Laboratory of Hepato-Gastroenterology, Institute of Experimental and Clinical Research, Université catholique de Louvain, Brussels, Belgium
Department of Hepato-Gastroenterology, Cliniques Universitaires St. Luc, Brussels, Belgium.
Clin Sci (Lond). 2018 Jan 19;132(2):199-212. doi: 10.1042/CS20171055. Print 2018 Jan 31.
Alcohol dependence and alcoholic liver disease represent a major public health problem with substantial morbidity and mortality. By yet incompletely understood mechanisms, chronic alcohol abuse is associated with increased intestinal permeability and alterations of the gut microbiota composition, allowing bacterial components, bacteria, and metabolites to reach the portal and the systemic circulation. These gut-derived bacterial products are recognized by immune cells circulating in the blood or residing in remote organs such as the liver leading to the release of pro-inflammatory cytokines which are considered important mediators of the liver-gut-brain communication. Although circulating cytokines are likely not the sole factors involved, they can induce liver inflammation/damage and reach the central nervous system where they favor neuroinflammation which is associated with change in mood, cognition, and drinking behavior. In this review, the authors focus on the current evidence describing the changes that occur in the intestinal microbiota with chronic alcohol consumption in conjunction with intestinal barrier breakdown and inflammatory changes sustaining the concept of a gut-liver-brain axis in the pathophysiology of alcohol dependence and alcoholic liver disease.
酒精依赖和酒精性肝病是一个主要的公共卫生问题，其发病率和死亡率都很高。目前尚不完全清楚的机制表明，慢性酒精滥用与肠道通透性增加和肠道微生物群落组成改变有关，使细菌成分、细菌和代谢物能够进入门静脉和全身循环。这些源自肠道的细菌产物被血液中循环的免疫细胞或驻留在肝脏等远程器官的免疫细胞识别，导致促炎细胞因子的释放，这些细胞因子被认为是肝肠脑通讯的重要介质。虽然循环细胞因子可能不是唯一涉及的因素，但它们可以诱导肝脏炎症/损伤，并到达中枢神经系统，在那里它们有利于神经炎症，这与情绪、认知和饮酒行为的改变有关。在这篇综述中，作者重点介绍了目前描述的与慢性酒精摄入相关的肠道微生物群变化的证据，以及肠道屏障破坏和炎症变化，这些变化维持了酒精依赖和酒精性肝病的生理病理学中肠-肝-脑轴的概念。
