胆固醇结石病发病机制的最新进展。
An update on the pathogenesis of cholesterol gallstone disease.
作者信息
Di Ciaula Agostino, Wang David Q-H, Portincasa Piero
机构信息
Division of Internal Medicine, Hospital of Bisceglie, Bisceglie, Italy.
Department of Medicine, Division of Gastroenterology and Liver Diseases, Marion Bessin Liver Research Center, Albert Einstein College of Medicine, Bronx, NY, USA.
出版信息
Curr Opin Gastroenterol. 2018 Mar;34(2):71-80. doi: 10.1097/MOG.0000000000000423.
PURPOSE OF REVIEW
Gallstone disease is a major epidemiologic and economic burden worldwide, and the most frequent form is cholesterol gallstone disease.
RECENT FINDINGS
Major pathogenetic factors for cholesterol gallstones include a genetic background, hepatic hypersecretion of cholesterol, and supersaturated bile which give life to precipitating cholesterol crystals that accumulate and grow in a sluggish gallbladder. Additional factors include mucin and inflammatory changes in the gallbladder, slow intestinal motility, increased intestinal absorption of cholesterol, and altered gut microbiota. Mechanisms of disease are linked with insulin resistance, obesity, the metabolic syndrome, and type 2 diabetes. The role of nuclear receptors, signaling pathways, gut microbiota, and epigenome are being actively investigated.
SUMMARY
Ongoing research on cholesterol gallstone disease is intensively investigating several pathogenic mechanisms, associated metabolic disorders, new therapeutic approaches, and novel strategies for primary prevention, including lifestyles.
综述目的
胆结石病是全球主要的流行病学和经济负担，最常见的形式是胆固醇结石病。
最新发现
胆固醇结石的主要致病因素包括遗传背景、肝脏胆固醇分泌过多以及胆汁过饱和，这些因素导致胆固醇晶体沉淀，在运动缓慢的胆囊中积聚并生长。其他因素包括胆囊中的粘蛋白和炎症变化、肠道蠕动缓慢、肠道对胆固醇的吸收增加以及肠道微生物群改变。疾病机制与胰岛素抵抗、肥胖、代谢综合征和2型糖尿病有关。核受体、信号通路、肠道微生物群和表观基因组的作用正在积极研究中。
总结
对胆固醇结石病的 ongoing research正在深入研究几种致病机制、相关的代谢紊乱、新的治疗方法以及包括生活方式在内的一级预防新策略。
注
原文中“ongoing research”直译为“正在进行的研究”，这里为了更通顺可灵活调整表述。
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