A growing body of evidence underscores the crucial role of the gut-microbiome and intestinal immunological homeostasis for human health and disease. The liver, the key metabolic organ, constantly encounters a massive load of dietary and microbiota associated antigens, which are derived from the intestine and reach the liver through the portal circulation.
During physiological conditions the healthy intestinal barrier limits translocation of microbiota associated molecular patterns such as lipopolysaccharides (LPS) while hepatic resident leukocytes hold a high capacity to promote immune tolerance.
However, acute and chronic liver diseases may change the composition of the intestinal microbiome leading to impaired intestinal barrier function, break down of hepatic immune tolerance and progression of liver disease through recruitment of inflammatory leukocytes.
Based on recent studies, the pivotal role of the intestinal microbiome and gut-liver crosstalk during chronic liver disease and the promising potential of future microbiota mediated therapies will be discussed. This will encompass the lifestyle-related and genetic impact on microbiome composition as well as specific aspects of alcoholic liver disease and its implications for gut-liver-crosstalk.