Alimentary Pharmabiotic Centre, Biosciences Institute, Floor 5, University College Cork, Cork, Ireland.
Nat Rev Gastroenterol Hepatol. 2010 Dec;7(12):691-701. doi: 10.1038/nrgastro.2010.172. Epub 2010 Nov 2.
Important metabolic functions have been identified for the gut microbiota in health and disease. Several lines of evidence suggest a role for the gut microbiota in both the etiology of nonalcoholic fatty liver disease (NAFLD) and progression to its more advanced state, nonalcoholic steatohepatitis (NASH). Both NAFLD and NASH are strongly linked to obesity, type 2 diabetes mellitus and the metabolic syndrome and, accordingly, have become common worldwide problems. Small intestinal bacterial overgrowth of Gram-negative organisms could promote insulin resistance, increase endogenous ethanol production and induce choline deficiency, all factors implicated in NAFLD. Among the potential mediators of this association, lipopolysaccharide (a component of Gram-negative bacterial cell walls) exerts relevant metabolic and proinflammatory effects. Although the best evidence to support a role for the gut microbiota in NAFLD and NASH comes largely from animal models, data from studies in humans (albeit at times contradictory) is accumulating and could lead to new therapeutic avenues for these highly prevalent conditions.
肠道微生物群在健康和疾病中具有重要的代谢功能。有几条证据表明，肠道微生物群在非酒精性脂肪性肝病（NAFLD）的病因学及其向更严重的非酒精性脂肪性肝炎（NASH）的进展中都发挥了作用。NAFLD 和 NASH 与肥胖、2 型糖尿病和代谢综合征密切相关，因此已成为全球常见的问题。革兰氏阴性菌的小肠细菌过度生长可能会促进胰岛素抵抗、增加内源性乙醇的产生并诱导胆碱缺乏，所有这些因素都与 NAFLD 有关。在这种关联的潜在介导物中，脂多糖（革兰氏阴性细菌细胞壁的组成部分）发挥相关的代谢和促炎作用。尽管支持肠道微生物群在 NAFLD 和 NASH 中发挥作用的最佳证据主要来自动物模型，但来自人类研究的数据（尽管有时相互矛盾）正在积累，并可能为这些高度流行的疾病开辟新的治疗途径。
