Department of Medicine, University of California San Diego, La Jolla, CA, USA.
Department of Internal Medicine, Amsterdam University Medical Centers, Location AMC, Amsterdam, Netherlands.
Nat Rev Gastroenterol Hepatol. 2024 Aug;21(8):556-571. doi: 10.1038/s41575-024-00937-w. Epub 2024 Jun 3.
The gut microbiome exerts metabolic actions on distal tissues and organs outside the intestine, partly through microbial metabolites that diffuse into the circulation. The disruption of gut homeostasis results in changes to microbial metabolites, and more than half of the variance in the plasma metabolome can be explained by the gut microbiome. Ethanol is a major microbial metabolite that is produced in the intestine of nearly all individuals; however, elevated ethanol production is associated with pathological conditions such as metabolic dysfunction-associated steatotic liver disease and auto-brewery syndrome, in which the liver's capacity to metabolize ethanol is surpassed. In this Review, we describe the mechanisms underlying excessive ethanol production in the gut and the role of ethanol catabolism in mediating pathogenic effects of ethanol on the liver and host metabolism. We conclude by discussing approaches to target excessive ethanol production by gut bacteria.
肠道微生物组对肠道外的远端组织和器官发挥代谢作用，部分是通过扩散到循环中的微生物代谢产物实现的。肠道内环境稳态的破坏会导致微生物代谢产物发生变化，而血浆代谢组的一半以上变异可以用肠道微生物组来解释。乙醇是一种主要的微生物代谢产物，几乎所有个体的肠道中都会产生；然而，乙醇产量的升高与代谢功能相关的脂肪性肝病和自酿综合征等病理状况有关，在这些情况下，肝脏代谢乙醇的能力超过了其代谢能力。在这篇综述中，我们描述了肠道中过度产生乙醇的机制，以及乙醇代谢在介导乙醇对肝脏和宿主代谢的致病作用中的作用。最后，我们讨论了通过肠道细菌来靶向过度产生乙醇的方法。
