Modulação da microbiota intestinal em indivíduos alcoolistas: uma revisão narrativa
DOI:
https://doi.org/10.33448/rsd-v12i3.40668Palavras-chave:
Álcool; Microbiota intestinal; Endotoxemia; Saúde.Resumo
Mediante o fato que o consumo de álcool tem aumentado, e que tal molécula pode promover diversas alterações, o objetivo desta revisão narrativa foi descrever o metabolismo do etanol e sua relação com a microbiota intestinal, assim como as doenças associadas a ambos. Foram utilizados artigos na elaboração da revisão narrativa. A dependência do álcool representa um importante problema de saúde pública que atinge milhões de pessoas no mundo todo. O consumo crônico de álcool está relacionado com o aumento da permeabilidade intestinal, favorecendo modificações significantes na composição da microbiota intestinal e permitindo que componentes bacterianos sejam translocados, e alcancem a circulação portal e sistêmica. Os produtos bacterianos que percorrem a circulação são reconhecidos por células do sistema imunológico, as quais liberam citocinas pró-inflamatórias e aumentam a formação de espécies reativas de oxigênio e nitrogênio bem como o estresse celular. O consumo de álcool também está relacionado com o desequilíbrio qualiquantitativo de microrganismos no intestino grosso, caracterizando a disbiose intestinal, onde há uma menor abundância de Bacteroidetes e maior de Proteobacteria em indivíduos alcoolistas quando comparados aos saudáveis. Conclui-se que a ingestão crônica de álcool modifica a microbiota intestinal e contribui para a disbiose intestinal.
Referências
Adak, A., & Khan, M. R. (2019). An insight into gut microbiota and its functionalities. Cellular and Molecular Life Sciences, 76, 473-49. 10.1007/s00018-018-2943-4.
Alleyne, J., & Dopico, A. M. (2021). Alcohol use disorders and their harmful effects on the contractility of skeletal, cardiac and smooth muscles. Advances in Drug and Alcohol Research, 1, 1-18. https://doi.org/10.3389/ADAR.2021.10011
Arora, T., Vanslette, A. M., Hjorth, S. A., & Bäckhed, Fredrik. (2021). Microbial regulation of enteroendocrine cells. Med Review, 2, 553-570. DOI: 10.1016/j.medj.2021.03.018.
Bailey, M. A., & Holscher, H. D. (2018). Microbiome-mediated effects of the mediterranean diet on inflammation. Advances in Nutrition, 9, 193-206. 10.1093/advances/nmy013.
Bajaj, J. S. (2019). Alcohol, liver disease and the gut microbiota. Nature Reviews Gastroenterology & Hepatology, 16, 235-246. 10.1038/s41575-018-0099-1.
Barr, T., Helms, C., Grant, K., & Messaoudi, I. (2016). Opposing effects of alcohol on the immune system. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 65, 242-251. https://doi.org/10.1016/j.pnpbp.2015.09.001.
Barroso, W. K. S., Rodrigues, C. I. S., Bartolotto, L. A., Mota-Gomes, M. A., Brandão, A. A., Feitosa, A. D. M., et al. (2020). Diretrizes Brasileiras de Hipertensão Arterial - 2020. Arquivos Brasileiros de Cardiologia, 116, 516-658. 10.36660/abc.20201238.
Bartoletti, M., Giannella, M., Caraceni P., Domenicali M., Ambretti S., Tedeschi S., et al. (2014). Epidemiology and outcomes of bloodstream infection in patients with cirrhosis. Journal of Hepatology, 61, 51-58. 10.1016/j.jhep.2014.03.021.
Bishehsari, F., Magno, E., Swanson, G., Desai, V., Voigt, R. M., Forsyth, C. B., et al. (2017). Alcohol and gut-derived inflammation. Alcohol Research: Current Reviews, 38, 163-171.
Bode, C., & Bode, J. C. (2003). Effect of alcohol consumption on the gut. Best Practice & Research. Clinical Gastroenterology, 17, 575-592. https://doi.org/10.1016/s1521-6918(03)00034-9.
Butterworth, R. F. (2014). Chapter 34 - Hepatic encephalopathy in alcoholic cirrhosis. Handbook of Clinical Neurology, 125, 589-602. 10.1016/b978-0-444-62619-6.00034-3.
