School of Biotechnology and Biomolecular Sciences, UNSW Sydney, Sydney, NSW, 2052, Australia.
School of Biotechnology and Biomolecular Sciences, UNSW Sydney, Sydney, NSW, 2052, Australia.
Best Pract Res Clin Gastroenterol. 2017 Dec;31(6):657-668. doi: 10.1016/j.bpg.2017.09.008. Epub 2017 Sep 5.
Non-alcoholic fatty liver disease (NAFLD) has become the most common chronic liver disease worldwide. It is well-accepted that gut dysbiosis is associated with NAFLD, however, there is some conflicting evidence regarding the nature of these alterations. Infection with Helicobacter species, mainly H. pylori, has also been associated with increased NAFLD risk, however, some studies have failed to reproduce this finding. Further studies including large study samples and standardised procedures for microbiota analyses, H. pylori detection and NAFLD diagnostic criteria, are required. The mechanisms involving Helicobacter species and the intestinal microbiome in NAFLD pathogenesis appear to be part of the multiple-hit theory, in which increased intestinal permeability, inflammatory responses, altered choline, bile acids and carbohydrate metabolism, production of short-chain fatty acids, urea cycle and urea transport systems, altered maintenance of hepatic γδT-17 cells, insulin resistance, hormones secreted by the adipose tissue, metabolic hormones, bacterial metabolites and Helicobacter toxins, are all implicated.
非酒精性脂肪性肝病（NAFLD）已成为全球最常见的慢性肝病。人们普遍认为肠道菌群失调与 NAFLD 有关，但关于这些变化的性质仍存在一些相互矛盾的证据。感染幽门螺杆菌（Helicobacter species），主要是 H. pylori，也与增加的 NAFLD 风险相关，但一些研究未能重现这一发现。需要进一步的研究，包括大样本研究和标准化的微生物组分析、H. pylori 检测和 NAFLD 诊断标准的程序。涉及 Helicobacter 物种和肠道微生物组在 NAFLD 发病机制中的机制似乎是多因素理论的一部分，其中包括增加的肠道通透性、炎症反应、胆碱、胆汁酸和碳水化合物代谢改变、短链脂肪酸的产生、尿素循环和尿素转运系统、肝 γδT-17 细胞的维持改变、胰岛素抵抗、脂肪组织分泌的激素、代谢激素、细菌代谢物和 Helicobacter 毒素。
