University of California, Los Angeles, California, USA.
Stony Brook University, Stony Brook, New York, USA.
J Viral Hepat. 2022 Feb;29(2):94-106. doi: 10.1111/jvh.13595. Epub 2021 Aug 30.
Current therapeutic interventions can only suppress hepatitis B virus (HBV) replication or reduce complications without a cure. Therefore, further development of new treatment methods is critical for the global eradication of HBV. Accumulating evidence suggests that the liver and gut share an interconnected relationship referred to as the 'Gut-Liver Axis', where exchanges happen bi-directionally. The gut itself is the host to a unique microbiota profile which has metabolic, immunological, neurological and nutritional functions. Gut microbiota is not only constantly intersecting with the liver but also associated with hepatic injury when dysbiosis occurs. In recent years, there has been increased interest in gut microbiota and its implications on liver disease treatment. Progress has been made in understanding the complex relationship between chronic hepatitis B (CHB) and gut microbiota. New investigative techniques such as colony-free sequencing enabled new perspectives into this field. Mouse models and human studies revealed that HBV infection is associated with significant alteration of gut microbiota, which differ depending on the stage of CHB disease progression. Different mechanisms of the hepatic injury from gut microbiota dysbiosis have also been proposed based on findings of increased intestinal permeability to toxins, disruption of normal bacterial metabolism, and colonization of the gut by oral microbiota. New treatment methods targeting gut microbiota in CHB, such as probiotics and faecal microbiota transplant, have also gained promising results in recent years. The current review recapitulated the most recent investigations into the relationship between gut microbiota and CHB to provide research directions towards the new therapeutic target of CHB.
目前的治疗干预措施只能抑制乙型肝炎病毒（HBV）的复制或减少并发症而无法治愈。因此，进一步开发新的治疗方法对于全球消除 HBV 至关重要。越来越多的证据表明，肝脏和肠道之间存在相互关联的关系，称为“肠-肝轴”，其中的物质交换是双向的。肠道本身是独特微生物群的宿主，具有代谢、免疫、神经和营养功能。肠道微生物群不仅与肝脏不断相互作用，而且当肠道菌群失调时还与肝损伤有关。近年来，人们对肠道微生物群及其对肝病治疗的影响越来越感兴趣。人们在理解慢性乙型肝炎（CHB）和肠道微生物群之间的复杂关系方面取得了进展。新兴的研究技术，如无培养物测序，为该领域提供了新的视角。小鼠模型和人类研究表明，HBV 感染与肠道微生物群的显著改变有关，而这种改变取决于 CHB 疾病进展的阶段。基于毒素肠通透性增加、正常细菌代谢紊乱和肠道中口腔微生物定植的发现，也提出了肠道微生物群失调引起肝损伤的不同机制。近年来，针对 CHB 肠道微生物群的新治疗方法，如益生菌和粪便微生物移植，也取得了有前景的结果。本文综述了肠道微生物群与 CHB 之间关系的最新研究进展，为 CHB 的新治疗靶点提供了研究方向。
