Therapeutic potential of rifaximin in liver diseases

• Published in: Biomedicine & pharmacotherapy Vol. 178; p. 117283
• Main Authors: Yang, Wanting, Guo, Gaoyue, Sun, Chao
• Format: Journal Article
• Language: English
• Published: Elsevier Masson SAS 01.09.2024; Elsevier
• Subjects: Antibiotic; Gut microbiota; Liver cirrhosis; Liver disease; Rifaximin; ALK; Val; Gut microbiota; FPN; CUMS; IBD; MDA; PXR; TRH; LPS; KCs; TLR; GSH; CDAA; SBP; GSSG; NSBB; PSC; GI; AOM/DSS; DCA; GM; HVPG; Liver disease; MASLD; NASH; Tyr; SCFA; MCD; SID; AS; Antibiotic; ZO-1; TFR1; CSPH; ROS; PH; ALD; Rifaximin; FTH; HE; MAP; Liver cirrhosis
• ISSN: 0753-3322; 1950-6007; 1950-6007
• DOI: 10.1016/j.biopha.2024.117283

Rifaximin, derived from rifamycin, is a broad-spectrum antibiotic by inhibiting bacterial RNA synthesis. Rifaximin has a very low intestinal absorption and exerts its antimicrobial activity primarily in the intestinal tract. It regulates the gut microbiota with limited side effects systemically. Rifaximin has been recommended for the treatment of hepatic encephalopathy but some studies shed light on its medicinal effects in many other diseases. For instance, rifaximin may suppress the progression of liver fibrosis and its related complications, and ameliorate metabolic dysfunction-associated steatotic liver disease and alcohol-associated liver disease, etc. Rifaximin can also mediate anti-inflammation, antiproliferation, and proapoptotic events by activating pregnane X receptor, which is efficious in cancers such as colon cancer. In addition, some investigations have shown rifaximin may play a therapeutic role in various autoimmune and neurological disorders. However, these findings still need more real-world practices and in-depth investigations to obtain more precise indications and fully elucidate the multifaceted potentials of rifaximin. [Display omitted] •Rifaximin affects the gut-liver axis, brain-gut axis, and gut-lung axis by regulating the gut microbiota.•Rifaximin is confined to the intestinal tract to exert multiple medicinal effects.•Rigorously designed animal experiments and clinical trials should be conducted to foster rifaximin-based precision medicine.