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Probiotic role in non-alcoholic fatty liver disease
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A doença de fígado gordo não alcoólica (NAFLD, do inglês non-alcoholic fatty liver disease) é uma patologia hepática comum associada à obesidade e à síndrome metabólica. Esta patologia é caracterizada pela acumulação de gordura nos hepatócitos, o que pode levar a inflamação, fibrose e, em casos graves, cirrose e insuficiência hepática. Embora a fisiopatologia exata da NAFLD não seja totalmente compreendida, acredita-se que a disbiose intestinal desempenha um papel crucial no desenvolvimento e progressão da doença. Os probióticos, microrganismos vivos que conferem benefícios para a saúde do hospedeiro, estão a emergir como uma abordagem promissora para prevenir e tratar a NAFLD.
A utilização de probióticos na NAFLD baseia-se no conceito de modulação da microbiota intestinal para restabelecer o equilíbrio normal entre bactérias e o epitélio intestinal. Os doentes com NAFLD têm uma composição alterada da microbiota intestinal, caracterizada por uma redução de Bifidobacterium e Lactobacillus e um aumento de Escherichia coli e Enterobacteriaceae. Esta disbiose poderá promover o desenvolvimento da NAFLD ao induzir a permeabilidade intestinal e a inflamação.
Os probióticos melhoram a NAFLD através de vários mecanismos. Em primeiro lugar, podem restaurar a função da barreira intestinal, reduzindo a permeabilidade intestinal e, como tal, a translocação de bactérias ou produtos bacterianos. Podem, ainda, modular o sistema imunitário no intestino e no fígado, reduzindo a atividade de citocinas pró-inflamatórias como a IL-1β, a IL-6 e o TNF-α. Por fim, podem contribuir para reduzir a acumulação de gordura no fígado, regulando o metabolismo lipídico e reduzindo a lipogénese de novo (DNL).
Foram estudadas várias estirpes de probióticos relativamente aos seus efeitos na NAFLD, incluindo Lactobacillus rhamnosus GG, Lactobacillus casei Shirot e Bifidobacterium bifidum. Ensaios clínicos demonstraram que os probióticos podem melhorar a função hepática, reduzir a esteatose hepática e melhorar a sensibilidade à insulina. No entanto, a estirpe, a dose e a duração ideais da suplementação com probióticos ainda não são claras, sendo necessários mais estudos para estabelecer a sua eficácia e segurança.
Non-alcoholic fatty liver disease (NAFLD) is a common liver disorder strongly associated with obesity and metabolic syndrome. The disease is characterized by fat accumulation in the liver cells, which can lead to inflammation, fibrosis, and, in severe cases, cirrhosis and liver failure. While the exact pathophysiology of NAFLD is not fully understood, it is believed that gut dysbiosis plays a crucial role in the development and progression of the disease. Probiotics, which are live microorganisms that confer health benefits to the host, are emerging as a promising approach to prevent and treat NAFLD. The use of probiotics in NAFLD is based on the concept of modulating the gut microbiota to restore the regular balance between bacteria and intestinal tissue. NAFLD patients have an altered gut microbiota composition, characterized by a reduction in Bifidobacterium and Lactobacillus and an increase in Escherichia coli and Enterobacteriaceae. This dysbiosis may promote the development of NAFLD by inducing gut permeability and inflammation. Probiotics have been shown to improve NAFLD by several mechanisms. Firstly, they can restore gut barrier function by reducing gut permeability and diminishing bacteria and bacterial metabolite translocation. Secondly, they can modulate the immune system in the gut and liver by reducing the activity of pro-inflammatory cytokines such as IL-1β, IL-6, and TNF-α. Thirdly, they can reduce liver fat accumulation by regulating lipid metabolism and reducing de novo lipogenesis. Several probiotics strains have been studied for their effects on NAFLD, including Lactobacillus rhamnosus GG, Lactobacillus casei Shirot, and Bifidobacterium bifidum. Clinical trials have shown that probiotics can improve liver function, reduce hepatic steatosis, and improve insulin sensitivity. However, the optimal strain, dose, and duration of probiotic supplementation are still unclear, and further studies are needed to establish their efficacy and safety.
Non-alcoholic fatty liver disease (NAFLD) is a common liver disorder strongly associated with obesity and metabolic syndrome. The disease is characterized by fat accumulation in the liver cells, which can lead to inflammation, fibrosis, and, in severe cases, cirrhosis and liver failure. While the exact pathophysiology of NAFLD is not fully understood, it is believed that gut dysbiosis plays a crucial role in the development and progression of the disease. Probiotics, which are live microorganisms that confer health benefits to the host, are emerging as a promising approach to prevent and treat NAFLD. The use of probiotics in NAFLD is based on the concept of modulating the gut microbiota to restore the regular balance between bacteria and intestinal tissue. NAFLD patients have an altered gut microbiota composition, characterized by a reduction in Bifidobacterium and Lactobacillus and an increase in Escherichia coli and Enterobacteriaceae. This dysbiosis may promote the development of NAFLD by inducing gut permeability and inflammation. Probiotics have been shown to improve NAFLD by several mechanisms. Firstly, they can restore gut barrier function by reducing gut permeability and diminishing bacteria and bacterial metabolite translocation. Secondly, they can modulate the immune system in the gut and liver by reducing the activity of pro-inflammatory cytokines such as IL-1β, IL-6, and TNF-α. Thirdly, they can reduce liver fat accumulation by regulating lipid metabolism and reducing de novo lipogenesis. Several probiotics strains have been studied for their effects on NAFLD, including Lactobacillus rhamnosus GG, Lactobacillus casei Shirot, and Bifidobacterium bifidum. Clinical trials have shown that probiotics can improve liver function, reduce hepatic steatosis, and improve insulin sensitivity. However, the optimal strain, dose, and duration of probiotic supplementation are still unclear, and further studies are needed to establish their efficacy and safety.
Descrição
Trabalho Final de Mestrado Integrado, Ciências Farmacêuticas, 2023, Universidade de Lisboa, Faculdade de Farmácia.
Palavras-chave
NAFLD NASH Probiotics Synbiotics Lipid metabolism Mestrado Integrado - 2023