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非酒精性脂肪性肝病患者尽管初级和次级胆汁酸产生增加,但肝胆汁酸信号受到抑制。

Suppressed hepatic bile acid signalling despite elevated production of primary and secondary bile acids in NAFLD.

机构信息

Department of Bioinformatics, School of Life Sciences and Technology, Tongji University, Shanghai, China.

Department of Pediatrics, Digestive Diseases and Nutrition Center, The State University of New York at Buffalo, Buffalo, New York, USA.

出版信息

Gut. 2018 Oct;67(10):1881-1891. doi: 10.1136/gutjnl-2017-314307. Epub 2017 Aug 3.

DOI:10.1136/gutjnl-2017-314307
PMID:28774887
Abstract

OBJECTIVE

Bile acids are regulators of lipid and glucose metabolism, and modulate inflammation in the liver and other tissues. Primary bile acids such as cholic acid and chenodeoxycholic acid (CDCA) are produced in the liver, and converted into secondary bile acids such as deoxycholic acid (DCA) and lithocholic acid by gut microbiota. Here we investigated the possible roles of bile acids in non-alcoholic fatty liver disease (NAFLD) pathogenesis and the impact of the gut microbiome on bile acid signalling in NAFLD.

DESIGN

Serum bile acid levels and fibroblast growth factor 19 (FGF19), liver gene expression profiles and gut microbiome compositions were determined in patients with NAFLD, high-fat diet-fed rats and their controls.

RESULTS

Serum concentrations of primary and secondary bile acids were increased in patients with NAFLD. In per cent, the farnesoid X receptor (FXR) antagonistic DCA was increased, while the agonistic CDCA was decreased in NAFLD. Increased mRNA expression for cytochrome P450 7A1, Na-taurocholate cotransporting polypeptide and paraoxonase 1, no change in mRNA expression for small heterodimer partner and bile salt export pump, and reduced serum FGF19 were evidence of impaired FXR and fibroblast growth factor receptor 4 (FGFR4)-mediated signalling in NAFLD. Taurine and glycine metabolising bacteria were increased in the gut of patients with NAFLD, reflecting increased secondary bile acid production. Similar changes in liver gene expression and the gut microbiome were observed in high-fat diet-fed rats.

CONCLUSIONS

The serum bile acid profile, the hepatic gene expression pattern and the gut microbiome composition consistently support an elevated bile acid production in NAFLD. The increased proportion of FXR antagonistic bile acid explains, at least in part, the suppression of hepatic FXR-mediated and FGFR4-mediated signalling. Our study suggests that future NAFLD intervention may target the components of FXR signalling, including the bile acid converting gut microbiome.

摘要

目的

胆汁酸是脂质和葡萄糖代谢的调节剂,并调节肝脏和其他组织中的炎症。初级胆汁酸,如胆酸和鹅脱氧胆酸(CDCA),在肝脏中产生,并被肠道微生物群转化为次级胆汁酸,如脱氧胆酸(DCA)和石胆酸。在这里,我们研究了胆汁酸在非酒精性脂肪性肝病(NAFLD)发病机制中的可能作用,以及肠道微生物组对 NAFLD 中胆汁酸信号的影响。

设计

测定了 NAFLD 患者、高脂肪饮食喂养的大鼠及其对照的血清胆汁酸水平和成纤维细胞生长因子 19(FGF19)、肝基因表达谱和肠道微生物组组成。

结果

NAFLD 患者的初级和次级胆汁酸血清浓度升高。以百分比表示,法尼醇 X 受体(FXR)拮抗剂 DCA 增加,而 NAFLD 中 FXR 激动剂 CDCA 减少。细胞色素 P450 7A1、Na-牛磺胆酸共转运蛋白和对氧磷酶 1 的 mRNA 表达增加,小异二聚体伴侣和胆汁盐输出泵的 mRNA 表达不变,血清 FGF19 减少,表明 FXR 和纤维母细胞生长因子受体 4(FGFR4)介导的信号在 NAFLD 中受损。NAFLD 患者肠道中牛磺酸和甘氨酸代谢细菌增加,反映了次级胆汁酸生成增加。高脂肪饮食喂养大鼠也观察到类似的肝基因表达和肠道微生物组变化。

结论

血清胆汁酸谱、肝基因表达模式和肠道微生物组组成一致支持 NAFLD 中胆汁酸生成增加。FXR 拮抗型胆汁酸比例增加至少部分解释了肝 FXR 介导和 FGFR4 介导信号的抑制。我们的研究表明,未来的 NAFLD 干预可能针对 FXR 信号的组成部分,包括胆汁酸转化的肠道微生物群。

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