Review Special Issues

Targeting gut health: Probiotics as promising therapeutics in alcohol-related liver disease management

  • Received: 30 August 2024 Revised: 09 May 2025 Accepted: 27 May 2025 Published: 11 June 2025
  • Alcohol consumption represents a major global health issue, accounting for approximately 4.7% of annual deaths and 5.1% of the disease burden worldwide. The liver is particularly vulnerable to alcohol-related damage, with chronic alcohol use leading to a spectrum of alcohol-associated liver diseases, including fatty liver, alcohol-associated hepatitis, cirrhosis, and hepatocellular carcinoma. Despite public awareness of the risks associated with excessive alcohol intake, a substantial proportion of the global population continues to consume alcohol, contributing to the increased incidence of liver-related conditions. Dysbiosis of the gut microbiota has emerged as a critical factor in the pathogenesis of alcohol-associated liver diseases, as alcohol consumption alters microbial composition and increases intestinal permeability, which contributes to systemic inflammation and liver injury through the translocation of endotoxins. Recent research into the therapeutic potential of probiotics, prebiotics, and synbiotics highlights their ability to restore microbial balance and enhance intestinal barrier function. Studies demonstrate that these interventions can significantly improve liver enzymes and reduce inflammation, suggesting their complementary role in the management of alcohol-associated liver diseases. However, further research is necessary to elucidate optimal dosing strategies and long-term efficacy. This review underscores the importance of a multifaceted approach toward understanding alcohol-associated liver diseases and the therapeutic potential of modulating the gut-liver axis through microbiota-targeted strategies.

    Citation: María José Lorenzo Pisarello, Antonela Marquez, Adriana Perez Chaia, Jaime Daniel Babot. Targeting gut health: Probiotics as promising therapeutics in alcohol-related liver disease management[J]. AIMS Microbiology, 2025, 11(2): 410-435. doi: 10.3934/microbiol.2025019

    Related Papers:

    [1] Maria Parapouli, Anastasios Vasileiadis, Amalia-Sofia Afendra, Efstathios Hatziloukas . Saccharomyces cerevisiae and its industrial applications. AIMS Microbiology, 2020, 6(1): 1-31. doi: 10.3934/microbiol.2020001
    [2] Kholoud Baraka, Rania Abozahra, Maged Wasfy Helmy, Nada Salah El Dine El Meniawy, Sarah M Abdelhamid . Investigation of the protective and therapeutic effects of Lactobacillus casei and Saccharomyces cerevisiae in a breast cancer mouse model. AIMS Microbiology, 2022, 8(2): 193-207. doi: 10.3934/microbiol.2022016
    [3] Amira ElBaradei, Dalia Ali Maharem, Ola Kader, Mustafa Kareem Ghareeb, Iman S. Naga . Fecal carriage of ESBL-producing Escherichia coli in Egyptian patients admitted to the Medical Research Institute hospital, Alexandria University. AIMS Microbiology, 2020, 6(4): 422-433. doi: 10.3934/microbiol.2020025
    [4] Saboura Haghighi, Hamid Reza Goli . High prevalence of blaVEB, blaGES and blaPER genes in beta-lactam resistant clinical isolates of Pseudomonas aeruginosa. AIMS Microbiology, 2022, 8(2): 153-166. doi: 10.3934/microbiol.2022013
    [5] Farzad Rahmati . Characterization of Lactobacillus, Bacillus and Saccharomyces isolated from Iranian traditional dairy products for potential sources of starter cultures. AIMS Microbiology, 2017, 3(4): 815-825. doi: 10.3934/microbiol.2017.4.815
    [6] Alberto Bernacchi, Giulia Semenzato, Manuel di Mascolo, Sara Amata, Angela Bechini, Fabiola Berti, Carmela Calonico, Valentina Catania, Giovanni Emiliani, Antonia Esposito, Claudia Greco, Stefano Mocali, Nadia Mucci, Anna Padula, Antonio Palumbo Piccionello, Battogtokh Nasanbat, Gantulga Davaakhuu, Munkhtsetseg Bazarragchaa, Francesco Riga, Claudio Augugliaro, Anna Maria Puglia, Marco Zaccaroni, Fani Renato . Antibacterial activity of Arthrobacter strains isolated from Great Gobi A Strictly Protected Area, Mongolia. AIMS Microbiology, 2024, 10(1): 161-186. doi: 10.3934/microbiol.2024009
    [7] Alaa Fathalla, Amal Abd el-mageed . Salt tolerance enhancement Of wheat (Triticum Asativium L) genotypes by selected plant growth promoting bacteria. AIMS Microbiology, 2020, 6(3): 250-271. doi: 10.3934/microbiol.2020016
    [8] Sabrine Balti, Yassine Mabrouk, Mouna Souihi, Imen Hemissi, Ismail Amri, Ethan Humm, Noor Khan, Ann M. Hirsch . Combined inoculation of rhizobacteria with Mesorhizobium promotes growth, nutrient contents, and protects chickpea against Fusarium redolens. AIMS Microbiology, 2025, 11(2): 318-337. doi: 10.3934/microbiol.2025015
    [9] Mohamed H. El-Sayed, Doaa A. Elsayed, Abd El-Rahman F. Gomaa . Nocardiopsis synnemataformans NBRM9, an extremophilic actinomycete producing extremozyme cellulase, using lignocellulosic agro-wastes and its biotechnological applications. AIMS Microbiology, 2024, 10(1): 187-219. doi: 10.3934/microbiol.2024010
    [10] Ashrafus Safa, Jinath Sultana Jime, Farishta Shahel . Cholera toxin phage: structural and functional diversity between Vibrio cholerae biotypes. AIMS Microbiology, 2020, 6(2): 144-151. doi: 10.3934/microbiol.2020009
  • Alcohol consumption represents a major global health issue, accounting for approximately 4.7% of annual deaths and 5.1% of the disease burden worldwide. The liver is particularly vulnerable to alcohol-related damage, with chronic alcohol use leading to a spectrum of alcohol-associated liver diseases, including fatty liver, alcohol-associated hepatitis, cirrhosis, and hepatocellular carcinoma. Despite public awareness of the risks associated with excessive alcohol intake, a substantial proportion of the global population continues to consume alcohol, contributing to the increased incidence of liver-related conditions. Dysbiosis of the gut microbiota has emerged as a critical factor in the pathogenesis of alcohol-associated liver diseases, as alcohol consumption alters microbial composition and increases intestinal permeability, which contributes to systemic inflammation and liver injury through the translocation of endotoxins. Recent research into the therapeutic potential of probiotics, prebiotics, and synbiotics highlights their ability to restore microbial balance and enhance intestinal barrier function. Studies demonstrate that these interventions can significantly improve liver enzymes and reduce inflammation, suggesting their complementary role in the management of alcohol-associated liver diseases. However, further research is necessary to elucidate optimal dosing strategies and long-term efficacy. This review underscores the importance of a multifaceted approach toward understanding alcohol-associated liver diseases and the therapeutic potential of modulating the gut-liver axis through microbiota-targeted strategies.



    Over the past few decades, the winemaking industry has placed a significant reliance on sulphur dioxide (SO2) as a preservative due to the numerous critical functions it performs [1]. In the context of winemaking, SO2 is an effective agent to combat acetic acid bacteria, lactic acid bacteria, and yeasts, thus maintaining the quality of the wine. Additionally, it acts as a potent antioxidant, thereby mitigating the effects of dissolved oxygen and inhibiting oxidising enzymes. Grape oxidases (tyrosinase and laccase), which are responsible for phenol oxidation and aroma development, are neutralised by SO2 [2]. This compound is a broad-spectrum antimicrobial agent that prevents off-flavor formation by inhibiting the indigenous microbiota that could otherwise lead to uncontrolled spontaneous fermentation [3]. SO2 enhances the wine color stability during ageing and facilitates the release of phenolic compounds from the grape skin during maceration [4]. Due to its affordability and ability to maintain wine characteristics even after bottling, SO2 is widely used in winemaking globally [5][8]. However, there are concerns about excessive SO2 levels. The World Health Organization (WHO) has recommended the use of alternative methods to either reduce or eliminate the consumption of sulphites, particularly in light of the potential negative effects on consumer health, especially for those with allergies or sensitivities [2]. Additionally, the International Organization of Vine and Wine (OIV) has been gradually lowering the maximum recommended dosage for distributed wines [9]. Furthermore, the European Community has mandated that wine containing SO2 must include this information on labels [10]. Moreover, global wine consumers have demonstrated a growing inclination towards products that align with the natural definition, which is characterized by a minimal use of preservatives and chemicals. The objective is to espouse ecologically responsible wine-growing and oenological practices that prioritize consumer health [11],[12].

