UMass Chan Medical School Faculty Publications

UMMS Affiliation

Department of Medicine, Division of Gastroenterology; UMass Metabolic Network

Publication Date


Document Type

Article Postprint


Digestive System Diseases | Gastroenterology | Hepatology


Beginning of article: The importance of the “gut‐liver axis” has been long established in alcoholic liver disease (ALD). The direct effects of alcohol, its metabolites, and reactive oxygen species produced during alcohol metabolism result in cellular stress in hepatocytes, release of damage‐associated molecules (DAMPs), and increased hepatocyte vulnerability to inflammation‐related cellular injury. Excessive alcohol use also results in gut “leakiness,” resulting in increased delivery of pathogen‐derived molecular patterns (PAMPs) to the liver through the portal system. All of these gut‐derived PAMPs and hepatocyte‐derived DAMPs contribute to Kupffer cell (KC) and innate immune cell activation in the liver in ALD.1 Alcohol use was shown to change the composition of the gut microbiome by modifying the quantity, quality, and diversity of bacteria in the intestines both in humans and mice.1 The composition of the gut microbiome is only partially understood and it includes bacteria, fungi, and viruses. Every individual's gastrointestinal tract contains thousands of different species of microbes, of which 99.9% belong to only a few species. The less abundant component of the microbiome is called a rare biosphere, which is more diverse and appears to have a major impact on health and disease. The fungal microbiota, also referred to as the mycobiome, is part of the rare biosphere and is a new and rapidly emerging field; scientific knowledge lags behind that of the bacterial microbiome. Increasing evidence suggests that the fungal mycobiome plays a role as a cofactor in inflammatory and metabolic disorders and in modulating the bacterial microbiome and host defense. The fungal mycobiome has been studied at mucosal sites such as the oral cavity, gastrointestinal and urogenital tracts, and the skin. Studies in healthy individuals revealed 66 different fungal genera in the fecal material where the most common genera were Saccharomyces, Candida, and Cladosporium.2 Recent studies have indicated a correlation between changes in the gut mycobiome and different disease conditions.

Rights and Permissions

© 2018 by the American Association for the Study of Liver Diseases. The version of the article available for download is the authors' accepted manuscript as prepared for publication in: Hepatology. Accepted manuscript posted after 12 months as allowed by the publisher's self-archiving policy at:

DOI of Published Version



Hepatology. 2018 Apr 23. doi: 10.1002/hep.30055. [Epub ahead of print] Link to article on publisher's site

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Hepatology (Baltimore, Md.)

PubMed ID