Quigley Eamonn M M, Abu-Shanab Ahmed, Murphy Eileen F, Stanton Catherine, Monsour Howard P
Gastroenterology and Hepatology, Lynda K. and David M. Underwood Center for Digestive Disorders, Houston Methodist Hospital and Weill Cornell Medical College, Houston, Texas.
Department of Gastroenterology and Hepatology, Mater Misercordiae Hospital, Dublin, Ireland.
Semin Liver Dis. 2016 Sep;36(4):312-316. doi: 10.1055/s-0036-1593880. Epub 2016 Dec 20.
Nonalcoholic fatty liver disease (NAFLD) has rapidly emerged as one of the most prevalent liver diseases worldwide and is set to achieve virtually epidemic proportions if current trends in obesity continue. A considerable volume of data from animal experiments has revealed the magnitude of the metabolic contribution of the gut microbiome and how a disordered microbial population could contribute to the development of obesity and its complications, including NAFLD. Although considerable progress has been made in developing a role for the microbiome in NAFLD and nonalcoholic steatosis (NASH), there are still many issues to be resolved, including the nature and location of the altered microbiome (i.e., small intestine or colon, or both); the specificity of deficits in intestinal integrity to NAFLD/NASH versus liver disease in general; the metabolic pathways, in man, that are key to the influence of the microbiome; and finally, the therapeutic interventions that are likely to be of benefit to our patients.As always, the situation in man is somewhat more complex than in animal models, but the role of the microbiota and of interventions that modulate the microbiome, though not yet ready for clinical practice, continue to be fertile areas for basic and clinical research.
非酒精性脂肪性肝病（NAFLD）已迅速成为全球最常见的肝脏疾病之一，如果肥胖的当前趋势持续下去，其规模将几乎达到流行程度。来自动物实验的大量数据揭示了肠道微生物群在代谢方面的贡献程度，以及微生物群紊乱如何导致肥胖及其并发症（包括NAFLD）的发生。尽管在确定微生物群在NAFLD和非酒精性脂肪性肝炎（NASH）中的作用方面已经取得了相当大的进展，但仍有许多问题有待解决，包括微生物群改变的性质和位置（即小肠或结肠，或两者兼有）；肠道完整性缺陷对NAFLD/NASH与一般肝病的特异性；在人类中，微生物群影响的关键代谢途径；最后，可能对我们的患者有益的治疗干预措施。与以往一样，人类的情况比动物模型更为复杂，但微生物群的作用以及调节微生物群的干预措施，尽管尚未准备好应用于临床实践，但仍然是基础和临床研究的丰富领域。