    In order to control the microbial populations in the context of winemaking, a number of alternative strategies have been explored, including the use of ultraviolet radiation, pulsed electric fields (PEF), high pressure, ultrasound, and high hydrostatic pressure treatments [13],[14]. Furthermore, researchers have investigated the potential of utilizing substances such as chitosan, lysozyme, dimethyl dicarbonate, and sorbic acid to address this challenge [6]. In addition to the aforementioned physical and chemical methods, there is a biological control alternative, known as bio-protection. The strategy is comprised of a series of techniques designed to prevent microbial contamination and to achieve the same results typically achieved through the use of SO2. In particular, various microbial species, including yeasts (both Saccharomyces and non-Saccharomyces) and bacteria, are introduced at different stages of the food production process, either before, during, or after the process [15]. These microorganisms act as bio-protectors by employing a range of mechanisms, comprising both passive and active strategies. Passive strategies include the deprivation of resources and the establishment of dominance within a colonized space [16][18]. Microorganisms deploy tactics to restrict the competitors' access to resources, including nutrients and oxygen. Furthermore, they secure dominance in terms of the space they occupy. Indeed, the nutrients, oxygen, and space are the main parameters that affect the population dynamics [19][22]. Conversely, active strategies include the production of several molecules with various effects, such as antimicrobial compounds [15]. Notably, to date, no studies have evaluated the effect of inoculating a low concentration of Saccharomyces cerevisiae before the pressing stage to enhance the defense against oxygen-related issues.

    The experimental plan is reported in Figure 1, and foresaw to evaluate the effect on oxygen consumption, organoleptic properties, and volatile compounds using Saccharomyces cerevisiae strains during the white vinification process. The Catarratto variety (Vitis vinifera L.) of grapes from a vineyard located in San Giuseppe Jato, (37°59′20′′ N; 13°11′34′′ E, Palermo, Sicily, Italy) were processed at a laboratory scale in the Department of Agricultural, Food and Forest Sciences (SAAF) at University of Palermo. Immediately after harvesting, the grapes were destemmed, crushed, and pressed without the addition of any coadjuvant (Trial A). In the second trial (B), 5 g/hL of the S. cerevisiae HD A54 strain was added at the pressing stage. The strain was used in its active dry yeast (ADY) form, and was rehydrated following the manufacturer's protocol. Clarification was carried out and lasted 24 h at 8 °C. The following products were used for clarification: Clarification Hzym® Extractive FCE G (2 g/hL; HTS Enologia, Marsala, Italy) and Hveg® Vegepure juice (20 g/hL; HTS Enologia, Marsala, Italy). SO2 was not added in “A” trial, nor in trial “B” before clarification. The Saccharomyces cerevisiae HD A54 strain, provided by HTS Enologia (Marsala, Italy), was used as a starter to carry out alcoholic fermentation, which was carried out at 14 °C. Prior to yeast inoculum, each trial was supplemented with 20 g/hL of Hnutrix® B-Starter simplex (HTS Enologia, Marsala, Italy), which is a yeast partial autolisate useful as a starting nutrient for ADY. Di-ammonium phosphate (DAP; 20 g/L; Chimica Noto s.r.l., Partinico, Italy) was added during alcoholic fermentation at 4% (v/v) of ethanol; during the last phase of alcoholic fermentation, 10 g/hL of Hnutrix® B-Energia (HTS Enologia, Marsala, Italy), which is a formulation of organic nitrogen and micronutrients, was added in order to avoid nutrient starvation during alcoholic fermentation. At the end of alcoholic fermentation, the wines were separated from the lees and transferred into a clean glass carboy; lastly, 5 g/hL of Hvin®UP Fresh (HTS Enologia, Marsala, Italy), a solution used to improve shelf life and to preserve wine aroma, and 8 g/hL of potassium metabisulphite were added. The wines were stored at 8 °C up to the bottling phase. Sample collection involved the grape must during several phases of the vinification process. In detail, the grape must was collected after pressing, before, during (12 h of process ongoing), and after clarification, at yeast inoculum, at 3 and 6 days of alcoholic fermentation, and at the end of alcoholic fermentation. All samples were immediately subjected to analyses.

    Figure 1.  Experimental design of Catarratto wine vinified with or without Saccharomyces cerevisiae bio-protective HD A54 strain.

    All samples collected during the wine production were analyzed; in particular, the yeast and lactic acid bacteria (LAB) populations were monitored. The samples were diluted in Ringer's solution (Sigma-Aldrich, Milan, Italy) (ratio 1:10) and analyzed in triplicate for total yeasts (TY) on Wallerstein Laboratory (WL) nutrient agar (Condalab, Torrejón de Ardoz, Spain) [23] at 28 °C for 72 h, and total non-Saccharomyces yeast on Lysine Agar (LA) (Thermo Fisher Scientific Inc., Milan, Italy) at 28 °C for 5 days [24]. Mesophilic lactobacilli were detected on de-Man, Rogosa, and Sharpe (MRS) agar medium (Condalab, Torrejón de Ardoz, Spain), which were supplemented with cycloheximide (10 mg/mL) and incubated under microaerophilic conditions at 30 °C for 48 h [25]. Presumptive Saccharomyces spp. were calculated as the difference between the total yeast count on WL nutrient agar and the total non-Saccharomyces.

    Regarding the chemical parameters monitored during alcoholic fermentation, the pH and total acidity were assessed following the OIV procedures [26],[27]. In addition, the remaining monitored chemical parameters were detected through enzymatic assays on an iCubio iMagic M9 (iCubio Biomedical Technology Co. Ltd., Shenzhen, China); in detail, the quantification of acetic, malic, tartaric, and lactic acids was conducted as reported by Matraxia et al. [28]. Furthermore, the ethanol content was measured as previously reported by Chawafambira [29]. The reagents were purchased from R-Biopharm AG (Darmstadt, Germany), and these analyses were performed in triplicate.

    The soluble oxygen was monitored to evaluate the effect of the S. cerevisiae HD A54 strain to reduce the oxygen content from post pressing to the end of alcoholic fermentation. To this end, a portable dissolved oxygen meter Mod. HQ30D, equipped with Intellical LDO101 Luminescence/Optical dissolved oxygen probe (Hach Lange S.r.l, Milan, Italy), was employed. The samples were analyzed for the absorbance using a 420 nm optical path before, during, and after clarification, at the inoculum, and at the end of alcoholic fermentation by spectrophotometer (UV-1601-Shimadsu, Tokyo, Japan).

    The standards for each compound were individually purchased from Sigma-Aldrich (82024 Taufkirchen, Germany). 2,3-butanediol was used as the standard for the alcohol fraction, acetoin as the standard for the carboxyl-function fraction, and ethyl lactate as the standard for the ester fraction. In addition, n-alkane standards (C8 to C40) were purchased from the Aldrich Chemical Co. (St. Louis, Mo., USA). The standard solutions of each compound were prepared at five different concentrations: 2,3-butanediol (53.2 mg/L, 112.5 mg/L, 225.0 mg/L, 262.0 mg/L, and 450.0 mg/L); acetoin (24.7 mg/L, 45.70 mg/L, 64.7 mg/L, 115.6 mg/L, 173.30 mg/L, and 289.8 mg/L); and ethyl lactate (79.0 mg/L, 134.0 mg/L, 224.0 mg/L, 326.0 mg/L, and 477.0 mg/L).

    In order to determine the volatile organic composition, the procedure outlined by Francesca et al. [30] was applied. In detail, the wine samples (10 mL) from all trials were mixed with MS SupraSolv® dichloromethane (5 mL) in a 50 mL conical flask. The mixture was stirred at room temperature for 30 min and then centrifuged at 4000 rpm for 10 min using a Low-Speed Centrifuge (ScanSpeed 416) with a Swing Rotor (LaboGene ApS Industrivej 6–8, Vassingerød, DK-3540 Lynge, Denmark). The aqueous phase was removed, and anhydrous sodium sulphate (1 g) was added before centrifugation at 4000 rpm for 5 min. The dichloromethane layer was removed and dried under N2 gas to 0.3 mL.

    Gas chromatographic analyses were performed with the Agilent 7000C GC system, fitted with a fused silica Agilent DB-5MS capillary column (30 m × 0.25 mm i.d.; 0.25 µm film thickness), coupled to an Agilent triple quadrupole Mass Selective Detector MSD 5973 (ionization voltage 70 eV; electron multiplier energy 2000 V; transfer line temperature 295 °C; solvent delay: 3.5 min). Helium was the carrier gas (1 mL/min).

    The temperature was initially maintained at 40 °C for 1 min. Then, it was gradually increased to 250 °C at a rate of 3 °C/min for 30 min, and finally maintained at 250 °C at 10 °C/min. One µL of sample was automatically injected at 250 °C and in the splitless mode, where the transfer line temperature was 295 °C. The individual peaks were analyzed using the GC MS Solution package, Version 2.72. The identification of compounds was carried out using Adams, NIST 11, Wiley 9, and the FFNSC 2 mass spectral database. These identifications were also confirmed by other published mass spectra and linear retention indices (LRI). The LRIs were calculated using a series of n-alkanes (C8–C40). Quantification was carried out using the three calibration lines. For compounds belonging to other classes than the standards, similarity was used for quantification.

    In order to determine the sensory profiles of the experimental wines, a quantitative descriptive analysis was conducted by following the methodology reported by Jackson [31].

    Each panelist had a strong experience on winemaking and sensory analyses, and were picked among people who already participated in past similar studies as judges. There was a total of 14 trained judges, consisting in 7 men and 7 women between the ages of 26 and 63 years old. In order to assess their sensory skills, they were previously subjected to a test based on flavors and tastes associated to the wines. Several descriptive attributes were chosen to evaluate the experimental wines in terms of the odor appearance, mouth feel, gustatory taste, flavor, and overall quality. Other descriptors regarded the identification and quantification of off-odors and off-flavors connected to microbial aspects and a list of several other attributes referring to pungent, putrid, and petroleum [32].

