the manuscript.

Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with
respect to the research, authorship, and/or publication of this
article.

Funding
The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this
article: This work was supported by the Czech Science
Foundation (15-09518S, 15-07268S, 16-06326S, 17-07332S,
and 17-09869S), the Czech Health Research Council (1528064A, 15-30782A, and 17-31248A), Charles University in
Prague, Faculty of Medicine in Hradec Kralove (project
'PRVOUK' P37/10) and Institutional Research Concept
(RVO: 61388971).

ORCID iD
Tomas Hrncir

http://orcid.org/0000-0001-6073-2412

References
1. Marciniak S and Perry GH. Harnessing ancient genomes
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3. Stecher B, Maier L and Hardt W-D. 'Blooming' in the gut:
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http://www.orcid.org/0000-0001-6073-2412 http://www.orcid.org/0000-0001-6073-2412

Laboratory Animals - June Issue

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