Alcohol-associated intestinal dysbiosis and bacterial overgrowth can lead to a dysregulation of tryptophan metabolism and lower production of indoles. Several of these indole derivatives are aryl hydrocarbon receptor ligands that, in turn, are involved in antimicrobial defense via induction of interleukin-22 (IL-22). IL-22 increases the expression of intestinal regenerating islet-derived 3 (Reg3) lectins, which maintain low bacterial colonization of the inner mucus layer and reduce bacterial translocation to the liver. Chronic alcohol consumption is associated with reduced intestinal expression of Reg3β and Reg3γ, increased numbers of mucosa-associated bacteria and bacterial translocation. Translocated microbial products and viable bacteria reach the liver and activate the innate immune system. Release of inflammatory molecules promotes inflammation, contributes to hepatocyte death and results in a fibrotic response. This review summarizes the mechanisms by which chronic alcohol intake changes the gut microbiota and contributes to alcohol-associated liver disease by changing microbial-derived metabolites.
Citations
Citations to this article as recorded by
Selective Depletion of Gut Gram-Negative Bacteria Attenuates Alcohol Binge-Induced Cardiovascular Dysfunction by Lowering Cardiac Anandamide Levels Sarah E. Cohen, Meagan E. Donovan, Davin J. Gardner, Danielle Sambo, Seray B. Karagoz, Resat Cinar, David Goldman, Jason D. Gardner, Pal Pacher, Janos Paloczi The American Journal of Pathology.2026; 196(1): 192. CrossRef
Therapeutic Application of Postbiotics in the Management of Polycystic Ovarian Syndrome Vaishnavi A. Pathak, Sanjay J. Kshirsagar, Gitanjali S. Deokar, Collins Fiifi Anyimadu, Papungkorn Sangsawad, Li Li, Kasim Sakran Abass, Nilesh Nirmal ACS Nutrition Science.2026; 1(2): 136. CrossRef
Enhanced Bioactivity of Puerariae Radix‐ Hovenia Seed Extracts Through Lactiplantibacillus plantarum and Lacticaseibacillus paracasei Co‐Fermentation: Impact on Alcoholic Liver Injury and Macrophage Polarization Yunpeng Sun, Shen Yao, Yuan Cui, Yiyu Ni, Meichen Liu, Daqing Zhao, Shiting Yu, Siming Wang Food Science & Nutrition.2026;[Epub] CrossRef
Diet-Derived Trimethylamine N-Oxide (TMAO) Pathway Disruption in Patients with Concurrent Alcohol Use Disorder and Smokers Persists After Alcohol Detoxification Betül Rabia Erdoğan, Zinnet Şevval Aksoyalp, Çağatay Hasip, Başak Bağcı, Saliha Aksun Journal of Basic and Clinical Health Sciences.2026; 10(2): 240. CrossRef
Lonicera caerulea polysaccharide alleviates alcoholic liver disease in mice associated with modulation of the gut bacteriome and mycobiome Yuhan Gai, Meng Li Carbohydrate Research.2026; 567: 109997. CrossRef
Early-Life Swine Inflammation and Necrosis Syndrome Is Associated with Later Tail Integrity and Systemic Hematological Changes in Organically Raised Pigs Karien Koenders-van Gog, Esther Krooshoop, Thomas Wijnands, Gerald Reiner Animals.2026; 16(13): 1962. CrossRef
Based on the “gut microbiota-barrier-immunity” axis to explore the mechanism of action of traditional Chinese medicine polysaccharides in the treatment of inflammatory bowel disease and structure-activity relationship: A review Xinjie Suo, Xinlin Wang, Peng Liang, Jin-ao Duan, Ping Xiao International Journal of Biological Macromolecules.2026; 378: 153802. CrossRef