    Each individual attribute was assessed by scoring on an unstructured 9 cm scale. Lastly, every panelist judged each sample in triplicate with a different wine bottle every time. An incomplete balanced block design was utilized to reduce the contrast impact between the samples [33].

    The XLStat software for Excel, version 2020.3.1 (Addinsoft, New York, USA), was used to process the statistical data and to generate the graphics. In particular, the physicochemical, microbiological, oenological, VOC, and sensory data were submitted to a one-way analysis of variance (ANOVA). The Tukey's test was performed to make the comparisons, and statistical significance was attributed to p < 0.05.

    During fermentation, the yeast populations were investigated (Figure 2), and the indigenous non-Saccharomyces population in the grape must was found to be 4.8 Log CFU/mL. Notably, the Saccharomyces species was not detected in the grape must, which is consistent with previous studies [34][36]. Additionally, low concentrations of LAB were observed at the start of the vinification process (<4.0 Log CFU/mL). However, these LAB levels are comparable to those found by Sannino et al. [37] on SO2 free grape must. In Trial B, the S. cerevisiae HD A54 strain was inoculated during the pressing phase at a density between 3.4–3.5 Log CFU/mL. In Trial A, the presumptive S. cerevisiae population was slightly above the detection limit (2.1 Log CFU/mL). Interestingly, the presumptive S. cerevisiae levels remained stable during the clarification phase in Trial A, while there was a small increase in the presumptive S. cerevisiae levels in Trial B due to cell multiplication of the inoculated S. cerevisiae HD A54 strain. Although no literature studies specifically address the addition of bioprotective S. cerevisiae, this increase can be considered a regular growth pattern for an inoculated S. cerevisiae strain within a few hours [38].

    In both Trials A and B, there was a consistent trend in non-Saccharomyces count values, with a slight decrease observed. The S. cerevisiae HD A54 strain was inoculated at a level of 6.0 Log CFU/mL in these trials. During alcoholic fermentation, both the presumptive Saccharomyces and presumptive non-Saccharomyces populations increased, reaching their peak at three days in Trial A and up to six days in Trial B. The fermentation kinetics of the S. cerevisiae population followed a regular pattern (Figure 2), which aligns with the findings of Morgan et al. [39] regarding SO2-free grape must.

    Figure 2.  Trend of Yeast and bacteria population (Log CFU/mL) during alcoholic fermentation: (A) Trial A microorganism levels; (B) Trial B microorganism levels. Abbreviations: AF, alcoholic fermentation; LAB, lactic acid bacteria.

    The key chemical parameters (sugars, organic acids, pH, total acidity, and glycerol) determined in the must and wine are reported in Table 1. Initially, the musts showed a sugar concentration of 275.7 g/L, a pH of 3.25, tartaric acid at 5.08 g/L, and malic acid at 1.36 g/L. The sugar consumption and acetic acid production showed similar trends between the treatments during alcoholic fermentation. However, the fructose values significantly differed, with Trial A showing consumption due to indigenous non-Saccharomyces yeasts that favor fructose [40]. Despite this, both treatments reached similar residual sugar levels (Figure 3). At the end of fermentation, the acetic acid levels were comparable to those reported by Alfonzo et al. [41] on “Catarratto bianco lucido” cultivar, which was likely influenced by the bioprotective effect of the HD A54 strain. Indeed, several S. cerevisiae strains exert their antimicrobial effect through the production of killer toxins or other inhibitory substances [42]. Alcoholic fermentation concluded in 12 days for both treatments, which resulted in residual sugar values below 2.0 g/L.

    Throughout the vinification process, no significant differences were found between the trials in terms of the acetic, malic, tartaric, or lactic acid, and the glycerol content. The ethanol levels were monitored at various sampling points during fermentation. Initially, both treatments showed similar ethanol values; however, by the sixth day, Trial A had a higher ethanol content (5.88 %) compared to Trial B (3.46 %). This trend continued, with Trial A reaching 13.34 % ethanol by the ninth day, while Trial B remained at 11.06 %. Ultimately, both treatments completed alcoholic fermentation with a similar ethanol content (14.10 % for Trial A and 14.04 % for Trial B), thus indicating successful fermentation.

    Figure 3.  Bar chart of glucose and fructose detected throughout the vinification process. Result indicates mean value ± standard deviation of two determinations from three replicates. Data displaying different letters at the top of each bar are significantly different (P value < 0.05), according to Tukey's test. Abbreviations: RS, residual sugar.
    Table 1.  Chemical parameters determined during the winemaking process.
    Parameters Must Vinification
    Pre-clarification Post-clarification 3 d of alcoholic fermentation
    A B S.S. A B S.S. A B S.S.
    Residual sugar Ψ 275.70 ± 3.41 269.6 ± 4.81a 273.80 ± 4.76a n.s. 262.67 ± 8.44a 271.19 ± 7.74a n.s. 255.05 ± 7.97a 265.61 ± 4.57a n.s.
    Fructose Ψ 156.15 ± 2.31 146.28 ± 0.46b 156.01 ± 0.46a *** 146.10 ± 1.55b 155.39 ± 1.59a ** 139.40 ± 3.51a 149.66 ± 6.04a n.s.
    Glicerol Ψ 0.00 ± 0.00 0.05 ± 0.01a 0.04 ± 0.01a n.s. 0.115 ± 0.00a 0.11 ± 0.00a n.s. 0.54 ± 0.02a 0.35 ± 0.13a n.s.
    Acetic acid Ψ 0.00 ± 0.00 0.00 ± 0.00a 0.00 ± 0.00a n.s. 0.00 ± 0.00a 0.00 ± 0.00a n.s. 0.08 ± 0.02a 0.07 ± 0.01a n.s.
    Malic acid Ψ 1.36 ± 0.03 1.37 ± 0.02a 1.36 ± 0.00a n.s. 1.37 ± 0.03a 1.35 ± 0.00a n.s. 1.29 ± 0.07a 1.31 ± 0.01a n.s.
    Tartaric acid Ψ 5.08 ± 0.05 4.33 ± 0.05a 4.56 ± 0.24a n.s. 4.04 ± 0.19a 4.09 ± 0.00a n.s. 4.85 ± 0.30a 4.42 ± 0.15a n.s.
    Lactic acid Ψ 0.00 ± 0.00 0.00 ± 0.00a 0.00 ± 0.00a n.s. 0.00 ± 0.00a 0.00 ± 0.00a n.s. 0.02 ± 0.01a 0.03 ± 0.00a n.s.
    Ethanol 0.00 ± 0.00 0.22 ± 0.07a 0.09 ± 0.04a n.s. 0.39 ± 0.16a 0.14 ± 0.09a n.s. 0.84 ± 0.22a 0.41 ± 0.23a n.s.
    Parameters 6 d of alcoholic fermentation 9 d of alcoholic fermentation End of alcoholic fermentation
    A B S.S. A B S.S. A B S.S.
    Residual sugar Ψ 157.00 ± 4.49b 202.25 ± 8.38a *** 11.75 ± 3.89b 57.60 ± 1.40a *** 1.53 ± 0.00a 0.51 ± 0.06b ***
    Fructose Ψ 104.51 ± 7.48b 126.77 ± 2.08a ** 9.63 ± 1.36b 52.61 ± 0.52a *** 0.47 ± 0.06a 0.07 ± 0.07b **
    Glicerol Ψ 4.98 ± 0.16a 6.20 ± 1.62a n.s. 6.58 ± 0.04a 7.12 ± 0.40a n.s. 7.05 ± 0.37a 6.77 ± 0.25a n.s.
    Acetic acid Ψ 0.20 ± 0.03a 0.17 ± 0.01a n.s. 0.10 ± 0.01a 0.10 ± 0.03a n.s. 0.07 ± 0.01a 0.07 ± 0.03a n.s.
    Malic acid Ψ 1.25 ± 0.01a 1.24 ± 0.04a n.s. 1.23 ± 0.05a 1.24 ± 0.10a n.s. 1.21 ± 0.05a 1.20 ± 0.05a n.s.
    Tartaric acid Ψ 4.44 ± 0.11a 4.11 ± 0.13b * 4.17 ± 0.17a 3.89 ± 0.17a n.s. 3.55 ± 0.05a 3.67 ± 0.17a n.s.
    Lactic acid Ψ 0.01 ± 0.00a 0.02 ± 0.01a n.s. 0.00 ± 0.00a 0.00 ± 0.00a n.s. 0.00 ± 0.00a 0.00 ± 0.00a n.s.
    Ethanol 5.88 ± 0.25a 3.46 ± 0.31b *** 13.34 ± 0.21a 11.06 ± 0.12b *** 14.04 ± 0.03a 14.10 ± 0.04a n.s.

