Department of Gastroenterology and Hepatology, Virginia Commonwealth University and McGuire VA Medical Center, Richmond, Virginia, USA.
Department of Periodontics, Virginia Commonwealth University, Richmond, Virginia, USA.
JCI Insight. 2017 Oct 5;2(19):94416. doi: 10.1172/jci.insight.94416.
Cirrhosis is a prevalent cause of morbidity and mortality, especially for those at an advanced decompensated stage. Cirrhosis development and progression involves several important interorgan communications, and recently, the gut microbiome has been implicated in pathophysiology of the disease. Dysbiosis, defined as a pathological change in the microbiome, has a variable effect on the compensated versus decompensated stage of cirrhosis. Adverse microbial changes, both in composition and function, can act at several levels within the gut (stool and mucosal) and have also been described in the blood and oral cavity. While dysbiosis in the oral cavity could be a source of systemic inflammation, current cirrhosis treatment modalities are targeted toward the gut-liver axis and do not address the oral microbiome. As interventions designed to modulate oral dysbiosis may delay progression of cirrhosis, a better understanding of this process is of the utmost importance. The concept of oral microbiota dysbiosis in cirrhosis is relatively new; therefore, this review will highlight the emerging role of the oral-gut-liver axis and introduce perspectives for future research.
肝硬化是发病率和死亡率的主要原因，尤其是在晚期失代偿阶段。肝硬化的发生和发展涉及几个重要的器官间通讯，最近，肠道微生物组被认为与疾病的病理生理学有关。肠道微生物组的病理性变化被定义为生态失调，对肝硬化的代偿期和失代偿期有不同的影响。不良的微生物变化，无论是在组成还是功能上，都可以在肠道（粪便和黏膜）的几个层面上发挥作用，并且在血液和口腔中也有描述。虽然口腔生态失调可能是全身炎症的来源，但目前的肝硬化治疗方法针对的是肠道-肝脏轴，而不针对口腔微生物组。由于设计用于调节口腔生态失调的干预措施可能会延迟肝硬化的进展，因此，对这一过程的深入了解至关重要。肝硬化中口腔微生物组生态失调的概念相对较新；因此，本综述将重点介绍口腔-肠道-肝脏轴的新作用，并为未来的研究提供新视角。