Cederbaum, A. I. (2012). Alcohol metabolism. Clinics in Liver Disease, 16, 667-685. 10.1016/j.cld.2012.08.002.
Chen, Y., Yang, F., Lu, H., Wang, B., Chen, Y., Lei, D., et al. (2011). Characterization of fecal microbial communities in patients with liver cirrhosis. Hepatology, 54, 562-572. 10.1002/hep.24423.
Day, E., & Rudd, J. H. F (2019). Alcohol use disorders and the heart. Addiction, 114, 1670-1678. 10.1111/add.14703.
Donaldson, G. P., Lee, S. M., & Mazmanian, S. K. (2015). Gut biogeography of the bacterial microbiota. Nature Reviews Microbiology, 14, 20-32. 10.1038/nrmicro3552.
Engen, P. A., Green, S. J., Voigt, R. M., Forsyth, C. B., & Keshavarzian, A. (2015). The gastrointestinal microbiome: alcohol effects on the composition of intestinal microbiota. Alcohol Research: Current Reviews, 37, 223-236.
Ezhilarasan, D. (2018). Oxidative stress is bane in chronic liver diseases: Clinical and experimental perspective. Arab Journal of Gastroenterology, 19, 56-64. https://doi.org/10.1016/j.ajg.2018.03.002.
Garcia, L. P., & Sanchez, Z. M. (2020). Consumo de álcool durante a pandemia da COVID-19: Uma reflexão necessária para o enfrentamento da situação. Cadernos de Saúde Pública, 36, e00124520. https://doi.org/10.1590/0102-311X00124520.
Gupta, H., Suk, K. T., & Kim, D. J. (2021). Gut microbiota at the intersection of alcohol, brain, and the liver. Journal of Clinical Medicine, 10, 541. https://doi.org/10.3390/jcm10030541.
Gurwara, S., Dai A., Ajami, N. J., Graham, D. Y., White, D. L., Chen, L., et al (2020). Alcohol use alters the colonic mucosa–associated gut microbiota in humans. Nutrition Research, 83, 119-128. 10.1016/j.nutres.2020.09.004.
Hadjihambi, A., Arias, N., Sheikh, M., & Jalan, R. (2017). Hepatic encephalopathy: A critical current review. Hepatology International, 12, 135-147. 10.1007/s12072-017-9812-3.
Han, S. H., Suk, K. T., Kim, D. J., Kim, M. Y., Baik, S. K., Kim, Y. D., et al. (2015). Effects of probiotics (cultured Lactobacillus subtilis/Streptococcus faecium) in the treatment of alcoholic hepatites: Randomized-controlled multicenter study. European Journal of Gastroenterology & Hepatology, 27, 1300-1306. 10.1097/meg.0000000000000458.
Hammer, A. M., Morris, N. L., Earley, Z. M., & Choudhry, M. A. (2015). The first line of defense: the effects of alcohol on post-burn intestinal barrier, immune cells, and microbiome. Alcohol Research: Current Reviews, 37, 209-222.
Hartmann, P., Lang S., Zeng, S., Duan, Y., Zhang, X., Wang, Y., et al. (2021). Dynamic changes of the fungal microbiome in alcohol use disorder. Frontiers in Physiology, 12, 1-10. 10.3389/fphys.2021.699253.
Heier, C., Xie, H., & Zimmermann, R. (2016). Nonoxidative ethanol metabolism in humans - from biomarkers to bioactive lipids. International Union of Biochemistry and Molecular Biology, 68, 916-923. 10.1002/iub.1569.
Hritz, I., Mandrekar, P., Velayudham, A., Catalano, D., Dolganiuc, A., Kodys, K., et al. (2008). The critical role of toll-like receptor (TLR) 4 in alcoholic liver disease is independent of the common TLR adapter MyD88. Hepatology, 48, 1224-1231. 10.1002/hep.22470.
Hugbart C., Verres Y., Daré B. L., Bucher S., Vène E., Bodin, A., et al. (2020). Non-oxidative ethanol metabolism in human hepatic cells in vitro: Involvement of uridine diphospho-glucuronosyltransferase 1A9 in ethylglucuronide production. Toxicology in Vitro, 66, 104842. https://doi.org/10.1016/j.tiv.2020.104842.
Hyun, J., Han, J., Lee, C., Yoon, M., & Jung, Y. (2021). Pathophysiological aspects of alcohol metabolism in the liver. International Journal of Molecular Sciences, 22, 5717. https://doi.org/10.3390/ijms22115717.