    Result indicates mean value ± standard deviation of two determinations from three replicates. Data within a row followed by the same letter are not significantly different according to Tukey's test. Tukey's test was not applied on must values. P value: *, P < 0.05 **, P < 0.01; ***, P < 0.001. Ψ, expressed in g/L; , expressed as % (v/v). Abbreviations: SS, statistical significance; n.s., not significant.

     | Show Table
    DownLoad: CSV

    The monitoring of oxygen levels during the clarification process is depicted in Figure 4. Following the completion of the pressing process, the oxygen concentration was found to be 4.67 mg/L in Trial A. In comparison, Trial B, which included the bio-protective HD A54 strain, demonstrated a significantly lower oxygen concentration of 3.40 mg/L. As stated by Catarino et al. [43], several winemaking operations, particularly the pressing stage, contribute to the uptake of oxygen. The considerable difference in the dissolved oxygen levels between Trial A and Trial B at this detection point, amounting to almost 30% less in Trial B, provides clear evidence of the beneficial impact of the bio-protective strain shortly after its addition. Both trials exhibited a comparable trend in dissolved oxygen during clarification; however, the disparity between the treatments persisted until the start of the clarification process, after which the differences leveled out. Furthermore, the dissolved oxygen concentrations exhibited a further decline at the inoculum stage for both trials. In particular, Trial A showed a reduction of 19.49% from the previous detection point, with a value of 1.02 mg/L. Trial B exhibited an even more pronounced reduction, with a decrease of 30.33% from the previous detection point, thus resulting in a value of 0.74 mg/L of dissolved oxygen at the inoculum stage. Additionally, slight differences between the treatments were evident at this detection point and at the end of alcoholic fermentation, as highlighted by the ANOVA.

    Figure 4.  Bar chart of dissolved O2 detected in must during pre-fermentative phase. Result indicates mean value ± standard deviation of two determinations from three replicates. Data within a sampling point followed by the same letter are not significantly different according to Tukey's test. Data followed by different letters are significantly different (P value < 0.05). Abbreviations: AF, alcoholic fermentation.

    In Figure 5, the absorbance values at 420 nm can be observed. The absorbance consistently decreased as the clarification proceeded. Following the pressing stage, Trial A showed significantly higher values (0.429) than Trial B (0.378). These findings slightly exceed the range reported by Darias-Martı́n et al. [44], who observed values between 0.2 to 0.6 after pressing, albeit with the addition of 40 mg/L of potassium metabisulphite immediately post-pressing. The trend persisted at the second detection point, where Trail B demonstrated the bioprotective effect of the HD A54 strain, thus yielding a lower value (0.295) than Trial A (0.348).

    Figure 5.  Bar chart of absorbance detected in must during pre-fermentative phase. Result indicates mean value ± standard deviation of two determinations from three replicates. Data within a sampling point followed by the same letter are not significantly different according to Tukey's test. Data followed by different letters are significantly different (P value < 0.05). Abbreviations: AF, alcoholic fermentation; n.s., not significant.

    Clarification, a common winemaking procedure, aims to enhance the wine appearance by reducing browning issues and achieving a greater clarity [45]. Interestingly, no significant differences were found between the treatments from this point until the end of alcoholic fermentation. Both the dissolved oxygen and absorbance analyses underscore the positive impact of the S. cerevisiae HD A54 strain in protecting against oxidative processes in the musts, especially during the phase between pressing and clarification.

    Table 2 reports the VOC composition, which consists of 30 compounds grouped into six classes: Alcohols, aldehydes, ketones, carboxylic acids, esters, and others. Alcohols were the most abundant, with Trial A containing a total of 117.58 ± 12.78 mg/L and Trial B containing a total of 189.49 ± 12.63 mg/L. Among the alcohol compounds, hydroxyethylbenzene exceeded the perception threshold. This compound is linked to floral odors [46],[47]. Notably, Trial B had a higher concentration of this compound (135.31 mg/L) compared to Trial A (44.23 mg/L). Additionally, 3-methyl-thio-1-propanol was more pronounced in Trial A (2.01 mg/L) than in Trial B, where it remained below the perception threshold. This particular compound is associated with an unpleasant odor reminiscent of a cooked potato [48]. The differences in the VOC composition between the two trials suggest that the HD A54 strain may have positively influenced Trial B.

    Table 2.  Volatile organic compounds of experimental wines.
    LRI Compounds (Common name) Odour Perception Threshold Trial A (mg/L) Trial B (mg/L)
    S.S.
    ∑Alcohols 117.58 ± 12.78b 189.49 ± 12.63a *
    607 2-methyl-1-propanol 40 mg/L [49] 1.00 ± 0.41a 0.00 ± 0.00b *
    764 1-pentanol 80 mg/L [50] 59.92 ± 5.32a 50.13 ± 4.08a n.s.
    765 1,2-propanediol Unknown 0.52 ± 0.07a 0.86 ± 0.14a n.s.
    824 2,3-butanediol 120 mg/L [51] 2.88 ± 0.27a 0.00 ± 0.00b ***
    856 3-methyl-1-pentanol Unknown 0.25 ± 0.08a 0.14 ± 0.03a n.s.
    878 1-hexanol 8 mg/L [52] 0.91 ± 0.08a 0.45 ± 0.09b *
    983 3-methyl-thio-1-propanol 1 mg/L [53] 2.01 ± 0.09a 0.85 ± 0.04b ***
    1134 Hydroxyethylbenzene 10 mg/L [46],[47] 44.23 ± 5.29b 135.31 ± 7.97a ***
    1314 2-methoxy-4-methyl-phenol Unknown 0.82 ± 0.05a 0.36 ± 0.11b ***
    1432 4-hydroxyphenyl ethanol Unknown 4.11 ± 1.05a 0.91 ± 0.09b *
    1505 2,4-di-tert-butyl phenol 0.2 mg/L [50] 0.93 ± 0.07a 0.48 ± 0.08b *
    ∑Aldehydes 3.03 ± 0.44a 2.16 ± 0.40a n.s.
    1224 3,4-dimethyl benzaldehyde Unknown 0.80 ± 0.15a 0.51 ± 0.12a n.s.
    2020 Octadecanal Unknown 2.23 ± 0.29a 1.65 ± 0.28a n.s.
    ∑Ketones 2.04 ± 0.54a 1.56 ± 0.30a n.s.
    722 3-hydroxy-2-butanone 30 mg/L [49] 0.49 ± 0.00a 0.51 ± 0.12a n.s.
    964 4-hydroxy-2-butanone Unknown 1.03 ± 0.51a 0.74 ± 0.11a n.s.
    1285 2-hydroxy-2-methyl-1-phenyl-1-propanone Unknown 0.52 ± 0.03a 0.31 ± 0.07b *
    ∑Carboxylic acids 4.47 ± 0.53a 0.94 ± 0.16b **
    590 Acetic acid 200 mg/L [54] 0.63 ± 0.08a 0.00 ± 0.00b *
    916 4-hydroxy butanoic acid Unknown 0.36 ± 0.06a 0.12 ± 0.04b **
    1015 Hexanoic acid 0.42 mg/L [52] 0.27 ± 0.08a 0.00 ± 0.00b **
    1195 Octanoic acid 2.20 mg/L [55] 3.21 ± 0.31a 0.82 ± 0.12b **
    ∑Esters 15.85 ± 3.50a 15.82 ± 2.39a n.s.
    589 Ethyl acetate 7.5 mg/L [54] 8.25 ± 0.99a 2.14 ± 0.62b **
    803 Ethyl lactate 60 mg/L [56] 0.15 ± 0.02a 0.29 ± 0.06a n.s.
    886 3-methyl-butyl acetate 0.03 mg/L [52] 2.99 ± 0.86b 7.84 ± 0.53a ***
    941 Ethyl 3-hydroxy butanoate Unknown 0.21 ± 0.08a 0.16 ± 0.04a n.s.
    1002 Ethyl-butyl acetate Unknown 1.40 ± 0.62a 0.76 ± 0.06a n.s.
    1199 Ethyl octanoate 0.005 mg/L [52] 0.66 ± 0.21b 1.40 ± 0.23a **
    1260 2-phenylethyl acetate 0.25 mg/L [57] 1.51 ± 0.63b 3.08 ± 0.77a *
    1386 Ethyl-9-decenoate Unknown 0.61 ± 0.07a 0.15 ± 0.08b *
    1395 Ethyl decanoate 0.2 mg/L [52] 0.07 ± 0.02a 0.00 ± 0.00b *
    ∑Others 0.25 ± 0.05a 0.17 ± 0.07a n.s.
    1768 3-(2-hydroxyethyl)-indole Unknown 0.25 ± 0.05a 0.17 ± 0.07a n.s.

    Result indicates mean value ± standard deviation of two determinations from three replicates. Data within a row followed by the same letter are not significantly different according to Tukey's test. P value: *, P < 0.05 **, P < 0.01; ***, P < 0.001. Abbreviations: SS, statistical significance; n.s., not significant.

     | Show Table
    DownLoad: CSV

    As the second most prevalent class of compounds, the esters had concentrations of 15.85 ± 3.50 for Trial A and 15.82 ± 2.39 mg/L for Trial B. Ethyl acetate, a prominent ester, exhibited significantly higher levels in Trial A (8.25 mg/L) compared to Trial B (2.14 mg/L), which remained below the threshold [54]. Interestingly, ethyl acetate serves as an indicator of oxidation: lower ester values correlate with a greater protection against oxidation [58]. In terms of fruity aromas, Trial B stood out due to the presence of 3-methyl-butyl acetate (banana-associated) [59] and ethyl octanoate (with pear and pineapple notes) [59], measuring 7.84 mg/L and 1.40 mg/L, respectively. Although Trial A recorded values above the perception threshold, they were significantly lower than those in Trial B (2.99 and 0.66 mg/L, respectively). Additionally, Trial B exhibited a higher concentration of 2-Phenylethyl acetate, an ester associated with flowery notes [47], at 3.08 mg/L, compared to Trial A at 1.51 mg/L.

