FATTY LIVER AND GUT MICROBIOTA: A NEW MULTI-DIMENSIONAL APPROACH FOR PERSONALIZED PREVENTIVE MEDICINE

Cardiovascular, degenerative, hepato-digestive, metabolic and neoplastic diseases are major causes of death; all of them are beckoned years before by fatty liver that can quantify by non-invasive ultrasound methods. Such a measure is sensitive and reproducible and qualifies as mirror of general health to monitor the efficacy of preventive care in pre-symptomatic subjects. One major determinant of alimentary and general health is the gut microbiota that regulates hepatic gene expression, lipid metabolism and contributes to hepatic inflammation and obesity. The microbiota can be dynamically modified by probiotic/ prebiotic supplementation, however a direct gut microbiota profiling by stool metagenomics is limited by sampling error. The study of blood and/or saliva metabolites (metabolomics) and circulating antimicrobial antibodies provide an indirect microbiota profiling. Studies need to be performed to test whether variation of metabolomics and antimicrobial antibody levels correlate with the in vivo bacteria dynamics. The non-invasive measure of fatty liver in combination with of the gut microbiota characterization by metagenomics, metabolomics and anti-microbial enzyme immune assays will provide an innovative technological approach to stratify individuals with fatty liver for both prevention, outcome prediction and personalized treatment and to identify new aetiologies, diagnostic and prognostic biomarkers and therapeutic targets