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Publication : Intestinal fungi contribute to development of alcoholic liver disease.

First Author  Yang AM Year  2017
Journal  J Clin Invest Volume  127
Issue  7 Pages  2829-2841
PubMed ID  28530644 Mgi Jnum  J:244481
Mgi Id  MGI:5913260 Doi  10.1172/JCI90562
Citation  Yang AM, et al. (2017) Intestinal fungi contribute to development of alcoholic liver disease. J Clin Invest 127(7):2829-2841
abstractText  Chronic liver disease with cirrhosis is the 12th leading cause of death in the United States, and alcoholic liver disease accounts for approximately half of all cirrhosis deaths. Chronic alcohol consumption is associated with intestinal bacterial dysbiosis, yet we understand little about the contribution of intestinal fungi, or mycobiota, to alcoholic liver disease. Here we have demonstrated that chronic alcohol administration increases mycobiota populations and translocation of fungal beta-glucan into systemic circulation in mice. Treating mice with antifungal agents reduced intestinal fungal overgrowth, decreased beta-glucan translocation, and ameliorated ethanol-induced liver disease. Using bone marrow chimeric mice, we found that beta-glucan induces liver inflammation via the C-type lectin-like receptor CLEC7A on Kupffer cells and possibly other bone marrow-derived cells. Subsequent increases in IL-1beta expression and secretion contributed to hepatocyte damage and promoted development of ethanol-induced liver disease. We observed that alcohol-dependent patients displayed reduced intestinal fungal diversity and Candida overgrowth. Compared with healthy individuals and patients with non-alcohol-related cirrhosis, alcoholic cirrhosis patients had increased systemic exposure and immune response to mycobiota. Moreover, the levels of extraintestinal exposure and immune response correlated with mortality. Thus, chronic alcohol consumption is associated with an altered mycobiota and translocation of fungal products. Manipulating the intestinal mycobiome might be an effective strategy for attenuating alcohol-related liver disease.
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