    Another represented class was carboxylic acids, which are often linked to unwanted odors in wine [30]. Surprisingly, all carboxylic acids remained below the perception threshold in this study. However, it is essential to note that hexanoic acid and octanoic acid are typically responsible for unpleasant odors such as fatty, cheesy, and rancid smells. In the bio-protected treatment (Trial B), these acids were either entirely absent or below the perception threshold. In Trial A, hexanoic acid remained below the threshold (0.42 mg/L), while octanoic acid was perceptible at a concentration of 3.21 mg/L. Furthermore, acetic acid, a key indicator of wine spoilage and quality reduction [60], remained below the perception threshold in Trial A and was totally absent in Trial B.

    Figure 6 displays a radar plot generated after a sensory evaluation of the experimental wines. Notably, the two treatments showed variability, particularly in the odor attributes. Bio-protected Trial B scored higher in several odor-related attributes, except for the “off-odor” attribute, where Trial A had a slightly greater score. The “fruity” attribute received a definitively higher score for Trial A, thus aligning with the VOC analysis that highlighted compounds associated with fruity aromas, such as 3-methyl-butyl acetate and ethyl octanoate. Similarly, in terms of the floral attribute, the judges favored Trial B, which is consistent with the VOC analysis that showed higher values for hydroxyethylbenzene and 2-phenylethyl acetate, both associated with floral scent, specifically rose.

    Considering these findings, Trial B scored better in terms of complexity and the overall odor quality. Interestingly, the scores for fruity and floral attributes closely resembled those reported in a study by Alfonzo et al. [41] on Catarratto wines produced with different S. cerevisiae strains. As for the taste descriptors, Trial B received a higher score for intensity, while Trial A scored better in the smoothness attribute. Although mouthfeel-related attributes are often linked to a higher concentration of glycerol produced by certain non-Saccharomyces yeast strains [61],[62], this study did not highlight significantly higher glycerol production in Trial A nor a greater non-Saccharomyces yeast population. Nevertheless, Trial B received a higher score for the descriptor “taste overall quality”. Overall, the judges preferred the attributes associated with Trial B.

    Figure 6.  Radar plot generated by sensory analysis conducted on experimental wines. Result indicates mean value ± standard deviation of two determinations from three replicates. P value: *, P < 0.05 **, P < 0.01; ***, P < 0.001. Abbreviations: T, taste; O, odour.

    In recent years, reducing SO2 levels in winemaking has gained importance. Bioprotective yeasts offer winemakers a valuable solution by limiting the growth of unwanted microorganisms, preserving the product quality, and optimizing the space utilization. Current research primarily focuses on non-Saccharomyces yeasts such as Torulaspora delbrueckii and Metschnikowia pulcherrima to play a bio-protection role and to enhance the sensory aspects, which are particularly crucial in this context. The use of non-Saccharomyces yeasts could deeply influence the wine quality, thereby producing peculiar metabolites and potentially affecting other wine parameters such as acidity and alcohol content. This study evaluated the bio-protective properties of a specific S. cerevisiae strain which was added during the pre-fermentative stage throughout winemaking. Specifically, the addition of the HD A54 S. cerevisiae strain positively influenced the dissolved O2 levels from post-pressing until the end of fermentation. Additionally, it impacted the absorbance values, particularly before clarification, thus mitigating the browning effects. Furthermore, the VOC composition revealed an enhanced protection in the bio-protected trial, specifically for compounds associated with fruity and floral aromas. A sensory evaluation by judges confirmed these findings, with Trial B receiving higher scores for floral and fruity attributes. Overall, the wines treated with S. cerevisiae HD A54 after pressing were favorably evaluated. Finally, this strain successfully facilitated must fermentation without the need for SO2, thus suggesting its potential use in wine fermentation to either eliminate or decrease the utilization of sulphites.

    The authors declare they have not used Artificial Intelligence (AI) tools in the creation of this article.


    Acknowledgments



    We thank Lic. Mabel Taljuk for her assistance in the search of bibliography. This article was funded by grants from Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET) [grants number PICT-2021-GRF-TI-00765 and PIBAA 2022-2023 Nº 0995]. The figures in this article were created with BioRender.com.

    Conflict of interest



    The authors declare no conflict of interest.

    Author contributions



    Conceptualization, M.J.L.P. and JDB; writing-original draft preparation, M.J.L.P. and A.M.; writing review and editing, A.P.C. and J.D.B; supervision, M.J.L.P., A.P.C., and J.D.B. All authors have read and agreed to the published version of the manuscript.

