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Emerging evidence suggests that ALD is not solely a liver pathology but also involves dysfunction of the gut\u2010liver axis, where alterations in the gut microbiota play a significant role. Although alcohol\u2010associated dysbiosis has been extensively studied, whether these microbial changes contribute to ALD development or are merely a consequence of alcohol exposure remains unclear. To prove causation, it is essential to decipher which specific taxa and their metabolites drive the maladaptation of host\u2010microbiota interactions upon alcohol exposure. In this review, we summarize the compositional changes in the gut microbiome after alcohol exposure, identifying traits of alcohol\u2010induced dysbiosis and distinguishing them from those associated with liver disease. The effects of alcohol\u2010induced dysbiosis on microbial metabolism and host responses are reviewed, focusing on the key classes of microbiota\u2010derived metabolites, notably free fatty acids, tryptophan and its indole derivatives, and secondary bile acids. We discuss how alterations in these metabolites disrupt intestinal barrier function, immune responses, and metabolic signaling pathways, thereby exacerbating alcohol\u2010induced injury. Advanced omics technologies and microbiome modulation strategies will help further investigation into these mechanisms. Detailed mechanistic insights into host\u2010microbiota interactions could unveil novel therapeutic targets, offering potential strategies to prevent or mitigate ALD by modulating the gut microbiome and its metabolites.<\/jats:p>","DOI":"10.1111\/jgh.17038","type":"journal-article","created":{"date-parts":[[2025,6,24]],"date-time":"2025-06-24T23:45:09Z","timestamp":1750808709000},"page":"2176-2189","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Compositional and Metabolomic Shifts of the Gut Microbiome in Alcohol\u2010Related Liver Disease"],"prefix":"10.1111","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-0399-3329","authenticated-orcid":false,"given":"Cheng\u2010Hao","family":"Kuo","sequence":"first","affiliation":[{"name":"School of Medicine National Yang Ming Chiao Tung University  Taiwan"},{"name":"Ph.D. Program of Interdisciplinary Medicine National Yang Ming Chiao Tung University  Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emad","family":"El\u2010Omar","sequence":"additional","affiliation":[{"name":"Microbiome Research Centre University of New South Wales  Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng\u2010Yen","family":"Kao","sequence":"additional","affiliation":[{"name":"Institute of Microbiology and Immunology, National Yang Ming Chiao Tung University  Taiwan"},{"name":"Microbiota Research Center National Yang Ming Chiao Tung University  Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9368-6141","authenticated-orcid":false,"given":"Jaw\u2010Town","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Internal Medicine E\u2010Da Hospital  Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5053-1801","authenticated-orcid":false,"given":"Chun\u2010Ying","family":"Wu","sequence":"additional","affiliation":[{"name":"School of Medicine National Yang Ming Chiao Tung University  Taiwan"},{"name":"Microbiome Research Centre University of New South Wales  Australia"},{"name":"Institute of Biomedical Informatics National Yang Ming Chiao Tung University  Taipei Taiwan"},{"name":"Health Innovation Center National Yang Ming Chiao Tung University  Taiwan"},{"name":"Division of Translational Research, Department of Medical Research Taipei Veterans General Hospital  Taipei Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,6,24]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41572-018-0014-7"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28530"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.12.008"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2015-310585"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.31496"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2016.10.029"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-022-10438-0"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-018-0099-1"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.10.019"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.16539"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1099\/ijsem.0.005056"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2020.04.077"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41564-017-0072-8"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/nature25973"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1128\/mBio.01492-17"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cell.2020.02.041"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2019.10.003"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41575-018-0011-z"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41586-020-2881-9"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.12900"},{"issue":"1","key":"e_1_2_7_22_1","first-page":"30","article-title":"Jejunal Microflora in Patients With Chronic Alcohol Abuse","volume":"31","author":"Bode J. 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