肠-肝轴、肠道微生物群及其在肝脏疾病治疗中的调控:文献综述。
Gut-Liver Axis, Gut Microbiota, and Its Modulation in the Management of Liver Diseases: A Review of the Literature.
机构信息
Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia.
Hospital for Infectious and Tropical Diseases, Clinical Center of Serbia, 11000 Belgrade, Serbia.
出版信息
Int J Mol Sci. 2019 Jan 17;20(2):395. doi: 10.3390/ijms20020395.
The rapid scientific interest in gut microbiota (GM) has coincided with a global increase in the prevalence of infectious and non-infectivous liver diseases. GM, which is also called "the new virtual metabolic organ", makes axis with a number of extraintestinal organs, such as kidneys, brain, cardiovascular, and the bone system. The gut-liver axis has attracted greater attention in recent years. GM communication is bi-directional and involves endocrine and immunological mechanisms. In this way, gut-dysbiosis and composition of "ancient" microbiota could be linked to pathogenesis of numerous chronic liver diseases such as chronic hepatitis B (CHB), chronic hepatitis C (CHC), alcoholic liver disease (ALD), non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), development of liver cirrhosis, and hepatocellular carcinoma (HCC). In this paper, we discuss the current evidence supporting a GM role in the management of different chronic liver diseases and potential new therapeutic GM targets, like fecal transplantation, antibiotics, probiotics, prebiotics, and symbiotics. We conclude that population-level shifts in GM could play a regulatory role in the gut-liver axis and, consequently, etiopathogenesis of chronic liver diseases. This could have a positive impact on future therapeutic strategies.
肠道微生物群(GM)的快速科学研究兴趣与传染病和非传染性肝病的全球发病率的增加同时发生。GM 也被称为“新的虚拟代谢器官”,与许多肠道外器官(如肾脏、大脑、心血管和骨骼系统)形成轴。近年来,肠道-肝脏轴引起了更多的关注。GM 通讯是双向的,涉及内分泌和免疫机制。通过这种方式,肠道失调和“古老”微生物组的组成可能与许多慢性肝病的发病机制有关,如慢性乙型肝炎(CHB)、慢性丙型肝炎(CHC)、酒精性肝病(ALD)、非酒精性脂肪性肝病(NAFLD)、非酒精性脂肪性肝炎(NASH)、肝硬化的发展和肝细胞癌(HCC)。在本文中,我们讨论了支持 GM 在不同慢性肝病管理中发挥作用的现有证据以及潜在的新治疗性 GM 靶点,如粪便移植、抗生素、益生菌、益生元、共生体。我们得出结论,GM 的人群水平变化可能在肠道-肝脏轴中发挥调节作用,从而影响慢性肝病的病因发病机制。这可能对未来的治疗策略产生积极影响。