    [1] World health OrganizationGlobal status report on alcohol and health and treatment of substance use disorders, 2024 (2024). Available from: https://www.who.int/publications/i/item/9789240096745
    [2] Thursz M, Gual A, Lackner C, et al. (2018) EASL clinical practice guidelines: Management of alcohol-related liver disease. J Hepatol 69: 154-181. https://doi.org/10.1016/j.jhep.2018.03.018
    [3] Han S, Yang Z, Zhang T, et al. (2021) Epidemiology of alcohol-associated liver disease. Clin Liver Dis 25: 483-492. https://doi.org/10.1016/j.cld.2021.03.009
    [4] Narro GEC, Díaz LA, Ortega EK, et al. (2024) Alcohol-related liver disease: A global perspective. Ann Hepatol 29: 101499. https://doi.org/10.1016/j.aohep.2024.101499
    [5] Camarotti AC, Jones D, Güelman M, et al. (2020) Changes in behaviors of alcohol consumption in the context of quarantine for COVID-19. A study in the Buenos Aires Metropolitan Area (Argentina). Rev Salud Pública : 37-50. Available from: https://revistas.unc.edu.ar/index.php/RSD/article/view/29140
    [6] Conde K, Gimenez PV, Salomón T, et al. (2021) Before and after the pandemic: Alcohol consumption and related problems in Argentina. Rev Interam Psicol J Psychol 55: e1444. https://doi.org/10.30849/ripijp.v55i1.1444
    [7] Karadayian A, Merlo A, Czerniczyniec A, et al. (2023) Alcohol consumption, hangovers, and smoking among Buenos Aires University students during the COVID-19 pandemic. J Clin Med 12: 1491. https://doi.org/10.3390/jcm12041491
    [8] Devarbhavi H, Asrani SK, Arab JP, et al. (2023) Global burden of liver disease: 2023 update. J Hepatol 79: 516-537. https://doi.org/10.1016/j.jhep.2023.03.017
    [9] Fedeli U, Amidei CB, Casotto V, et al. (2023) Mortality from chronic liver disease: Recent trends and impact of the COVID-19 pandemic. World J Gastroenterol 29: 4166-4173. https://doi.org/10.3748/wjg.v29.i26.4166
    [10] Amonker S, Houshmand A, Hinkson A, et al. (2023) Prevalence of alcohol-associated liver disease: A systematic review and meta-analysis. Hepatol Commun 7: e0133. https://doi.org/10.1097/HC9.0000000000000133
    [11] Parker R (2020) The natural history of alcohol-related liver disease. Curr Opin Gastroenterol 36: 164-168. https://doi.org/10.1097/MOG.0000000000000627
    [12] Torruellas C, French SW, Medici V (2014) Diagnosis of alcoholic liver disease. World J Gastroenterol WJG 20: 11684-11699. https://doi.org/10.3748/wjg.v20.i33.11684
    [13] Thomes PG, Rasineni K, Saraswathi V, et al. (2021) Natural recovery by the liver and other organs after chronic alcohol use. Alcohol Res Curr Rev 41: 05. https://doi.org/10.35946/arcr.v41.1.05
    [14] Hernández-Évole H, Jiménez-Esquivel N, Pose E, et al. (2024) Alcohol-associated liver disease: Epidemiology and management. Ann Hepatol 29: 101162. https://doi.org/10.1016/j.aohep.2023.101162
    [15] Mitra S, De A, Chowdhury A (2020) Epidemiology of non-alcoholic and alcoholic fatty liver diseases. Transl Gastroenterol Hepatol 5: 16. https://doi.org/10.21037/tgh.2019.09.08
    [16] Ventura-Cots M, Ballester-Ferré MP, Ravi S, et al. (2019) Public health policies and alcohol-related liver disease. JHEP Rep 1: 403-413. https://doi.org/10.1016/j.jhepr.2019.07.009
    [17] Yan C, Hu W, Tu J, et al. (2023) Pathogenic mechanisms and regulatory factors involved in alcoholic liver disease. J Transl Med 21: 300. https://doi.org/10.1186/s12967-023-04166-8
    [18] Das SK, Vasudevan DM (2007) Alcohol-induced oxidative stress. Life Sci 81: 177-187. https://doi.org/10.1016/j.lfs.2007.05.005
    [19] Liu SY, Tsai IT, Hsu YC (2021) Alcohol-related liver disease: Basic mechanisms and clinical perspectives. Int J Mol Sci 22: 5170. https://doi.org/10.3390/ijms22105170
    [20] Yang YM, Cho YE, Hwang S (2022) Crosstalk between oxidative stress and inflammatory liver injury in the pathogenesis of alcoholic liver disease. Int J Mol Sci 23: 774. https://doi.org/10.3390/ijms23020774
    [21] French SW (2001) Intragastric ethanol infusion model for cellular and molecular studies of alcoholic liver disease. J Biomed Sci 8: 20-27. https://doi.org/10.1159/000054009
    [22] Fleming S, Toratani S, Shea-Donohue T, et al. (2001) Pro- and anti-inflammatory gene expression in the murine small intestine and liver after chronic exposure to alcohol. Alcohol Clin Exp Res 25: 579-589. https://doi.org/10.1111/j.1530-0277.2001.tb02253.x
    [23] Mendes BG, Schnabl B (2020) From intestinal dysbiosis to alcohol-associated liver disease. Clin Mol Hepatol 26: 595-605. https://doi.org/10.3350/cmh.2020.0086
    [24] Fairfield B, Schnabl B (2021) Gut dysbiosis as a driver in alcohol-induced liver injury. JHEP Rep 3: 100220. https://doi.org/10.1016/j.jhepr.2020.100220
    [25] Hartmann P, Chu H, Duan Y, et al. (2019) Gut microbiota in liver disease: Too much is harmful, nothing at all is not helpful either. Am J Physiol-Gastrointest Liver Physiol 316: G563-G573. https://doi.org/10.1152/ajpgi.00370.2018
    [26] Schnabl B (2013) Linking intestinal homeostasis and liver disease. Curr Opin Gastroenterol 29: 264-270. https://doi.org/10.1097/MOG.0b013e32835ff948
    [27] Alvarez-Payares JC, Bello-Simanca JD, De La Peña-Arrieta EDJ, et al. (2021) Common pitfalls in the interpretation of endocrine tests. Front Endocrinol 12: 1-14. https://doi.org/10.3389/fendo.2021.727628
    [28] Tadokoro T, Morishita A, Himoto T, et al. (2023) Nutritional support for alcoholic liver disease. Nutrients 15: 1360. https://doi.org/10.3390/nu15061360
    [29] Adekunle AD, Adejumo A, Singal AK (2023) Therapeutic targets in alcohol-associated liver disease: Progress and challenges. Ther Adv Gastroenterol 16: 17562848231170946. https://doi.org/10.1177/17562848231170946
    [30] Rangra S, Rana D, Prajapati A, et al. (2024) Nutritional and microbiota-based therapeutic interventions for alcohol-associated liver disease: From pathogenesis to therapeutic insights. Life Sci 352: 122852. https://doi.org/10.1016/j.lfs.2024.122852
    [31] Vidya Bernhardt G, Shivappa P, Pinto JR, et al. (2024) Probiotics—role in alleviating the impact of alcohol liver disease and alcohol deaddiction: A systematic review. Front Nutr 11: 1372755. https://doi.org/10.3389/fnut.2024.1372755
    [32] Mullish BH, Thursz MR (2024) Alcohol-associated liver disease: Emerging therapeutic strategies. Hepatology 80: 1372-1389. https://doi.org/10.1097/HEP.0000000000000986
    [33] Hou K, Wu ZX, Chen XY, et al. (2022) Microbiota in health and diseases. Signal Transduct Target Ther 7: 1-28. https://doi.org/10.1038/s41392-022-00974-4
    [34] Tripathi A, Debelius J, Brenner DA, et al. (2018) The gut–liver axis and the intersection with the microbiome. Nat Rev Gastroenterol Hepatol 15: 397-411. https://doi.org/10.1038/s41575-018-0011-z
    [35] Ciocan D, Spatz M, Trainel N, et al. (2022) Modulation of the bile acid enterohepatic cycle by intestinal microbiota alleviates alcohol liver disease. Cells 11: 968. https://doi.org/10.3390/cells11060968
    [36] Ridlon JM, Kang DJ, Hylemon PB, et al. (2015) Gut microbiota, cirrhosis and alcohol regulate bile acid metabolism in the gut. Dig Dis Basel Switz 33: 338-345. https://doi.org/10.1159/000371678
    [37] Schnabl B, Brenner DA (2014) Interactions between the intestinal microbiome and liver diseases. Gastroenterology 146: 1513-1524. https://doi.org/10.1053/j.gastro.2014.01.020
    [38] Hsu CL, Schnabl B (2023) The gut–liver axis and gut microbiota in health and liver disease. Nat Rev Microbiol 21: 719-733. https://doi.org/10.1038/s41579-023-00904-3
    [39] Wang W, Wang C, Xu H, et al. (2020) Aldehyde dehydrogenase, liver disease and cancer. Int J Biol Sci 16: 921-934. https://doi.org/10.7150/ijbs.42300
    [40] Leclercq S, De Saeger C, Delzenne N, et al. (2014) Role of inflammatory pathways, blood mononuclear cells, and gut-derived bacterial products in alcohol dependence. Biol Psychiatry 76: 725-733. https://doi.org/10.1016/j.biopsych.2014.02.003
    [41] Xu J, Chen N, Li Z, et al. (2025) Gut microbiome and liver diseases. Fundam Res 5: 890-901. https://doi.org/10.1016/j.fmre.2024.09.007
    [42] Shasthry SM (2020) Fecal microbiota transplantation in alcohol related liver diseases. Clin Mol Hepatol 26: 294-301. https://doi.org/10.3350/cmh.2020.0057
    [43] Zeng S, Rosati E, Saggau C, et al. (2023) Candida albicans-specific Th17 cell-mediated response contributes to alcohol-associated liver disease. Cell Host Microbe 31: 389-404.e7. https://doi.org/10.1016/j.chom.2023.02.001
    [44] Jiang L, Lang S, Duan Y, et al. (2020) Intestinal virome in patients with alcoholic hepatitis. Hepatology 72: 2182-2196. https://doi.org/10.1002/hep.31459
    [45] Chen L, Hou X, Chu H (2023) The novel role of phage particles in chronic liver diseases. Microorganisms 11: 1181. https://doi.org/10.3390/microorganisms11051181
    [46] Hsu CL, Zhang X, Jiang L, et al. (2022) Intestinal virome in patients with alcohol use disorder and after abstinence. Hepatol Commun 6: 2058-2069. https://doi.org/10.1002/hep4.1947
    [47] Grander C, Adolph TE, Wieser V, et al. (2018) Recovery of ethanol-induced Akkermansia muciniphila depletion ameliorates alcoholic liver disease. Gut 67: 891-901. https://doi.org/10.1136/gutjnl-2016-313432
