Gut-liver-brain axis and alcohol use disorder: treatment potential of fecal microbiota transplantation

Chronic alcohol use is a major cause of liver damage and death. In the United States, multiple factors have led to low utilization of pharmacotherapy for alcohol use disorder (AUD), including lack of provider knowledge and comfort in prescribing medications for AUD. Alcohol consumption has direct effects on the gut microbiota, altering the diversity of bacteria and leading to bacterial overgrowth. Growing evidence suggests that alcohol’s effects on the gut microbiome may contribute to increased alcohol consumption
An article published in Alcohol Research Current Reviews, reviews human and preclinical studies investigating the role of fecal microbiota transplantation (FMT) in ameliorating alcohol-associated alterations to the liver, gut, and brain resulting in altered behaviour. The article also discusses the therapeutic potential of FMT.
For the narrative review, a literature search was conducted in September 2022 of PubMed, Web of Science Core Collection, and Google Scholar to identify relevant studies. Very few papers described clinical or preclinical studies that were directly investigating the effects of FMT on alcohol drinking or related behaviours. Ultimately, 16 studies were included in the review.
The literature search identified only a few studies that were directly investigating the effect of FMT on ALD or alcohol drinking and related behaviours. Largely proof-of-concept studies, these findings demonstrate that alcohol can alter the gut microbiome and that the microbiome can be transferred between humans and rodents to alter affective behaviours frequently associated with increased alcohol use. Other studies have shown promise of FMT or other probiotic supplementation in alleviating some of the symptoms associated with ALD and drinking. These results show that the implementation of FMT as a therapeutic approach is still in the investigatory stages.
Source: Wolstenholme JT, Duong NK, Brocato ER, Bajaj JS. Gut-Liver-Brain Axis and Alcohol Use Disorder: Treatment Potential of Fecal Microbiota Transplantation. Alcohol Res. 2024 Feb 1;44(1):01.