The global incidence and mortality rates of alcohol-related liver disease are on the rise, reflecting a growing health concern worldwide. Alcohol-related liver disease develops due to a complex interplay of multiple reasons, including oxidative stress generated during the metabolism of ethanol, immune response activated by immunogenic substances, and subsequent inflammatory processes. Recent research highlights the gut microbiota’s significant role in the progression of alcohol-related liver disease. In patients with alcohol-related liver disease, the relative abundance of pathogenic bacteria, including Enterococcus faecalis, increases and is positively correlated with the level of severity exhibited by alcohol-related liver disease. Supplement probiotics like Lactobacillus, as well as Bifidobacterium, have been found to alleviate alcohol-related liver disease. The gut microbiota is speculated to trigger specific signaling pathways, influence metabolite profiles, and modulate immune responses in the gut and liver. This research aimed to investigate the role of gut microorganisms in the onset and advancement of alcohol-related liver disease, as well as to uncover the underlying mechanisms by which the gut microbiota may contribute to its development. This review outlines current treatments for reversing gut dysbiosis, including probiotics, fecal microbiota transplantation, and targeted phage therapy. Particularly, targeted therapy will be a vital aspect of future alcohol-related liver disease treatment. It is to be hoped that this article will prove beneficial for the treatment of alcohol-related liver disease.

The incidence and mortality of alcohol-related liver disease are increasing worldwide. The pathogenesis of alcohol-related liver disease includes the combined effects of multiple factors such as oxidative stress caused by ethanol metabolism, immune response and inflammation. Recent studies reported that gut microbiota also play important roles in the development of alcohol-related liver disease. The relative abundance of pathogenic bacteria increased in alcohol-related liver disease patients and Enterococcus faecalis was positive related with the severity of alcohol-related liver disease. Some probiotics such as Lactobacillus and Bifidobacterium can alleviate alcohol-related liver disease. We further explored the impact of gut microbiota on the occurrence and development of alcohol-related liver disease, discussed the potential mechanism of gut microbiome promoting the development of alcohol-related liver disease, and provided an effective early intervention method for alcohol-related liver disease.