    [48] Leclercq S, Matamoros S, Cani PD, et al. (2014) Intestinal permeability, gut-bacterial dysbiosis, and behavioral markers of alcohol-dependence severity. Proc Natl Acad Sci 111: E4485-E4493. https://doi.org/10.1073/pnas.1415174111
    [49] Addolorato G, Mirijello A, Leggio L, et al. (2013) Management of alcohol dependence in patients with liver disease. CNS Drugs 27: 287-299. https://doi.org/10.1007/s40263-013-0043-4
    [50] Kirpich IA, McClain CJ, Vatsalya V, et al. (2017) Liver injury and endotoxemia in male and female alcohol-dependent individuals admitted to an alcohol treatment program. Alcohol Clin Exp Res 41: 747-757. https://doi.org/10.1111/acer.13346
    [51] Li W, Gao W, Yan S, et al. (2025) Gut microbiota as emerging players in the development of alcohol-related liver disease. Biomedicines 13: 74. https://doi.org/10.3390/biomedicines13010074
    [52] Kirpich IA, Solovieva NV, Leikhter SN, et al. (2008) Probiotics restore bowel flora and improve liver enzymes in human alcohol-induced liver injury: A pilot study. Alcohol Fayettev N 42: 675-682. https://doi.org/10.1016/j.alcohol.2008.08.006
    [53] Raya Tonetti F, Eguileor A, Mrdjen M, et al. (2024) Gut-liver axis: Recent concepts in pathophysiology in alcohol-associated liver disease. Hepatology 80: 1342-1371. https://doi.org/10.1097/HEP.0000000000000924
    [54] Pant K, Venugopal SK, Lorenzo Pisarello MJ, et al. (2023) The role of gut microbiome-derived short-chain fatty acid butyrate in hepatobiliary diseases. Am J Pathol 193: 1455-1467. https://doi.org/10.1016/j.ajpath.2023.06.007
    [55] Visekruna A, Luu M (2021) The role of short-chain fatty acids and bile acids in intestinal and liver function, inflammation, and carcinogenesis. Front Cell Dev Biol 9: 703218. https://doi.org/10.3389/fcell.2021.703218
    [56] Sosnowski K, Przybyłkowski A (2024) Ethanol-induced changes to the gut microbiome compromise the intestinal homeostasis: A review. Gut Microbes 16: 2393272. https://doi.org/10.1080/19490976.2024.2393272
    [57] Szabo G (2015) Gut–liver axis in alcoholic liver disease. Gastroenterology 148: 30-36. https://doi.org/10.1053/j.gastro.2014.10.042
    [58] Alvarado-Tapias E, Pose E, Gratacós-Ginès J, et al. (2025) Alcohol-associated liver disease: Natural history, management and novel targeted therapies. Clin Mol Hepatol 31: S112-S133. https://doi.org/10.3350/cmh.2024.0709
    [59] Chen X, Zhang Z, Cui B, et al. (2020) Combination of chronic alcohol consumption and high-salt intake elicits gut microbial alterations and liver steatosis in mice. J Agric Food Chem 68: 1750-1759. https://doi.org/10.1021/acs.jafc.9b07368
    [60] Arab JP, Arrese M, Shah VH (2020) Gut microbiota in non-alcoholic fatty liver disease and alcohol-related liver disease: Current concepts and perspectives. Hepatol Res 50: 407-418. https://doi.org/10.1111/hepr.13473
    [61] Li F, Jiang C, Krausz KW, et al. (2013) Microbiome remodelling leads to inhibition of intestinal farnesoid X receptor signalling and decreased obesity. Nat Commun 4: 2384. https://doi.org/10.1038/ncomms3384
    [62] Ridlon JM, Kang DJ, Hylemon PB, et al. (2014) Bile acids and the gut microbiome. Curr Opin Gastroenterol 30: 332-338. https://doi.org/10.1097/MOG.0000000000000057
    [63] Gao B, Emami A, Nath S, et al. (2021) Microbial products and metabolites contributing to alcohol-related liver disease. Mol Nutr Food Res 65: 2000023. https://doi.org/10.1002/mnfr.202000023
    [64] Grondin JA, Khan WI (2024) Emerging roles of gut serotonin in regulation of immune response, microbiota composition and intestinal inflammation. J Can Assoc Gastroenterol 7: 88-96. https://doi.org/10.1093/jcag/gwad020
    [65] Shukla S, Hsu CL (2025) Alcohol use disorder and the gut–brain axis: A narrative review of the role of gut microbiota and implications for treatment. Microorganisms 13: 67. https://doi.org/10.3390/microorganisms13010067
    [66] Albillos A, de Gottardi A, Rescigno M (2020) The gut-liver axis in liver disease: Pathophysiological basis for therapy. J Hepatol 72: 558-577. https://doi.org/10.1016/j.jhep.2019.10.003
    [67] Kaufmann B, Seyfried N, Hartmann D, et al. (2023) Probiotics, prebiotics, and synbiotics in nonalcoholic fatty liver disease and alcohol-associated liver disease. Am J Physiol-Gastrointest Liver Physiol 325: G42-G61. https://doi.org/10.1152/ajpgi.00017.2023
    [68] Vallianou NG, Kounatidis D, Psallida S, et al. (2024) NAFLD/MASLD and the gut–liver axis: From pathogenesis to treatment options. Metabolites 14: 366. https://doi.org/10.3390/metabo14070366
    [69] Del Barrio M, Lavín L, Santos-Laso Á, et al. (2023) Faecal microbiota transplantation, paving the way to treat non-alcoholic fatty liver disease. Int J Mol Sci 24: 6123. https://doi.org/10.3390/ijms24076123
    [70] Jiménez-González C, Vallejo I, Sordo D, et al. (2024) Assessing the therapeutic potential of fecal microbiota transplantation in steatotic liver disease: Current insights and future pathways. Curr Hepatol Rep 23: 435-444. https://doi.org/10.1007/s11901-024-00670-7
    [71] Shah YR, Ali H, Tiwari A, et al. (2024) Role of fecal microbiota transplant in management of hepatic encephalopathy: Current trends and future directions. World J Hepatol 16: 17-32. https://doi.org/10.4254/wjh.v16.i1.17
    [72] Litwinowicz K, Gamian A (2023) Microbiome alterations in alcohol use disorder and alcoholic liver disease. Int J Mol Sci 24: 2461. https://doi.org/10.3390/ijms24032461
    [73] Calzadilla N, Zilberstein N, Hanscom M, et al. (2024) Serum metabolomic analysis in cirrhotic alcohol-associated liver disease patients identified differentially altered microbial metabolites and novel potential biomarkers for disease severity. Dig Liver Dis 56: 923-931. https://doi.org/10.1016/j.dld.2023.10.006
    [74] Jew MH, Hsu CL (2023) Alcohol, the gut microbiome, and liver disease. J Gastroenterol Hepatol 38: 1205-1210. https://doi.org/10.1111/jgh.16199
    [75] Skladany L, Kubanek N, Adamcova Selcanova S, et al. (2024) 3PM-guided innovation in treatments of severe alcohol-associated hepatitis utilizing fecal microbiota transplantation. EPMA J 15: 677-692. https://doi.org/10.1007/s13167-024-00381-5
    [76] Ganesan R, Suk KT (2022) Microbiome and metabolomics in alcoholic liver disease. Clin Mol Hepatol 28: 580-582. https://doi.org/10.3350/cmh.2022.0171
    [77] Ryu T, Kim K, Choi SE, et al. (2023) New insights in the pathogenesis of alcohol-related liver disease: The metabolic, immunologic, and neurologic pathways. Liver Res 7: 1-8. https://doi.org/10.1016/j.livres.2022.09.004
    [78] Bloom PP, Bajaj JS (2024) The current and future state of microbiome therapeutics in liver disease. Off J Am Coll Gastroenterol ACG 119: S36-S41. https://doi.org/10.14309/ajg.0000000000003009
    [79] Hill C, Guarner F, Reid G, et al. (2014) Expert consensus document. The International Scientific Association for Probiotics and Prebiotics consensus statement on the scope and appropriate use of the term probiotic. Nat Rev Gastroenterol Hepatol 11: 506-514. https://doi.org/10.1038/nrgastro.2014.66
    [80] Binda S, Hill C, Johansen E, et al. (2020) Criteria to qualify microorganisms as “probiotic” in foods and dietary supplements. Front Microbiol 11: 1662. https://doi.org/10.3389/fmicb.2020.01662
    [81] Zavišić G, Ristić S, Petković B, et al. (2023) Microbiological quality of probiotic products. Arh Za Farm 73: 17-34. https://doi.org/10.5937/arhfarm73-42160
    [82] Tsai YL, Lin TL, Chang CJ, et al. (2019) Probiotics, prebiotics and amelioration of diseases. J Biomed Sci 26: 3. https://doi.org/10.1186/s12929-018-0493-6
    [83] Li HY, Zhou DD, Gan RY, et al. (2021) Effects and mechanisms of probiotics, prebiotics, synbiotics, and postbiotics on metabolic diseases targeting gut microbiota: A narrative review. Nutrients 13: 3211. https://doi.org/10.3390/nu13093211
    [84] Ji J, Jin W, Liu SJ, et al. (2023) Probiotics, prebiotics, and postbiotics in health and disease. MedComm 4: e420. https://doi.org/10.1002/mco2.420
    [85] Gibson GR, Hutkins R, Sanders ME, et al. (2017) Expert consensus document: The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of prebiotics. Nat Rev Gastroenterol Hepatol 14: 491-502. https://doi.org/10.1038/nrgastro.2017.75
    [86] Swanson KS, Gibson GR, Hutkins R, et al. (2020) The International Scientific Association for Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of synbiotics. Nat Rev Gastroenterol Hepatol 17: 687-701. https://doi.org/10.1038/s41575-020-0344-2
    [87] Thilakarathna WPDW, Rupasinghe HPV (2024) Proanthocyanidins-based synbiotics as a novel strategy for nonalcoholic fatty liver disease (NAFLD) risk reduction. Molecules 29: 709. https://doi.org/10.3390/molecules29030709
    [88] Salminen S, Collado MC, Endo A, et al. (2021) The International Scientific Association of Probiotics and Prebiotics (ISAPP) consensus statement on the definition and scope of postbiotics. Nat Rev Gastroenterol Hepatol 18: 649-667. https://doi.org/10.1038/s41575-021-00440-6
