Intestinal fungi increases risk in alcoholic liver disease sufferers' health

Washington D.C.: A team of researchers has found that intestinal fungi, chronic liver damage, increase risk of death for the people with alcohol-related liver disease.

The study also found that anti-fungal compounds like amphotericin B protect from the alcohol-related liver disease progression.Yet, apart from alcohol abstinence, there are no specific treatments to reduce the severity of alcohol-associated liver disease.

Senior author Bernd Schnabl from the University of California San Diego said that they might be able to slow the progression of alcoholic liver disease by manipulating the balance of fungal species living in a patient's intestine.

The team found that fungi flourished in the intestines of the mice with chronic alcohol exposure.Chronic inflammation kills liver cells and ultimately promotes alcoholic liver disease.The researchers were able to protect mice from alcohol-induced liver disease by treating them with the anti-fungal compound amphotericin B.

Compared to untreated mice, mice with alcohol-related liver disease that received amphotericin B had lower levels of liver injury and fat accumulation. These outcomes were determined by measuring plasma levels of a liver enzyme called alanine aminotransferase (reduced by approximately 55 percent) and levels of liver triglycerides (reduced by approximately 21 percent).

In this study, the mice received a type of oral amphotericin B that is not absorbed into the bloodstream.However, oral amphotericin B is not FDA-approved for human use.Intravenous amphotericin B is FDA approved for the treatment of serious fungal infections and it can cause side effects such as stomach, bone, muscle or joint pain and shortness of breath.

The team also compared fungi in the stool of eight healthy people and 20 people with chronic alcohol abuse and various stages of liver disease.They found that the healthy people had a richer diversity of fungi living in their intestines, as compared to alcohol-dependent patients.

In addition, the team also found a correlation between fungi and disease severity in a separate group of 27 patients with alcohol-related liver disease.After five years, 77 percent of the low-fungi group survived, compared to 36 percent of the high-fungi group.

Since it was so effective in mice, the researchers are interested in testing amphotericin B in patients with alcohol-related liver disease, Schnabl noted.The study is published in the journal of Clinical Investigation.