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从菌群失调角度看肝硬化及其并发症

Liver cirrhosis and complications from the perspective of dysbiosis.

作者信息

Nie Guole, Zhang Honglong, Xie Danna, Yan Jun, Li Xun

机构信息

The First School of Clinical Medicine, Lanzhou University, Lanzhou, China.

Department of General Surgery, The First Hospital of Lanzhou University, Lanzhou, China.

出版信息

Front Med (Lausanne). 2024 Jan 16;10:1320015. doi: 10.3389/fmed.2023.1320015. eCollection 2023.

Abstract

The gut-liver axis refers to the intimate relationship and rigorous interaction between the gut and the liver. The intestinal barrier's integrity is critical for maintaining liver homeostasis. The liver operates as a second firewall in this interaction, limiting the movement of potentially dangerous compounds from the gut and, as a result, contributing in barrier management. An increasing amount of evidence shows that increased intestinal permeability and subsequent bacterial translocation play a role in liver damage development. The major pathogenic causes in cirrhotic individuals include poor intestinal permeability, nutrition, and intestinal flora dysbiosis. Portal hypertension promotes intestinal permeability and bacterial translocation in advanced liver disease, increasing liver damage. Bacterial dysbiosis is closely related to the development of cirrhosis and its related complications. This article describes the potential mechanisms of dysbiosis in liver cirrhosis and related complications, such as spontaneous bacterial peritonitis, hepatorenal syndrome, portal vein thrombosis, hepatic encephalopathy, and hepatocellular carcinoma, using dysbiosis of the intestinal flora as an entry point.

摘要

肠-肝轴指的是肠道与肝脏之间密切的关系和紧密的相互作用。肠道屏障的完整性对于维持肝脏内环境稳定至关重要。在这种相互作用中,肝脏起到第二道防火墙的作用,限制潜在危险化合物从肠道的移动,从而有助于屏障管理。越来越多的证据表明,肠道通透性增加及随后的细菌易位在肝损伤发展过程中起作用。肝硬化患者的主要致病原因包括肠道通透性差、营养问题和肠道菌群失调。门静脉高压会促进晚期肝病患者的肠道通透性和细菌易位,加重肝损伤。细菌失调与肝硬化及其相关并发症的发生密切相关。本文以肠道菌群失调为切入点,阐述肝硬化及相关并发症(如自发性细菌性腹膜炎、肝肾综合征、门静脉血栓形成、肝性脑病和肝细胞癌)中失调的潜在机制。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d29b/10824916/4c3d636abccc/fmed-10-1320015-g001.jpg

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