    [89] Siciliano RA, Reale A, Mazzeo MF, et al. (2021) Paraprobiotics: A new perspective for functional foods and nutraceuticals. Nutrients 13: 1225. https://doi.org/10.3390/nu13041225
    [90] Rodríguez-Pastén A, Pérez-Hernández N, Añorve-Morga J, et al. (2022) The activity of prebiotics and probiotics in hepatogastrointestinal disorders and diseases associated with metabolic syndrome. Int J Mol Sci 23: 7229. https://doi.org/10.3390/ijms23137229
    [91] Mishra G, Singh P, Molla M, et al. (2023) Harnessing the potential of probiotics in the treatment of alcoholic liver disorders. Front Pharmacol 14: 1212742. https://doi.org/10.3389/fphar.2023.1212742
    [92] Barbuti RC, Schiavon LL, Oliveira CP, et al. (2020) Gut microbiota, prebiotics, probiotics, and synbiotics in gastrointestinal and liver diseases: Proceedings of a joint meeting of the Brazilian Society of Hepatology (SBH), Brazilian Nucleus for the Study of Helicobacter pylori and Microbiota (NBEHPM), and Brazilian Federation of Gastroenterology (FBG). Arq Gastroenterol 57: 381-398. https://doi.org/10.1590/S0004-2803.202000000-72
    [93] Argemi J, Ventura-Cots M, Rachakonda V, et al. (2020) Alcoholic-related liver disease: Pathogenesis, management and future therapeutic developments. Rev Esp Enfermedades Dig 112: 869-878. https://doi.org/10.17235/reed.2020.7242/2020
    [94] Yoon EL, Kim W (2023) Current and future treatment for alcoholic-related liver diseases. J Gastroenterol Hepatol 38: 1218-1226. https://doi.org/10.1111/jgh.16257
    [95] Nanji AA, Sadrzadeh SMH, Dannenberg AJ (1994) Liver microsomal fatty acid composition in ethanol-fed rats: Effect of different dietary fats and relationship to liver injury. Alcohol Clin Exp Res 18: 1024-1028. https://doi.org/10.1111/j.1530-0277.1994.tb00077.x
    [96] Marotta F, Barreto R, Wu C, et al. (2005) Experimental acute alcohol pancreatitis-related liver damage and endotoxemia: Synbiotics but not metronidazole have a protective effect. Chin J Dig Dis 6: 193-197. https://doi.org/10.1111/j.1443-9573.2005.00230.x
    [97] Forsyth CB, Farhadi A, Jakate SM, et al. (2009) Lactobacillus GG treatment ameliorates alcohol-induced intestinal oxidative stress, gut leakiness, and liver injury in a rat model of alcoholic steatohepatitis. Alcohol Fayettev N 43: 163-172. https://doi.org/10.1016/j.alcohol.2008.12.009
    [98] Zhao H, Zhao C, Dong Y, et al. (2015) Inhibition of miR122a by Lactobacillus rhamnosus GG culture supernatant increases intestinal occludin expression and protects mice from alcoholic liver disease. Toxicol Lett 234: 194-200. https://doi.org/10.1016/j.toxlet.2015.03.002
    [99] Ye D, Guo S, Al–Sadi R, et al. (2011) MicroRNA regulation of intestinal epithelial tight junction permeability. Gastroenterology 141: 1323-1333. https://doi.org/10.1053/j.gastro.2011.07.005
    [100] Furuta GT, Turner JR, Taylor CT, et al. (2001) Hypoxia-inducible factor 1–dependent induction of intestinal trefoil factor protects barrier function during hypoxia. J Exp Med 193: 1027-1034. https://doi.org/10.1084/jem.193.9.1027
    [101] Lindemans CA, Calafiore M, Mertelsmann AM, et al. (2015) Interleukin-22 promotes intestinal-stem-cell-mediated epithelial regeneration. Nature 528: 560-564. https://doi.org/10.1038/nature16460
    [102] Khailova L, Dvorak K, Arganbright KM, et al. (2009) Bifidobacterium bifidum improves intestinal integrity in a rat model of necrotizing enterocolitis. Am J Physiol-Gastrointest Liver Physiol 297: G940-G949. https://doi.org/10.1152/ajpgi.00141.2009
    [103] Chang B, Sang L, Wang Y, et al. (2013) The protective effect of VSL#3 on intestinal permeability in a rat model of alcoholic intestinal injury. BMC Gastroenterol 13: 151. https://doi.org/10.1186/1471-230X-13-151
    [104] Huang H, Lin Z, Zeng Y, et al. (2019) Probiotic and glutamine treatments attenuate alcoholic liver disease in a rat model. Exp Ther Med 18: 4733-4739. https://doi.org/10.3892/etm.2019.8123
    [105] Mutlu E, Keshavarzian A, Engen P, et al. (2009) Intestinal dysbiosis: A possible mechanism of alcohol-induced endotoxemia and alcoholic steatohepatitis in rats. Alcohol Clin Exp Res 33: 1836-1846. https://doi.org/10.1111/j.1530-0277.2009.01022.x
    [106] Han SH, Suk KT, Kim DJ, et al. (2015) Effects of probiotics (cultured Lactobacillus subtilis/Streptococcus faecium) in the treatment of alcoholic hepatitis: Randomized-controlled multicenter study. Eur J Gastroenterol Hepatol 27: 1300-1306. https://doi.org/10.1097/MEG.0000000000000458
    [107] Stadlbauer V, Mookerjee RP, Hodges S, et al. (2008) Effect of probiotic treatment on deranged neutrophil function and cytokine responses in patients with compensated alcoholic cirrhosis. J Hepatol 48: 945-951. https://doi.org/10.1016/j.jhep.2008.02.015
    [108] Koga H, Tamiya Y, Mitsuyama K, et al. (2013) Probiotics promote rapid-turnover protein production by restoring gut flora in patients with alcoholic liver cirrhosis. Hepatol Int 7: 767-774. https://doi.org/10.1007/s12072-012-9408-x
    [109] Li X, Liu Y, Guo X, et al. (2021) Effect of Lactobacillus casei on lipid metabolism and intestinal microflora in patients with alcoholic liver injury. Eur J Clin Nutr 75: 1227-1236. https://doi.org/10.1038/s41430-020-00852-8
    [110] Gupta H, Kim SH, Kim SK, et al. (2022) Beneficial shifts in gut microbiota by Lacticaseibacillus rhamnosus R0011 and Lactobacillus helveticus R0052 in alcoholic hepatitis. Microorganisms 10: 1474. https://doi.org/10.3390/microorganisms10071474
    [111] Vatsalya V, Feng W, Kong M, et al. (2023) The beneficial effects of Lactobacillus GG therapy on liver and drinking assessments in patients with moderate alcohol-associated hepatitis. Off J Am Coll Gastroenterol ACG 118: 1457-1460. https://doi.org/10.14309/ajg.0000000000002283
    [112] Shen H, Zhou L, Zhang H, et al. (2024) Dietary fiber alleviates alcoholic liver injury via Bacteroides acidifaciens and subsequent ammonia detoxification. Cell Host Microbe 32: 1331-1346.e6. https://doi.org/10.1016/j.chom.2024.06.008
    [113] Ferrere G, Wrzosek L, Cailleux F, et al. (2017) Fecal microbiota manipulation prevents dysbiosis and alcohol-induced liver injury in mice. J Hepatol 66: 806-815. https://doi.org/10.1016/j.jhep.2016.11.008
    [114] Yan AW, Fouts DE, Brandl J, et al. (2011) Enteric dysbiosis associated with a mouse model of alcoholic liver disease. Hepatology 53: 96-105. https://doi.org/10.1002/hep.24018
    [115] Wei L, Pan Y, Guo Y, et al. (2024) Symbiotic combination of Akkermansia muciniphila and inosine alleviates alcohol-induced liver injury by modulating gut dysbiosis and immune responses. Front Microbiol 15: 1355225. https://doi.org/10.3389/fmicb.2024.1355225
    [116] Irwin C, Khalesi S, Cox AJ, et al. (2018) Effect of 8-weeks prebiotics/probiotics supplementation on alcohol metabolism and blood biomarkers of healthy adults: A pilot study. Eur J Nutr 57: 1523-1534. https://doi.org/10.1007/s00394-017-1437-8
    [117] Zhu Y, Wang X, Zhu L, et al. (2022) Lactobacillus rhamnosus GG combined with inosine ameliorates alcohol-induced liver injury through regulation of intestinal barrier and Treg/Th1 cells. Toxicol Appl Pharmacol 439: 115923. https://doi.org/10.1016/j.taap.2022.115923
    [118] Parthasarathy G, Malhi H, Bajaj JS (2024) Therapeutic manipulation of the microbiome in liver disease. Hepatolog . https://doi.org/10.1097/HEP.0000000000000987
    [119] Zhou P, Chen C, Patil S, et al. (2024) Unveiling the therapeutic symphony of probiotics, prebiotics, and postbiotics in gut-immune harmony. Front Nutr 11: 1355542. https://doi.org/10.3389/fnut.2024.1355542
    [120] Xu R, Yu Y, Chen T (2025) Exploring the dark side of probiotics to pursue light: Intrinsic and extrinsic risks to be opportunistic pathogens. Curr Res Food Sci 10: 101044. https://doi.org/10.1016/j.crfs.2025.101044
    [121] Maslennikov R, Poluektova E, Zolnikova O, et al. (2023) Gut microbiota and bacterial translocation in the pathogenesis of liver fibrosis. Int J Mol Sci 24: 16502. https://doi.org/10.3390/ijms242316502
    [122] Pinzone MR, Celesia BM, Di Rosa M, et al. (2012) Microbial translocation in chronic liver diseases. Int J Microbiol 2012: 694629. https://doi.org/10.1155/2012/694629
  • This article has been cited by:

    1. Fatima El Dana, Vanessa David, Raphaëlle Tourdot-Maréchal, Salem Hayar, Marie-Charlotte Colosio, Hervé Alexandre, Bioprotection with Saccharomyces cerevisiae: A Promising Strategy, 2025, 13, 2076-2607, 1163, 10.3390/microorganisms13051163
    2. Diana A. Al-Quwaie, Aminah Allohibi, Isolation, identification, and molecular characterization of plant growth-promoting rhizobacteria as an environmentally friendly fungicide against leaf blight disease in Alternaria terricola-infected tomato plants, 2025, 2239-7264, 10.1007/s42161-025-01933-y
  • Reader Comments
  • © 2025 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索

Metrics

Article views(596) PDF downloads(39) Cited by(0)

Figures and Tables

Figures(2)  /  Tables(3)

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog