Fig. 2
From: Immunological mechanisms and emerging therapeutic targets in alcohol-associated liver disease
Interaction Between Gut Microbiome and both Hepatocytes and Hepatic Immune Cells. Chronic alcohol consumption and gut dysbiosis synergistically impair intestinal barrier integrity through suppressing the expression of critical defense factors, including antimicrobial peptides, regenerating islet-derived protein 3α (REG3α), and mucins, thereby exacerbating pathological permeability in the gut-liver axis. Gut microbial components, including pathogen-associated molecular patterns (PAMPs) such as lipopolysaccharide, flagellin, peptidoglycan, cytolysin, and β-glucan, can translocate across a compromised intestinal barrier and activate inflammatory signaling pathways in hepatic immune cells, particularly Kupffer cells. This activation triggers an inflammatory cascade that contributes to liver injury and disease progression. Conversely, prebiotics and probiotics may exert hepatoprotective effects by strengthening gut barrier integrity and modulating immune responses through their metabolites, potentially mitigating inflammation and liver damage
