Verdier Julien, Luedde Tom, Sellge Gernot
Department of Internal Medicine III, University Hospital RWTH Aachen, Aachen, Germany.
Viszeralmedizin. 2015 Jun;31(3):156-61. doi: 10.1159/000431071. Epub 2015 Jun 5.
The biliary system is in continuous contact with the complex microbiota of the intestine. Microbial products have recently been proposed as potential triggers for biliary diseases.
The aim of this review is to provide a summary of the current knowledge regarding the role of the biliary and intestinal microbiome in biliary inflammatory diseases.
Previously, it was suggested that the healthy biliary system is a sterile organ, while acute cholangitis and cholecystitis may occur from ascending infections. Although non-inflammatory biliary colonization by certain bacteria such as Salmonella spp. has been already recognized since several decades, human and animal studies indicated only very recently that the gallbladder harbors a complex microbiota also under non-pathologic conditions. Novel findings suggested that - similar to the situation in the intestine - the biliary mucosa features a chemical, mechanical, and immunological barrier, ensuring immunological tolerance against commensals. However, microbial triggers might influence acute and chronic inflammatory disease of the biliary system and the whole liver.
Although yet undefined, dysbiosis of the biliary or intestinal microbiota rather than a single microorganism may influence disease progression.
胆道系统与肠道复杂的微生物群持续接触。微生物产物最近被认为是胆道疾病的潜在触发因素。
本综述的目的是总结当前关于胆道和肠道微生物群在胆道炎性疾病中作用的知识。
以前认为健康的胆道系统是一个无菌器官，而急性胆管炎和胆囊炎可能由上行感染引起。尽管几十年前就已认识到某些细菌（如沙门氏菌属）的非炎性胆道定植，但人类和动物研究直到最近才表明，在非病理条件下胆囊也含有复杂的微生物群。新的研究结果表明，与肠道情况类似，胆道黏膜具有化学、机械和免疫屏障，可确保对共生菌的免疫耐受。然而，微生物触发因素可能会影响胆道系统和整个肝脏的急性和慢性炎症性疾病。
尽管尚未明确，但胆道或肠道微生物群的失调而非单一微生物可能会影响疾病进展。
