Gut microbiota produce alcohol and contribute to NAFLD

The hypothesis that alcohol metabolism contributes to the pathogenesis of non-alcoholic fatty liver disease (NAFLD) dates back to 2000 when Cope et al 1 reported elevated alcohol concentration in the breath of ob/ob mice and demonstrated that breath alcohol concentration can be reduced by gut microbial intervention with neomycin. In the last 15 years, accumulating evidence in support of this hypothesis has been reported by several groups (reviewed at ref. 2), including the group led by Bergheim, who first reported elevated serum alcohol in NAFLD.3 Previous studies indicated that the elevated alcohol level in NAFLD is associated with increased representation of alcohol producing bacteria in the gut microbiome.4 ,5 However, a recent report by Bergheim and her colleagues suggested a very different mechanism for the …