Wang Fangzhao, Cui Qianru, Zeng Yunong, Chen Peng
Department of Pathophysiology, College of Basic Medical Sciences, Southern Medical University, Guangzhou 510515, China.
Nan Fang Yi Ke Da Xue Xue Bao. 2020 Apr 30;40(4):595-600. doi: 10.12122/j.issn.1673-4254.2020.04.23.
Gut microbiota constitute a complicated but manifold ecosystem, in which specific symbiotic relationships are formed among various bacteria. To maintain a steady state, the gastrointestinal tract and the liver form a close anatomical and functional two-way, interconnected network through the portal circulation. "Gut-liver axis" plays a key role in the pathogenesis of liver diseases. Accumulating evidence indicates that gut microbiota can influence the liver pathophysiology directly or indirectly via a variety of signal pathways. In a pathological state where an ecological imbalance occurs at the compositional and functional levels, gut microbes would interact with the host immune system and other type of cells to cause liver steatosis, inflammation and fibrosis, which in turn give rise to the development of such liver diseases as alcoholic liver disease, nonalcoholic fatty liver disease, primary sclerosing cholangitis, and acute liver failure, to name a few. Studies have shown that microorganisms, such as prebiotics and probiotics, can improve the prognosis of certain diseases, which open a new era of treating liver diseases with bacteria. There are many unknowns and hidden values in the gut microbiome. To explore the pathophysiological mechanism of various complex diseases and develop scientific and effective clinical treatment strategies, efforts should be made to obtain insights into how certain intestinal microbiota participates in the occurrence and progression of liver diseases. As the connection between gut microbiota and liver diseases at both the acute and chronic phases was not elaborated in previously published review articles, herein we discuss the association between gut microbiota and both acute and chronic liver injury. The anatomical structure of the liver enables it to form a close network with the gut microbiota, which is an important mediator in the regulation of the hepatic physiological and pathological functions.
肠道微生物群构成了一个复杂但多样的生态系统,其中各种细菌之间形成了特定的共生关系。为了维持稳态,胃肠道和肝脏通过门静脉循环形成了一个紧密的解剖学和功能上的双向互联网络。“肠-肝轴”在肝脏疾病的发病机制中起关键作用。越来越多的证据表明,肠道微生物群可通过多种信号通路直接或间接影响肝脏病理生理学。在组成和功能水平出现生态失衡的病理状态下,肠道微生物会与宿主免疫系统及其他类型的细胞相互作用,导致肝脏脂肪变性、炎症和纤维化,进而引发诸如酒精性肝病、非酒精性脂肪性肝病、原发性硬化性胆管炎和急性肝衰竭等肝脏疾病。研究表明,益生元和益生菌等微生物可改善某些疾病的预后,这开启了用细菌治疗肝脏疾病的新时代。肠道微生物组存在许多未知和潜在价值。为了探索各种复杂疾病的病理生理机制并制定科学有效的临床治疗策略,应努力深入了解某些肠道微生物群如何参与肝脏疾病的发生和发展。由于此前发表的综述文章未阐述肠道微生物群与急慢性肝病阶段的联系,因此我们在此讨论肠道微生物群与急慢性肝损伤之间的关联。肝脏的解剖结构使其能够与肠道微生物群形成紧密网络,而肠道微生物群是调节肝脏生理和病理功能的重要介质。