Int J Biol Sci 2020; 16(13):2357-2366. doi:10.7150/ijbs.46405


The Gut-liver Axis in Immune Remodeling: New insight into Liver Diseases

Xinyu Yang1,2*, Di Lu1,2*, Jianyong Zhuo1,2, Zuyuan Lin1,2, Modan Yang1,2, Xiao Xu1,2✉

1. Department of Hepatobiliary and Pancreatic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, 79 Qingchun Road, Hangzhou 310003, China.
2. NHFPC Key Laboratory of Combined Multi-Organ Transplantation, Hangzhou, 310003, China.
*These authors contributed equally to this work.

This is an open access article distributed under the terms of the Creative Commons Attribution License ( See for full terms and conditions.
Yang X, Lu D, Zhuo J, Lin Z, Yang M, Xu X. The Gut-liver Axis in Immune Remodeling: New insight into Liver Diseases. Int J Biol Sci 2020; 16(13):2357-2366. doi:10.7150/ijbs.46405. Available from

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The gut microbiota consists of a dynamic multispecies community of bacteria, fungi, archaea, and protozoans, playing a fundamental role in the induction, training, and function of the host immune system. The liver is anatomically and physiologically linked to the gut microbiota via enterohepatic circulation, specifically receiving intestine-derived blood through the portal vein. The gut microbiota is crucial for maintaining immune homeostasis of the gut-liver axis. A shift in gut microbiota composition can result in activation of the mucosal immune response causing homeostasis imbalance. This imbalance results in translocation of bacteria and migration of immune cells to the liver, which is related to inflammation-mediated liver injury and tumor progression. In this review, we outline the role of the gut microbiota in modulating host immunity and summarize novel findings and recent advances in immune-based therapeutics associated with the gut-liver axis. Moving forward, a deep understanding of the microbiome-immune-liver axis will provide insight into the basic mechanisms of gut microbiota dysbiosis affecting liver diseases.

Keywords: gut-liver axis, immunity, gut microbiome, dysbiosis, immunotherapy