Fig. 5: Mode of action. | Nature Communications

Fig. 5: Mode of action.

From: The postbiotic ReFerm® versus standard nutritional support in advanced alcohol-related liver disease (GALA-POSTBIO): a randomized controlled phase 2 trial

Fig. 5

In alcohol-related liver disease progression of liver fibrosis is driven by gut dysbiosis and increased gut permeability, leading to a translocation of bacterial products to the liver, inducing inflammation and fibrosis formation. Treatment with ReFerm® leads to an improved gut barrier (reduction in gut permeability) marked by reduced levels of circulating intestinal fatty acid-binding protein (I-FABP). The improved gut barrier leads to a decrease in liver inflammation and induction of hepatic regeneration marked by higher levels of circulating Neurotrophin-3 (NT-3), which leads to lower fibrosis formation marked by improvement (reduction) in α-smooth muscle actin (α-SMA), transient elastography (TE), enhanced liver fibrosis (ELF), and N-terminal type III collagen (PRO-C3).

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