The multifaceted role of oral microbiota-host interactions in oral submucous fibrosis: from pathogenic mechanisms to microecological regulation therapies Yan Xie, Saifei Xie, Mengying Shao, Lizhen Zhuang, Taohua Pan, Shun Mao, Hui Xie Frontiers in Microbiology.2026;[Epub] CrossRef
Gut–Liver Axis Dysfunction in Alcohol-Associated Liver Disease and the Potential Role of Sheep Yogurt: A Scoping Review and Mechanistic Framework Yunfeng Wu, Yulong Zhao, Wenna Yao, Yanyan Yang, Hui Bai, Siqin Bao, Xihe Li, Yongli Song Nutrients.2026; 18(15): 2549. CrossRef
Multistrain Probiotics Alleviate Diarrhea by Modulating Microbiome-Derived Metabolites and Serotonin Pathway Jin-Ju Jeong, Yoo-Jeong Jin, Raja Ganesan, Hee Jin Park, Byeong Hyun Min, Min Kyo Jeong, Sang Jun Yoon, Mi Ran Choi, Satya Priya Sharma, You Jin Jang, Uigi Min, Jong-Hyun Lim, Kyeong Min Na, Jieun Choi, Sang Hak Han, Young Lim Ham, Do Yup Lee, Byung-Yong Probiotics and Antimicrobial Proteins.2025; 17(5): 2894. CrossRef
Treating chronic stress and chronic pain by manipulating gut microbiota with diet: can we kill two birds with one stone? Alessia Costa, Elena Lucarini Nutritional Neuroscience.2025; 28(2): 221. CrossRef
Rifaximin treatment in patients with severe alcohol-associated hepatitis: A multicenter, randomized controlled, open-label, pilot trial Do Seon Song, Jin Mo Yang, Young Kul Jung, Hyung Joon Yim, Hee Yeon Kim, Chang Wook Kim, Soon Sun Kim, Jae Youn Cheong, Hae Lim Lee, Sung Won Lee, Jeong-Ju Yoo, Sang Gyune Kim, Young Seok Kim Annals of Hepatology.2025; 30(1): 101749. CrossRef
Unveiling the distinctive gut microbiota and metabolites in liver cirrhosis and its complications: Novel diagnostic biomarkers: Editorial on “Gut microbiome and metabolome signatures in liver cirrhosis-related complications” Soon Kyu Lee, Jong Young Choi Clinical and Molecular Hepatology.2025; 31(1): 301. CrossRef
Lactobacillus rhamnosus GG Combined with Metformin Alleviates Alcohol-Induced Liver Inflammation in Mice by Maintaining the Intestinal Barrier and Regulating Treg/Th1 Cells Yin Zhu, Yizhi Pan, Xiaozhi Wang, Li Wei, Lujian Zhu, Yu Guo, HaoRan Jin, Yingying Gu, Yaqin Wang, Yongping Chen, Lanman Xu Journal of Medicinal Food.2025; 28(4): 354. CrossRef
Role of Kynurenine and Its Derivatives in Liver Diseases: Recent Advances and Future Clinical Perspectives Qiwen Tan, Shenghe Deng, Lijuan Xiong International Journal of Molecular Sciences.2025; 26(3): 968. CrossRef
Role of Alcohol in Steatotic Liver Disease: Impact on Patients with Cardiometabolic Risk Factors Francisco Capinha, Sofia Carvalhana, Helena Cortez-Pinto Digestive Diseases and Sciences.2025; 70(5): 1746. CrossRef
NLRP3 and Gut–Liver Axis: New Possibility for the Treatment of Alcohol‐Associated Liver Disease Lu Dong, Haotian Zhang, Yanyu Kang, Fei Wang, Ting Bai, Yong Yang Journal of Gastroenterology and Hepatology.2025; 40(5): 1070. CrossRef
Prolonged Intestinal Ethanol Absorption and Oxidative Stress: Revisiting the Gut–Liver Axis in Alcohol-Associated Disease Beom Sun Chung, Keungmo Yang, Chihyun Park, Tom Ryu International Journal of Molecular Sciences.2025; 26(12): 5442. CrossRef
Ferroptosis and gut microbiota: A new horizon in alcohol-associated liver disease management Yue Chen, Wenkang Gao, Kailin Cai, Ling Yang, Huikuan Chu Cellular and Molecular Life Sciences.2025;[Epub] CrossRef
