Sorbonne Université, INSERM, UMRS U1269, Nutriomics Research Unit, Paris, France; Nutrition Department, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Centre de Recherche en Nutrition Humaine d'Ile de France, Paris, France; Department of Vascular Medicine, University of Amsterdam Medical Center, Amsterdam, The Netherlands.
Department of Vascular Medicine, University of Amsterdam Medical Center, Amsterdam, The Netherlands.
Gastroenterology. 2020 May;158(7):1881-1898. doi: 10.1053/j.gastro.2020.01.049. Epub 2020 Feb 8.
Gut microbiota plays a role in the pathophysiology of metabolic diseases, which include nonalcoholic fatty liver diseases, through the gut-liver axis. To date, clinical guidelines recommend a weight loss goal of 7%-10% to improve features of nonalcoholic fatty liver diseases. Because this target is not easily achieved by all patients, alternative therapeutic options are currently being evaluated. This review focuses on therapeutics that aim to modulate the gut microbiota and the gut-liver axis. We discuss how probiotics, prebiotics, synbiotic, fecal microbiota transfer, polyphenols, specific diets, and exercise interventions have been found to modify gut microbiota signatures; improve nonalcoholic fatty liver disease outcomes; and detail, when available, the different mechanisms by which these beneficial outcomes might occur. Apart from probiotics that have already been tested in human randomized controlled trials, most of these potential therapeutics have been studied in animals. Their efficacy still warrants confirmation in humans using appropriate design.
肠道微生物群在代谢性疾病（包括非酒精性脂肪性肝病）的病理生理学中发挥作用，通过肠道-肝脏轴发挥作用。迄今为止，临床指南建议将体重减轻 7%-10%作为改善非酒精性脂肪性肝病特征的目标。由于并非所有患者都容易达到这一目标，目前正在评估替代治疗方案。这篇综述重点介绍了旨在调节肠道微生物群和肠道-肝脏轴的治疗方法。我们讨论了益生菌、益生元、合生菌、粪便微生物群移植、多酚、特定饮食和运动干预如何被发现可以改变肠道微生物群特征；改善非酒精性脂肪性肝病的结果；并详细说明在有条件的情况下，这些有益结果可能发生的不同机制。除了已经在人体随机对照试验中测试过的益生菌外，这些潜在的治疗方法中的大多数都在动物中进行了研究。它们的疗效仍需要使用适当的设计在人体中进行确认。
