• The gut microbiota as a potential treatment for liver cancer (Systematic review)
  • Mahya Najjari,1 Sepideh Hasanzadeh,2,*
    1. Department of Microbiology and Virology, Mashhad University of Medical Sciences, Mashhad, Iran
    2. Department of Medical Laboratory Sciences, Varastegan Institute for Medical Sciences, Mashhad, Iran


  • Introduction: Liver cancer is a life-threatening malignancy due to its high incidence and mortality worldwide. The imbalance of gut microbiota plays an essential role in the occurrence and progression of liver cancer. The aim of this study is to investigate gut microbiota-mediated therapy as a potential option for liver cancer treatment.
  • Methods: This review article was performed within articles published at PubMed, Science Direct, Google Scholar, SID, and Cochrane until September 2022. The keywords were liver cancer, gut microbiota, probiotics, and treatment. By searching this database; 79 articles were found, 35 of them by Reading titles and abstracts were removed. 44 articles were selected under the inclusion criteria. All articles were chosen from English and Persian articles.
  • Results: Finally, 44 articles were included in the study. Gut microbiota could present a non-invasive biomarker for early liver cancer diagnosis. Bacillus subtilis, Lactobacillus casei, and Candida utilis could degrade aflatoxin and had a positive effect on the prevention of hepatocellular carcinoma (HCC). Prevotella and Oscillibacter were known as producers of anti-inflammatory metabolites, which reduced the Th17 polarization and promoted the differentiation of anti-inflammatory Treg/Tr1 cells in the gut. Probiotics modulated host gut microbiota, to prevent pathogen-associated-molecular patterns (PAMPs)-mediated hepatic inflammation. The gut microbiota could modulate host responses to chemotherapeutic drugs for liver cancer and the mechanisms were translocation, immunomodulation, metabolisms, enzymatic degeneration and reduced diversity. Modified FMT could bring the gut microbiota of HCC patients closer to normal people. Immunotherapy targeting CTLA4 and PD-1 could improve the immunosuppressive environment shaped by harmful species of gut microbiota. Farnesoid X receptor (FXR) agonists like obeticholic acid and TLR4 inhibitors such as eritoran might inhibit HCC development by altering the gut microbiota indirectly. Sodium butyrate treatment reduced inflammation and by enriching Christensenellacease, Blautia, Lactobacillus and bifidobacterium. Synbiotics that consisted of Lactobacillus paracasei B21060 plus arabinogalactan could reduce hepatic inflammation.
  • Conclusion: Targeting the gut microbiota has a vital function in the diagnosis, prevention, and treatment of liver cancer. However, need to be more research done on this topic.
  • Keywords: Liver cancer, gut microbiota, treatment, probiotics