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Figure 1. The microbiome-gut-liver-brain axis and molecules involved in this network. These molecules are classified into six categories,
including short-chain fatty acids, hormones, neurotransmitters and false neurotransmitters, bile acids, lipids and lipid derivatives, and
immune-related molecules, indole and indole derivatives. Amino acids, glucose, protein, fatty acids, vitamins, minerals, and other
nutrients that are absorbed from food in the gut participate in the synthesis and conversion of these molecules directly or indirectly.
5-HT: 5-hydroxytryptamine; GABA: γ-aminobutyric acid; NO: nitric oxide.
abundance of selected gut microbiota that have a nitrogen fixation capacity, including Lactobacteria,
Bifidobacteria, E. coli, Klebsiella, and Clostridiales strains, can stimulate expression of inducible NO synthase
in host epithelial cells by regulating microglia maturation and activation .
[38]
Considering the important roles of the gut microbiome in the pathogenesis of liver and brain disease, the
molecular network consisting of the microbiome-gut-liver-brain axis should not be neglected in studies on
the pathogenesis and treatment of HE. For example, urease-containing bacteria such as Klebsiella, Proteus,
