The gut microbiome and nicotine metabolism in NAFLD

In conclusion, it is becoming clear that the influence of nicotine on intestinal microbiota is important in the pathogenesis of NAFLD. Smoking can cause intestinal dysbiosis, exacerbating hepatic steatosis through AMPK inactivation, regulation of SMPD3 and increase in ceramides, catecholamine and glucagon that can contribute to the progression of NAFLD. We propose that further prospective cohort studies are needed that also examine the changing status of smoking behavior on the progression and resolution of NAFLD. Further pre-clinical studies are also urgently needed to elucidate the mechanistic pathways underlying smoking-induced changes in the microbiome and intestinal function in NAFLD.