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Mediators of Inflammation
Volume 2018, Article ID 9321643, 7 pages
Review Article

Gut Microbiota as a Driver of Inflammation in Nonalcoholic Fatty Liver Disease

1Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
2Department of Gastroenterology, Catholic University, School of Medicine and Surgery, A. Gemelli Hospital, Rome, Italy
3CytoCure LLC, Beverly, MA, USA

Correspondence should be addressed to Giovanni Cammarota; ti.ttacinu@atorammaC.innavoiG

Received 5 May 2017; Revised 12 July 2017; Accepted 26 July 2017; Published 31 January 2018

Academic Editor: Jorg Fritz

Copyright © 2018 Stefano Bibbò et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The prevalence of nonalcoholic fatty liver disease and the consequent burden of metabolic syndrome have increased in recent years. Although the pathogenesis of nonalcoholic fatty liver disease is not completely understood, it is thought to be the hepatic manifestation of the dysregulation of insulin-dependent pathways leading to insulin resistance and adipose tissue accumulation in the liver. Recently, the gut-liver axis has been proposed as a key player in the pathogenesis of NAFLD, as the passage of bacteria-derived products into the portal circulation could lead to a trigger of innate immunity, which in turn leads to liver inflammation. Additionally, higher prevalence of intestinal dysbiosis, larger production of endogenous ethanol, and higher prevalence of increased intestinal permeability and bacterial translocation were found in patients with liver injury. In this review, we describe the role of intestinal dysbiosis in the activation of the inflammatory cascade in NAFLD.