Illiano, P., Brambilla, R., & Parolini, C. (2020). The mutual interplay of gut microbiota, diet and human disease. The FEBS Journal, 287, 833-855. 10.1111/febs.15217.
Johansson, M. E. V., & Hansson, G. C. (2016). Immunological aspects of intestinal mucus and mucins. Nature Reviews Immunology, 16, 639-649. https://doi.org/10.1038/nri.2016.88.
Jones, R. M., & Neish, A. S. (2021). Gut microbiota in intestinal and liver disease. Annual Review of Pathology: Mechanisms of Disease, 16, 251-275. https://doi.org/10.1146/annurev-pathol-030320-095722.
Jung, S-J., Hwang, J-H., Park, E-O., Lee, S-O., Chung, Y-J., Chung, M-J., et al. (2021). Regulation of alcohol and acetaldehyde metabolism by a mixture of lactobacillus and bifidobacterium species in human. Nutrients, 13, 1875. https://doi.org/10.3390/nu13061875.
Kc, D., Sumner, R., & Lippmann, S. (2020). Gut microbiota and health. Postgraduate Medicine, 132, 274. https://doi.org/10.1080/00325481.2019.1662711.
Keir, M. E., Yi, T., Lu, T. T., & Ghilardi, N. (2020). The role of IL-22 in intestinal health and disease. Journal of Experimental Medicine, 217, e20192195. https://doi.org/10.1084/jem.20192195.
Khaderi, S. A. (2019). Introduction: Alcohol and alcoholism. Clinics in Liver Disease, 23, 1-10. 10.1016/j.cld.2018.09.009.
Lazar, V., Ditu, L-M., Pircalabioru, G. G., Picu, A., Petcu, L., Cucu, N., et al. (2019). Gut microbiota, host organism, and diet trialogue in diabetes and obesity. Frontiers in Nutrition, 6, 1-20. 10.3389/fnut.2019.00021.
Leclercq, S., Saeger, C., Delzenne, N., Timary, P., & Stärkel, P. (2014). Role of inflammatory pathways, blood mononuclear cells, and gut-derived bacterial products in alcohol dependence. Biological Psychiatry, 76, 725-733. 10.1016/j.biopsych.2014.02.003.
Levitt, D. G., & Levitt, M. D. (2018). A model of blood-ammonia homeostasis based on a quantitative analysis of nitrogen metabolism in the multiple organs involved in the production, catabolism, and excretion of ammonia in humans. Clinical and Experimental Gastroenterology, 11, 193-215. 10.2147/CEG.S160921.
Li, X., Liu, Y., Guo, X., Ma, Y., Zhang, H., & Liang, H. (2021). Effect of Lactobacillus casei on lipid metabolism and intestinal microflora in patients with alcoholic liver injury. European Journal of Clinical Nutrition, 75, 1227-1236. https://doi.org/10.1038/s41430-020-00852-8.
Li, Y., Pan, A., Wang, D. D., Liu, X., Dhana, K., Franco, O. H., et al. (2018). Impact of healthy lifestyle factors on life expectancies in the US population. Circulation, 138, 345-355. https://doi.org/10.1161/CIRCULATIONAHA.117.032047.
Liberale, L., Bonaventura, A., Montecucco, F., Dallegri, F., & Carbone, F. (2019). Impact of red wine consumption on cardiovascular health. Current Medicinal Chemistry, 26, 3542-3566. https://doi.org/10.2174/0929867324666170518100606.
Lu, R., Voigt, R. M., Zhang, Y., Kato, I., Xia, Y., Forsyth, C. B., et al. (2017). Alcohol injury damages intestinal stem cells. Alcoholism: Clinical and Experimental Research, 41, 727-734. 10.1111/acer.13351.
Lu, Y., & Cederbaum, A. I. (2008). CYP2E1 and oxidative liver injury by alcohol. Free Radical Biology and Medicine, 44, 723-738. https://doi.org/10.1016/j.freeradbiomed.2007.11.004.
Manolis, T. A., Manolis, A. A., & Manolis, A. S. (2019). Cardiovascular effects of alcohol: A double-edged sword / how to remain at the nadir point of the J-Curve? Alcohol, 76, 117-129. https://doi.org/10.1016/j.alcohol.2018.08.011.