Inflammation and Necrosis Syndrome in Young Piglets—A Longitudinal Study Sabrina Becker, Katrin Hindenlang, Josef Kuehling, Mirjam Lechner, Gerald Reiner Veterinary Sciences.2025; 12(8): 752. CrossRef
Synergistic toxicity in alcohol-associated liver disease and PFAS exposure Arthur D Stem, Ricardo Scheufen Tieghi, Vaia Lida Chatzi, Nicole Kleinstreuer, Damaskini Valvi, David C Thompson, Vasilis Vasiliou Toxicological Sciences.2025; 208(1): 9. CrossRef
Sex-Specific Effect of Ethanol on Colon Content Lipidome in a Mice Model Using Nontargeted LC/MS Jayashankar Jayaprakash, Siddabasave Gowda B. Gowda, Pradeep K. Shukla, Divyavani Gowda, Lipsa Rani Nath, Hitoshi Chiba, Radhakrishna Rao, Shu-Ping Hui ACS Omega.2024; 9(14): 16044. CrossRef
Lactobacillus helveticus attenuates alcoholic liver injury via regulation of gut microecology in mice Jiawen Lv, Guanjing Lang, Qiangqiang Wang, Wenlong Zhao, Ding Shi, Ziyuan Zhou, Yangfan Shen, He Xia, Shengyi Han, Lanjuan Li Microbial Biotechnology.2024;[Epub] CrossRef
Gut microbiome and metabolome signatures in liver cirrhosis-related complications Satya Priya Sharma, Haripriya Gupta, Goo-Hyun Kwon, Sang Yoon Lee, Seol Hee Song, Jeoung Su Kim, Jeong Ha Park, Min Ju Kim, Dong-Hoon Yang, Hyunjoon Park, Sung-Min Won, Jin-Ju Jeong, Ki-Kwang Oh, Jung A Eom, Kyeong Jin Lee, Sang Jun Yoon, Young Lim Ham, G Clinical and Molecular Hepatology.2024; 30(4): 845. CrossRef
Mapping the relationship between alcohol use disorder and gut microbiota: a 20-year bibliometric study Ao Xiang, Yonglong Chang, Li Shi, Xuhui Zhou Frontiers in Microbiology.2024;[Epub] CrossRef
Cell-to-cell and organ-to-organ crosstalk in the pathogenesis of alcohol-associated liver disease Hui Gao, Yanchao Jiang, Ge Zeng, Nazmul Huda, Themis Thoudam, Zhihong Yang, Suthat Liangpunsakul, Jing Ma eGastroenterology.2024; 2(4): e100104. CrossRef
Conventional type 1 dendritic cells protect against gut barrier disruption via maintaining Akkermansia muciniphila in alcoholic steatohepatitis Liuyi Hao, Wei Zhong, Jongmin Woo, Xiaoyuan Wei, Hao Ma, Haibo Dong, Wei Guo, Xinguo Sun, Ruichao Yue, Jiangchao Zhao, Qibin Zhang, Zhanxiang Zhou Hepatology.2023; 78(3): 896. CrossRef
TRPV6 deficiency attenuates stress and corticosterone-mediated exacerbation of alcohol-induced gut barrier dysfunction and systemic inflammation Avtar S. Meena, Pradeep K. Shukla, Rupa Rao, Cherie Canelas, Joseph F. Pierre, RadhaKrishna Rao Frontiers in Immunology.2023;[Epub] CrossRef
Soy Lecithin in High‐Fat Diets Exerts Dual Effects on Adipose Tissue Versus Ileum Charline Buisson, Valentin Leuzy, Emmanuelle Loizon, Emmanuelle Meugnier, Magali Monnoye, Catherine Philippe, Philippe Gérard, Marie‐Caroline Michalski, Fabienne Laugerette Molecular Nutrition & Food Research.2023;[Epub] CrossRef
Global prevalence, incidence, and outcomes of alcohol related liver diseases: a systematic review and meta-analysis Xuanxuan Niu, Lin Zhu, Yifan Xu, Menghan Zhang, Yanxu Hao, Lei Ma, Yan Li, Huichun Xing BMC Public Health.2023;[Epub] CrossRef
Circadian rhythms and inflammatory diseases of the liver and gut Jessica M. Ferrell Liver Research.2023; 7(3): 196. CrossRef
The Role of the Gut Microbiome and the Hepatic Axis in the Pathogenesis of Metabolic Syndrome and Therapeutics K. P. Divya, Parneet Hari, Navjot Kanwar, Navita Aggarwal, Preeti Singh Dhoat, Lu Liu, Abhinav Kanwal, Shailendra Pratap Singh, Jiong Yu Advanced Gut & Microbiome Research.2023; 2023: 1. CrossRef
