Vargas-Beltran AM, Mialma-Omana SJ, Vivanco-Tellez DO. Targeting gut microbiota in liver disease: A pharmacological approach for hepatic encephalopathy and beyond. World J Gastrointest Pharmacol Ther 2025; 16(4): 110271 [PMID: 41378067 DOI: 10.4292/wjgpt.v16.i4.110271]
Corresponding Author of This Article
Andres Manuel Vargas-Beltran, MD, Department of Hepatology, General Hospital Dr. Manuel Gea Gonzalez, Calz. de Tlalpan 4800, Belisario Domínguez Secc 16, Mexico City 14080, Ciudad de México, Mexico. andresman.vargas@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Pharmacol Ther. Dec 5, 2025; 16(4): 110271 Published online Dec 5, 2025. doi: 10.4292/wjgpt.v16.i4.110271
Targeting gut microbiota in liver disease: A pharmacological approach for hepatic encephalopathy and beyond
Andres Manuel Vargas-Beltran, Stuart Javier Mialma-Omana, Diego Omar Vivanco-Tellez
Andres Manuel Vargas-Beltran, Department of Hepatology, General Hospital Dr. Manuel Gea Gonzalez, Mexico City 14080, Ciudad de México, Mexico
Andres Manuel Vargas-Beltran, Stuart Javier Mialma-Omana, Diego Omar Vivanco-Tellez, Faculty of Medicine, Meritorious Autonomous University of Puebla, Puebla 72420, Puebla, Mexico
Stuart Javier Mialma-Omana, Department of Surgery, National Institute of Medical Sciences and Nutrition Salvador Zubiran, Mexico City 14080, Ciudad de México, Mexico
Author contributions: Vargas-Beltran AM, Mialma-Omana SJ, and Vivanco-Tellez DO wrote the manuscript and prepared the figures; Vargas-Beltran AM revised and polished the manuscript as a co-corresponding author and was responsible for the submission of the current version of the manuscript; All authors read and approved the final manuscript.
Conflict-of-interest statement: All authors have no conflicts of interest to declare for this article.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Andres Manuel Vargas-Beltran, MD, Department of Hepatology, General Hospital Dr. Manuel Gea Gonzalez, Calz. de Tlalpan 4800, Belisario Domínguez Secc 16, Mexico City 14080, Ciudad de México, Mexico. andresman.vargas@gmail.com
Received: June 4, 2025 Revised: July 4, 2025 Accepted: September 28, 2025 Published online: December 5, 2025 Processing time: 184 Days and 19.5 Hours
Core Tip
Core Tip: The gut microbiota is a key player in the progression of liver diseases, especially hepatic encephalopathy, by influencing ammonia levels, inflammation, and neurocognitive function. This review discussed current and emerging therapies that target the gut-liver axis, including non-absorbable disaccharides, antibiotics, probiotics, synbiotics, postbiotics, and fecal microbiota transplantation. Novel agents such as bile acid modulators and microbiome-targeted molecules were also explored. Modulating gut microbiota may not only alleviate hepatic encephalopathy but also benefit conditions like metabolic dysfunction-associated steatotic liver disease and cirrhosis, facilitating the way for more personalized and effective liver disease management strategies.
