Xia Qinglan, Lei Yumeng, Wang Jiadun, Wang Qiang
Institute of Infection, Immunology and Tumor Microenvironment, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Medicine, Wuhan University of Science and Technology, Wuhan 430065, China.
Asia General Hospital Affiliated to Wuhan University of Science and Technology, Wuhan 430056, China.
Open Life Sci. 2023 Oct 17;18(1):20220741. doi: 10.1515/biol-2022-0741. eCollection 2023.
The interaction between intestinal microecological dysregulation, altered inflammatory factors, and cirrhosis is unclear. The aim of this systematic review and meta-analysis was to synthesize the results of previous studies to assess the efficacy of probiotics in the treatment of cirrhosis and their effect on inflammatory factors, as well as to explore the relationship between gut microecological dysregulation and liver disease to gain a deeper understanding of this interaction. Up to December 2022, eligible studies were identified by searching the following databases: National Knowledge Infrastructure (CNKI), Wanfang Data, Web of Science, PubMed, Embase, Medline, and the Cochrane Library. Statistical analysis was performed using software RevMan Version 5.4. A total of 33 eligible randomized controlled trials were included in the study, and data on probiotic strains, duration of intervention, measures in the control group, and outcomes were extracted and evaluated. Compared to the control group, the experimental group had significant improvements in overall efficacy. The results of the meta-analysis revealed that probiotic use significantly decreased biochemical parameters for liver function, including aspartate transaminase, alanine aminotransferase, and total bilirubin. Similar result was obtained in interleukin-6, tumor necrosis factor-α, and endotoxin. However, probiotic intervention did not significantly affect interleukin-2 and interleukin-10. The current meta-analysis illustrates that probiotic supplementation reduces inflammatory markers and biochemical parameters for liver function in patients with cirrhosis, suggesting that probiotic management may be a novel treatment for cirrhosis. Furthermore, the interaction of the gut microbiota, associated metabolites, and inflammation factors with cirrhosis may provide a promising therapeutic target for the pharmacological and clinical treatment of cirrhosis.
肠道微生态失调、炎症因子改变与肝硬化之间的相互作用尚不清楚。本系统评价和荟萃分析的目的是综合以往研究结果，评估益生菌在肝硬化治疗中的疗效及其对炎症因子的影响，并探讨肠道微生态失调与肝病之间的关系，以更深入地了解这种相互作用。截至2022年12月，通过检索以下数据库确定符合条件的研究：中国知网（CNKI）、万方数据、科学网、PubMed、Embase、Medline和Cochrane图书馆。使用RevMan 5.4版软件进行统计分析。本研究共纳入33项符合条件的随机对照试验，并提取和评估了益生菌菌株、干预持续时间、对照组措施及结果的数据。与对照组相比，实验组的总体疗效有显著改善。荟萃分析结果显示，使用益生菌可显著降低肝功能的生化参数，包括天冬氨酸转氨酶、丙氨酸转氨酶和总胆红素。白细胞介素-6、肿瘤坏死因子-α和内毒素也得到了类似结果。然而，益生菌干预对白细胞介素-2和白细胞介素-10没有显著影响。当前的荟萃分析表明，补充益生菌可降低肝硬化患者的炎症标志物和肝功能生化参数，提示益生菌治疗可能是肝硬化的一种新疗法。此外，肠道微生物群、相关代谢产物和炎症因子与肝硬化的相互作用可能为肝硬化的药理和临床治疗提供一个有前景的治疗靶点。