The Protective Effect of Auricularia cornea var. Li. Polysaccharide on Alcoholic Liver Disease and Its Effect on Intestinal Microbiota Tianci Wang, Zikun Jia, Canghai An, Ping Ren, Yiting Yang, Wanting Wang, Ling Su Molecules.2023; 28(24): 8003. CrossRef
Gut liver brain axis in diseases: the implications for therapeutic interventions Mengyao Yan, Shuli Man, Benyue Sun, Long Ma, Lanping Guo, Luqi Huang, Wenyuan Gao Signal Transduction and Targeted Therapy.2023;[Epub] CrossRef
Gut Barrier and Microbiota in Cirrhosis Cyriac A. Philips, Philip Augustine Journal of Clinical and Experimental Hepatology.2022; 12(2): 625. CrossRef
Probiotics attenuate alcohol-induced muscle mechanical hyperalgesia: Preliminary observations Paul G Green, Pedro Alvarez, Jon D Levine Molecular Pain.2022;[Epub] CrossRef
Gut Microbiome in Non-Alcoholic Fatty Liver Disease: From Mechanisms to Therapeutic Role Haripriya Gupta, Byeong-Hyun Min, Raja Ganesan, Yoseph Asmelash Gebru, Satya Priya Sharma, Eunju Park, Sung-Min Won, Jin-Ju Jeong, Su-Been Lee, Min-Gi Cha, Goo-Hyun Kwon, Min-Kyo Jeong, Ji-Ye Hyun, Jung-A. Eom, Hee-Jin Park, Sang-Jun Yoon, Mi-Ran Choi, Do Biomedicines.2022; 10(3): 550. CrossRef
Immune Response of an Oral Enterococcus faecalis Phage Cocktail in a Mouse Model of Ethanol-Induced Liver Disease Beatriz Garcia Mendes, Yi Duan, Bernd Schnabl Viruses.2022; 14(3): 490. CrossRef
A novel ladderlectin from hybrid crucian carp possesses antimicrobial activity and protects intestinal mucosal barrier against Aeromonas hydrophila infection Chen Feng, Xiaofeng Liu, Yiyang Tang, Mengzhe Feng, Zejun Zhou, Shaojun Liu Fish & Shellfish Immunology.2022; 124: 1. CrossRef
Principles of diagnosis and treatment of alcohol-induced liver fibrosis D. V. Garbuzenko Meditsinskiy sovet = Medical Council.2022; (7): 104. CrossRef
Gut Microbiota Regulation of AHR Signaling in Liver Disease Baohong Wang, Ziyuan Zhou, Lanjuan Li Biomolecules.2022; 12(9): 1244. CrossRef
Pathophysiological Prerequisites and Therapeutic Potential of Fecal Microbiota Transplantation in Severe Alcoholic Hepatitis D. V. Garbuzenko The Russian Archives of Internal Medicine.2022; 12(5): 352. CrossRef
Trimethylamine N-Oxide (TMAO) and Indoxyl Sulfate Concentrations in Patients with Alcohol Use Disorder Laurent Coulbault, Alice Laniepce, Shailendra Segobin, Céline Boudehent, Nicolas Cabé, Anne Lise Pitel Nutrients.2022; 14(19): 3964. CrossRef
Gut Microbiota at the Intersection of Alcohol, Brain, and the Liver Haripriya Gupta, Ki Tae Suk, Dong Joon Kim Journal of Clinical Medicine.2021; 10(3): 541. CrossRef
Intestinal Barrier in Human Health and Disease Natalia Di Tommaso, Antonio Gasbarrini, Francesca Romana Ponziani International Journal of Environmental Research and Public Health.2021; 18(23): 12836. CrossRef
Interleukin-17 in Liver Disease Pathogenesis Na Li, Gen Yamamoto, Hiroaki Fuji, Tatiana Kisseleva Seminars in Liver Disease.2021; 41(04): 507. CrossRef
REG3α is a novel biomarker that potentially correlates with acute allograft rejection after intestinal transplantation Carolyn P. Smullin, Robert S. Venick, Elizabeth A. Marcus, Bita V. Naini, Douglas G. Farmer Clinical Transplantation.2021;[Epub] CrossRef
First
Prev
