Evidence map›Paper›PMID 42070114›Full record

ArticleGut microbes2026

Lactic acid bacteria and endogenous ethanol mediate proton pump inhibitor-associated MASLD: a multicohort cross-sectional mediation analysis.

Mark Davids, Hilde Herrema, Albert K Groen, Henrike Galenkamp, Aeilko Zwinderman, Joonatan Palmu, Aki Havulinna, Teemu Niiranen, Rob Knight, Yaïr Acherman and 9 more

Abstract read
In one paragraph

Article in Gut microbes, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Mark DavidsDepartment of Experimental Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.ORCID 0000-0003-3081-9124
Hilde HerremaDepartment of Experimental Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.ORCID 0000-0002-0112-6348
Albert K GroenDepartment of Experimental Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.ORCID 0000-0002-9942-1854
Henrike GalenkampDepartment of Public and Occupational Health, Amsterdam Public Health (APH), Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.ORCID 0000-0002-5904-3465
Aeilko ZwindermanDepartment of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.ORCID 0000-0003-0361-3139
Joonatan PalmuDivision of Medicine, Turku University Hospital and University of Turku, Turku, Finland.ORCID 0000-0003-0059-3347
Aki HavulinnaDepartment of Computing, Turku University Hospital and University of Turku, Turku, Finland.ORCID 0000-0002-4787-8959
Teemu NiiranenDivision of Medicine, Turku University Hospital and University of Turku, Turku, Finland.ORCID 0000-0002-7394-7487
Rob KnightDepartment of Pediatrics, Department of Computer Science & Engineering, Shu Chien-Gene Lay Department of Bioengineering, and Halıcıoğlu Data Science Institute, University of California, San Diego, USA.ORCID 0000-0002-0975-9019
Yaïr AchermanDepartment of Metabolic and Bariatric Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands.ORCID 0000-0003-2787-8596
Rutger FrankenDepartment of Metabolic and Bariatric Surgery, Spaarne Gasthuis, Hoofddorp, The Netherlands.
Joanne VerheijDepartment of Pathology, UMC, University of Amsterdam, Cancer Center Amsterdam, Amsterdam, The Netherlands.ORCID 0000-0003-1283-630X
Michael DukasDepartment of Pathology, Erasmus Medical Center Cancer Institute, Erasmus University Medical Center, Rotterdam, The Netherlands.ORCID 0000-0001-5064-1939
Dutch Liver Pathology Panel
Jasmohan BajajDivision of Gastroenterology, Hepatology, and Nutrition, Virginia Commonwealth University and Richmond VA Medical Center, Richmond, VA, USA.ORCID 0000-0003-4928-3681
Cristina LlorenteDepartment of Medicine, University of California San Diego, La Jolla, CA, USA.ORCID 0000-0001-8135-9186
Bernd SchnablDepartment of Medicine, University of California San Diego, La Jolla, CA, USA.ORCID 0000-0002-6281-825X
Max NieuwdorpDepartment of Internal Medicine, section Vascular Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam Cardiovascular Sciences, Amsterdam, The Netherlands.ORCID 0000-0002-1926-7659
Abraham MeijnikmanTytgat Institute for Liver and Intestinal Research, Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam University Medical Center, Location AMC, University of Amsterdam, Amsterdam, The Netherlands.ORCID 0000-0002-6015-4656

Funding

Goblet cells and intestinal immune response in alcohol-associated liver diseaseR01AA029106 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Ana Cristina Llorente Izquierdo · 2022 to 2026
$2.3M
The role of intestinal gp130 in alcohol-associated liver diseaseR21AA030654 · NIAAA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI LLORENTE IZQUIERDO, ANA CRISTINA · 2023 to 2023
$415k
NIAAA NIH HHS R01 AA029106NIAAA NIH HHS R21 AA030654
6 · The paper itself

Abstract

BACKGROUND &

aimsProton pump inhibitor (PPI) use has been associated with metabolic dysfunction associated with steatotic liver disease (MASLD) in multiple studies. While the association is confounded by various risk factors, such as BMI and age, a potential mediating factor of the microbiome has been suggested. In this study, we aimed to identify bacterial clades with the highest mediating potential and evaluate the serially mediated path through microbially derived endogenous ethanol.

methodsMicrobiome mediation analysis of PPI use and MASLD was conducted in two cohorts. In a bariatric surgery cohort (

resultsSeveral bacterial taxa, which are predominantly found in the small intestine, showed a potential role in mediating the effects of PPIs on MASLD, postprandial ethanol levels, and FLI score. The Lactobacillales order showed the strongest mediating potential across the outcomes tested in both discovery cohorts. A notable serial mediation pathway was identified, linking PPI use to MASLD via Lactobacillales abundance and postprandial plasma ethanol concentrations. The mediating role of Lactobacillales in the association between PPI use and FLI scores was confirmed in the final study cohort.

conclusionsData from multiple cross-sectional cohort studies support a mediating potential of the microbiome in the association between PPI use and hepatic steatosis, independent of alcohol consumption. The effect of PPIs on MASLD appears to be mediated mainly by increased lactic acid bacteria abundance, and is potentially, in part, serially mediated by endogenous ethanol production.

Indexed as

EthanolFatty LiverGastrointestinal MicrobiomeProton Pump InhibitorsAdultBacteriaCohort StudiesCross-Sectional StudiesFemaleHumansMaleMediation AnalysisMiddle AgedEthanolProton Pump Inhibitorsethanolfermentationgastrointestinal microbiomelactobacillalesMASLDmediation analysisobesityproton pump inhibitorssmall intestine

Identifiers

PMID42070114
PMCPMC13154942

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.