New insights along the gut-liver axis in cardiometabolic disease

In this thesis we targeted the human gut microbiome for the development of therapeutic strategies in metabolic disorders. In chapter 3 we performed a randomized placebo-controlled cross-over study in individuals with the metabolic syndrome in which we showed that a single duodenal infusion of A. soehngenii improved peripheral glycemic control. In chapter 4 we studied the effect of a 2 weeks oral A. soehngenii treatment in individuals with T2D treated with metformin on their glycemic control.
The second part of the thesis focused on MASLD, currently the most common cause of chronic liver dysfunction worldwide. In chapter 5 we reviewed the gut microbial and gut microbial-derived metabolite signatures associated with the development and disease progression of MASLD. To dissect causality of intestinal microbiota in MASLD, in chapter 6 we performed a single-center, double-blind, randomized controlled proof-of-principle pilot study comparing the effect of three 8-weekly lean vegan donor FMT versus autologous FMT on the severity of MASLD, using liver biopsies in individuals with hepatic steatosis on ultrasound. Moreover, we aimed to identify and validate noninvasive diagnostic methods in disease progression in MASLD. Hence, in chapter 7 we examined the diagnostic performance of multiparametric MRI for the assessment of disease severity along the MASLD disease spectrum with comparison to histological scores.