Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA; Division of Gastroenterology, Hepatology, and Nutrition, Texas Children's Hospital, Houston, TX, USA.
Department of Pediatrics, Harvard Medical School, Boston, MA, USA; Division of Gastroenterology and Nutrition, Department of Medicine, Boston Children's Hospital, Boston, MA, USA.
Lancet Gastroenterol Hepatol. 2017 Jun;2(6):446-455. doi: 10.1016/S2468-1253(16)30241-2.
The intestinal microbiome has been the intense focus of recent study, but how the microbiota affects connected organs, such as the liver, has not been fully elucidated. The microbiome regulates intestinal permeability and helps to metabolise the human diet into small molecules, thus directly affecting liver health. Several studies have linked intestinal dysbiosis to the severity and progression of liver diseases, such as non-alcoholic fatty liver disease, non-alcoholic steatohepatitis, primary sclerosing cholangitis, total parenteral nutrition-associated liver disease, and cystic fibrosis-associated liver disease. However, there is limited information and interpretation with regard to how the microbiome could contribute to liver disease in the paediatric population. Notably, the gut microbiota is distinct at birth and does not establish an adult profile until the third year of life. Clinical research suggests that paediatric liver disease differs in both severity and rate of progression compared with adult forms, suggesting independent mechanisms of pathogenesis. We discuss data linking the intestinal microbiome to liver disease development and therapeutic efforts to modify the microbiome in children.
肠道微生物组一直是近期研究的重点，但微生物组如何影响肝脏等相关器官尚未完全阐明。微生物组调节肠道通透性，并帮助将人体饮食代谢成小分子，从而直接影响肝脏健康。几项研究将肠道菌群失调与非酒精性脂肪肝、非酒精性脂肪性肝炎、原发性硬化性胆管炎、全胃肠外营养相关肝病和囊性纤维化相关肝病等肝病的严重程度和进展联系起来。然而，关于微生物组如何导致儿科人群中的肝病，相关信息和解释有限。值得注意的是，肠道微生物组在出生时就具有独特性，直到生命的第三年才形成成人特征。临床研究表明，与成人形式相比，儿科肝病在严重程度和进展速度上存在差异，这表明存在独立的发病机制。我们讨论了将肠道微生物组与肝病发展联系起来的数据，并探讨了改变儿童微生物组的治疗方法。
