Peer-reviewedCC BYJHEP Reports
Hepatic encephalopathy in chronic liver disease: Emerging insights from the gut microbiome
- 1Corresponding author. Address: Roger Williams Institute of Liver Studies, King’s College London, UK.
- 2Roger Williams Institute of Liver Studies, School of Immunology and Microbial Sciences, Faculty of Life Sciences and Medicine, King’s College London, UK
Abstract
Hepatic encephalopathy remains an underserved complication of chronic liver disease. Reliable diagnostic and prognostic biomarkers linked to disease pathophysiology are currently lacking, as are options for treatment that reduce mortality beyond lactulose and rifaximin. However, with the advent of high-throughput sequencing and multi-omics techniques to interrogate microbial taxonomy and metabolic pathways, our understanding of the gut-liver-brain-axis has moved beyond the ammonia-inflammation hypothesis. This review summarises recent studies that have aimed to characterise the role of the gut-liver-brain axis in hepatic encephalopathy and how this can be leveraged to create novel diagnostic, prognostic and therapeutic approaches.
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BibTeX
@article{ntuli2026hepatic,
title = {{Hepatic encephalopathy in chronic liver disease: Emerging insights from the gut microbiome}},
author = {Yevedzo Ntuli and Maria Nehme Ibrahimi and Victoria Tatiana Kronsten and Debbie Lindsay Shawcross},
journal = {JHEP Reports},
year = {2026},
month = nov,
doi = {10.1016/j.jhepr.2026.102022},
url = {https://doi.org/10.1016/j.jhepr.2026.102022},
note = {CC BY},
}
RIS
TY - JOUR
TI - Hepatic encephalopathy in chronic liver disease: Emerging insights from the gut microbiome
AU - Yevedzo Ntuli
AU - Maria Nehme Ibrahimi
AU - Victoria Tatiana Kronsten
AU - Debbie Lindsay Shawcross
PY - 2026
DA - 2026/11/06
JO - JHEP Reports
DO - 10.1016/j.jhepr.2026.102022
UR - https://doi.org/10.1016/j.jhepr.2026.102022
AB - Hepatic encephalopathy remains an underserved complication of chronic liver disease. Reliable diagnostic and prognostic biomarkers linked to disease pathophysiology are currently lacking, as are options for treatment that reduce mortality beyond lactulose and rifaximin. However, with the advent of high-throughput sequencing and multi-omics techniques to interrogate microbial taxonomy and metabolic pathways, our understanding of the gut-liver-brain-axis has moved beyond the ammonia-inflammation hypothesis. This review summarises recent studies that have aimed to characterise the role of the gut-liver-brain axis in hepatic encephalopathy and how this can be leveraged to create novel diagnostic, prognostic and therapeutic approaches.
SN - 2589-5559
ER -