Center of Liver Diseases Division 3, Beijing Ditan Hospital, Capital Medical University, 8 Jingshundong Street, Chaoyang District, Beijing, 100015, China.
Division of Gastroenterology and Hepatology, NYU Langone Health, New York University School of Medicine, New York, USA132-21 41Ave, Flushing, NY, 11355, USA.
Hepatol Int. 2021 Oct;15(5):1053-1067. doi: 10.1007/s12072-021-10230-6. Epub 2021 Oct 1.
Accumulating evidence shows that the intestinal microbiota is closely related to the pathophysiology and the disease progression of chronic hepatitis B virus (HBV) infection. The intestinal microbiota acts on the host through its metabolites. This review aimed to discuss the effects of gut microbiota metabolites on the disease progression of chronic HBV infection. A literature search on PubMed database and Wiley Online Library with pre-specified criteria yielded 96 unique results. After consensus by all authors, the contents from 86 original publications were extracted and included in this review. In liver disease with HBV infection, the intestinal microbiota changed in different stages and affected the production of bacterial metabolites. The abundance of bacteria producing short-chain fatty acids such as butyrate reduced, which was associated with bacterial translocation and the progression of liver disease. The intestinal microbiota-bile acid-host axis was destroyed, affecting the progression of the disease. Under the control of intestinal microbiota, tryptophan affected the gut-liver axis through three main metabolic pathways, among which the kynurenine pathway was closely related to the immune response of hepatitis B. The level of trimethylamine-N-oxide decreased in liver cancer with HBV infection and were used as a potential biomarker of liver cancer. Vitamin deficiencies, including those of vitamin D and vitamin A related to microbiota, were common and associated with survival. Hydrogen sulfide regulated by the intestinal microbiota was also closely related to the gut-liver axis. In liver disease with hepatitis B infection, the intestinal microbiota is imbalanced, and a variety of intestinal microbiota metabolites participate in the occurrence and development of the disease.
越来越多的证据表明，肠道微生物群与慢性乙型肝炎病毒（HBV）感染的病理生理学和疾病进展密切相关。肠道微生物群通过其代谢物作用于宿主。本综述旨在讨论肠道微生物群代谢物对慢性 HBV 感染疾病进展的影响。通过预定义标准在 PubMed 数据库和 Wiley Online Library 上进行文献检索，共获得 96 项独特的结果。经过所有作者的一致同意，从 86 篇原始出版物中提取内容并包含在本综述中。在乙型肝炎病毒感染相关的肝病中，肠道微生物群在不同阶段发生变化并影响细菌代谢物的产生。产生短链脂肪酸（如丁酸盐）的细菌丰度减少，这与细菌易位和肝病进展有关。肠道微生物群-胆汁酸-宿主轴被破坏，影响疾病的进展。在肠道微生物群的控制下，色氨酸通过三种主要代谢途径影响肠道-肝脏轴，其中犬尿氨酸途径与乙型肝炎的免疫反应密切相关。乙型肝炎感染相关肝癌中三甲基胺 N-氧化物的水平降低，并可用作肝癌的潜在生物标志物。包括与微生物群相关的维生素 D 和维生素 A 在内的维生素缺乏症很常见，与生存有关。由肠道微生物群调节的硫化氢也与肠道-肝脏轴密切相关。在乙型肝炎感染相关的肝病中，肠道微生物群失衡，多种肠道微生物群代谢物参与疾病的发生和发展。
