Kiseleva Y, Maslennikov R, Poluektova E, Zolnikova O, Sigidaev A, Zharikov Y, Shirokova E, Ivashkin V. Microbiome-immune interactions in autoimmune liver diseases. World J Gastroenterol 2026; 32(12): 115853 [DOI: 10.3748/wjg.v32.i12.115853]
Corresponding Author of This Article
Roman Maslennikov, MD, Associate Professor, Department of Internal Medicine, Gastroenterology and Hepatology, Sechenov University, Pogodinskaya str., 1, bld. 1, Moscow 119435, Russia. mmmm00@yandex.ru
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Gastroenterology & Hepatology
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Review
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Mar 28, 2026 (publication date) through Mar 19, 2026
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World Journal of Gastroenterology
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1007-9327
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Kiseleva Y, Maslennikov R, Poluektova E, Zolnikova O, Sigidaev A, Zharikov Y, Shirokova E, Ivashkin V. Microbiome-immune interactions in autoimmune liver diseases. World J Gastroenterol 2026; 32(12): 115853 [DOI: 10.3748/wjg.v32.i12.115853]
World J Gastroenterol. Mar 28, 2026; 32(12): 115853 Published online Mar 28, 2026. doi: 10.3748/wjg.v32.i12.115853
Microbiome-immune interactions in autoimmune liver diseases
Yana Kiseleva, Roman Maslennikov, Elena Poluektova, Oksana Zolnikova, Alexey Sigidaev, Yury Zharikov, Elena Shirokova, Vladimir Ivashkin
Yana Kiseleva, Roman Maslennikov, Elena Poluektova, Oksana Zolnikova, Elena Shirokova, Vladimir Ivashkin, Department of Internal Medicine, Gastroenterology and Hepatology, Sechenov University, Moscow 119435, Russia
Elena Poluektova, Scientific Community for Human Microbiome Research, Moscow 119435, Russia
Alexey Sigidaev, Department of Clinical Disciplines, Tyumen State Medical University, Tyumen 625023, Russia
Alexey Sigidaev, Coordination and Analytical Center for Chemical and Biological Safety, Sechenov University, Moscow 119435, Russia
Yury Zharikov, Department of Human Anatomy and Histology, Sechenov University, Moscow 125009, Russia
Author contributions: Ivashkin V, Poluektova E, and Maslennikov R conceived the idea for this review; Kiseleva Y written the main text; Maslennikov R, Ivashkin V, Poluektova E, Zolnikova O, Sigidaev A, Zarikov Y, and Shirokova E edited the sections on autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Corresponding author: Roman Maslennikov, MD, Associate Professor, Department of Internal Medicine, Gastroenterology and Hepatology, Sechenov University, Pogodinskaya str., 1, bld. 1, Moscow 119435, Russia. mmmm00@yandex.ru
Received: October 28, 2025 Revised: December 29, 2025 Accepted: January 20, 2026 Published online: March 28, 2026 Processing time: 143 Days and 6 Hours
Abstract
The impact of gut microbiota on immune regulation has received increasing attention in recent years, particularly its role in immune-mediated liver diseases such as autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), and immunoglobulin G4 (IgG4)-related sclerosing cholangitis (IgG4-SC). Disturbances in gut microbiota composition (gut dysbiosis) compromise the intestinal barrier and trigger abnormal immune activity, which foster persistent inflammation, autoimmunity and subsequent liver damage. An increase in Veillonella, Streptococcus, and Lactobacillus were found in most studies for all four diseases. A decrease in Clostridium was detected in AIH and PBC, but an increase in these bacteria is observed in PSC and IgG4-SC. Other common changes in AIH and PBC were an increase in Klebsiella and a decrease in Ruminococcus. In contrast, Ruminococcus is often found to be elevated in PSC. Common features of PBC and PSC are an increase in Enterococcus and a decrease in Faecalibacterium, Enterobacterium, and Coprococcus. Gut microbiome changes in IgG4-SC are most similar to PSC. Probiotics have positive effects in AIH and cholestatic liver diseases in small randomized controlled trial (RCTs). Positive effects of butyrate were in mice models of AIH and PBC. A small study found a positive effect of butyrate on patients with PBC. Indole-3-carboxaldehyde reduced the inflammatory activity of T-cells in patients with AIH in vitro and reduced inflammation in a PSC mouse model. Fecal microbiota transplantation showed beneficial effects in mouse models of AIH and in patients with PSC. Many studies demonstrated the effectiveness of microbiota-targeted therapy on mouse models of autoimmune liver diseases. However, these results remain to be verified in RCTs involving humans.
Core Tip: The impact of gut microbiota on immune regulation has received increasing attention in recent years, particularly its role in the onset and progression of immune-mediated liver disorders. Disturbances in the microbial balance compromise the intestinal barrier and trigger abnormal immune activity, which foster persistent inflammation, autoimmunity and subsequent liver damage. A deeper understanding of the gut-liver axis is expected to support the creation of more effective approaches aimed at improving prognosis and enhancing patients’ quality of life.
