Research ArticleLiver disease

The Liver May Act as a Firewall Mediating Mutualism Between the Host and Its Gut Commensal Microbiota

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Science Translational Medicine  21 May 2014:
Vol. 6, Issue 237, pp. 237ra66
DOI: 10.1126/scitranslmed.3008618

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Breaching Barriers

Premature death from chronic liver disease is a rising global trend. Opportunistic bacterial infections caused by beneficial microbes that have breached the gut and its immune barrier often lead to death in liver cirrhosis patients. Balmer et al. now show that the liver forms a second vascular barrier for eliminating commensal bacteria that have escaped from the gut. In animal models of liver disease and gut dysfunction and in patients with nonalcoholic steatohepatitis, the liver is unable to capture escaped gut commensal bacteria, which then leak into the systemic circulation, resulting in a robust host nonmucosal immune response and the breakdown of mutualism between the host and its gut microbiota. Mutualism breakdown is an important complication of liver disease.