Marques, D. O., & Quintilio, M. S. V. (2021). Farmacologia e riscos das drogas para emagrecer. Revista Coleta Científica, 5, 38-49. https://doi.org/10.5281/zenodo.5093482.
Martin-Gallausiaux, C., Marinelli, L., Blottière, H. M., Larraufie, P., & Lapaque, N. (2021). SCFA: Mechanisms and functional importance in the gut. The Proceedings of the Nutrition Society, 80, 37-49. https://doi.org/10.1017/S0029665120006916.
McCauley, H. A., Matthis, A. L., Enriquez, J. R., Nichol, J. T., Sanchez, J. G., Stone, W. J., et al. (2020). Enteroendocrine cells couple nutrient sensing to nutrient absorption by regulating ion transport. Nature Communications, 11, 4791. https://doi.org/10.1038/s41467-020-18536-z.
Mendes, B. G., & Schnabl, B. (2020). From intestinal dysbiosis to alcohol-associated liver disease. Clinical and Molecular Hepatology, 26, 595-605. https://doi.org/10.3350/cmh.2020.0086.
Meroni, M., Longo, M., & Dongiovanni, P. (2019). Alcohol or gut microbiota: who is the guilty? International Journal of Molecular Sciences, 20, 4568. https://doi.org/10.3390/ijms20184568.
Michalak, A., Lach, T., & Cichoż-Lach, H. (2021). Oxidative stress-a key player in the course of alcohol-related liver disease. Journal Clinical Medicine, 10, 3011. 10.3390/jcm10143011.
Minzer, S., Losno, R. A., & Casas, R. (2020). The effect of alcohol on cardiovascular risk factors: is there new information? Nutrients, 12, 912. https://doi.org/10.3390/nu12040912.
Morais, L. H., Schreiber, H. L., & Mazmanian, S. K. (2020). The gut microbiota-brain axis in behaviour and brain disorders. Nature Reviews Microbiology, 19, 241-255. 10.1038/s41579-020-00460-0.
Mutlu, E. A., Gillevet, P. M., Rangwala, H., Sikaroodi, M., Naqvi, A., Engen, P. A., et al. (2012). Colonic microbiome is altered in alcoholism. American Journal of Physiology-Gastrointestinal and Liver Physiology, 302, G966-G978. 10.1152/ajpgi.00380.2011.
Mutlu, E., Keshavarzian, A., Engen, P., Forsyth, C. B., Sikarodi, M., & Gillevet, P. (2009). Intestinal dysbiosis: a possible mechanism of alcohol-induced endotoxemia and alcoholic steatohepatitis in rats. Alcohol: Clinical & Experimental Research, 33, 1836-1846. 10.1111/j.1530 0277.2009.01022.x.
Passos, M. C. F., & Prado Moraes-Filho, J. (2017). Intestinal microbiota in digestive diseases. Arquivos de Gastroenterologia, 54, 255-262. dx.doi.org/10.1590/S0004-2803.201700000-31.
Pushpanathan, P., Mathew, G. S., Selvarajan, S., Seshadri, K. G., & Srikanth, P. (2019). Gut microbiota and its mysteries. Indian Journal of Medical Microbiology, 37, 268-277. https://doi.org/10.4103/ijmm.IJMM_19_373.
Rodrigues, R. R., Gurung, M., Li, Z., García-Jaramillo, M. G., Greer, R., Gaulke, C., et al. (2021). Transkingdom interactions between Lactobacilli and hepatic mitochondria attenuate western diet-induced diabetes. Nature Communications, 12, 101. 10.1038/s41467-020-20313-x.
Sarin, S. K., Pande, A., & Schnabl, B. (2019). Microbiome as a therapeutic target in alcohol-related liver disease. Journal of Hepatology, 70, 260-272. https://doi.org/10.1016/j.jhep.2018.10.019.
Seki, E., & Schnabl, B. (2012). Role of innate immunity and the microbiota in liver fibrosis: crosstalk between the liver and gut. The Journal of Physiology, 590, 447-458. 10.1113/jphysiol.2011.219691.
Seitz, H. K., Bataller, R., Cortez-Pinto, H., Gao, B., Gual, A., Lackner, C., et al. (2018). Alcoholic liver disease. Nature Reviews Disease Primers, 4, 1-22. 10.1038/s41572-018-0014-7.
Shiba, S., Nakamoto N., Chu, P-S., Ojiro, K., Taniki, N., Yamaguchi, A., et al. (2021). Acetaldehyde exposure underlies functional defects in monocytes induced by excessive alcohol consumption. Scientific Reports, 11, 13690. 10.1038/s41598-021-93086-y.
Slevin, E., Baiocchi, L., Wu, N., Ekser, B., Sato, K., Lin, E., et al. (2020). Kupffer cells: inflammation pathways and cell-cell interactions in alcohol-associated liver disease. The American Journal of Pathology, 190, 2185-2193. https://doi.org/10.1016/j.ajpath.2020.08.014.
Taniai, M. (2020). Alcohol and hepatocarcinogenesis. Clinical and Molecular Hepatology, 26, 736-741. https://doi.org/10.3350/cmh.2020.0203.
Tomasello, G., Mazzola, M., Leone, A., Sinagra, E., Zummo, G., Farina, F., et al. (2016). Nutrition, oxidative stress and intestinal dysbiosis: Influence of diet on gut microbiota in inflammatory bowel diseases. Biomedical Papers of the Medical Faculty of the University Palacky Olomouc Czech Repub, 160, 461-466. https://doi.org/10.5507/bp.2016.052.
Trebicka, J., Bork, P., Krag, A., & Arumugam, M. (2020). Utilizing the gut microbiome in decompensated cirrhosis and acute-on-chronic liver failure. Nature Reviews Gastroenterology & Hepatology, 18, 167-180. 10.1038/s41575-020-00376-3.
Wang, H., Mehal, W., Nagy, L. E., & Rotman, Y. (2021). Immunological mechanisms and therapeutic targets of fatty liver diseases. Cellular & Molecular Immunology, 18, 73-91. https://doi.org/10.1038/s41423-020-00579-3.
Wang, S-C., Chen, Y-C., Chen, S-J., Lee, C-H., & Cheng, C-M. (2020). Alcohol addiction, gut microbiota, and alcoholism treatment: A review. International Journal of Molecular Sciences, 21, 6413. https://doi.org/10.3390/ijms21176413.
Wannamethee, S. G., Shaper, A. G., & Whincup, P. H. (2005) Alcohol and adiposity: effects of quantity and type of drink and time relation with meals. International Journal of Obesity, 29, 1436-1444. 10.1038/sj.ijo.0803034.
Wolk, K., Witte, E., Witte, K., Warszawska, K., & Sabat, R. (2010). Biology of interleukin-22. Seminars in Immunopathology, 32, 17-31. https://doi.org/10.1007/s00281-009-0188-x.
Woźniak, D., Cichy, W., Przysławski, J., & Drzymała-Czyż, S. (2021). The role of microbiota and enteroendocrine cells in maintaining homeostasis in the human digestive tract. Advances in Medical Sciences, 66, 284-292. https://doi.org/10.1016/j.advms.2021.05.003.
Wu, Y., Min, J., Ge, C., Shu, J., Tian, D., Yuan, Y., & Zhou, D. (2020). Interleukin 22 in liver injury, inflammation and cancer. International Journal of Biological Sciences, 16, 2405-2413. https://doi.org/10.7150/ijbs.38925.
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Copyright (c) 2023 Bianca Ferreira de Santana; Martha Elisa Ferreira de Almeida; Beatriz Barakat ; Lucas Inácio de Loyola Vinha; Madalena Geralda Cupertino Ribeiro; Gabrielly Senna Parussolo
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.
Autores que publicam nesta revista concordam com os seguintes termos:
1) Autores mantém os direitos autorais e concedem à revista o direito de primeira publicação, com o trabalho simultaneamente licenciado sob a Licença Creative Commons Attribution que permite o compartilhamento do trabalho com reconhecimento da autoria e publicação inicial nesta revista.
2) Autores têm autorização para assumir contratos adicionais separadamente, para distribuição não-exclusiva da versão do trabalho publicada nesta revista (ex.: publicar em repositório institucional ou como capítulo de livro), com reconhecimento de autoria e publicação inicial nesta revista.
3) Autores têm permissão e são estimulados a publicar e distribuir seu trabalho online (ex.: em repositórios institucionais ou na sua página pessoal) a qualquer ponto antes ou durante o processo editorial, já que isso pode gerar alterações produtivas, bem como aumentar o impacto e a citação do trabalho publicado.
