Cheng Zilu, Yang Ling, Chu Huikuan
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, China.
Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277 Jiefang Avenue, Wuhan, Hubei Province 430022, China.
J Adv Res. 2025 Jun;72:353-367. doi: 10.1016/j.jare.2024.07.002. Epub 2024 Jul 3.
The liver disorders caused by alcohol abuse are termed alcoholic-related liver disease (ALD), including alcoholic steatosis, alcoholic steatohepatitis, alcoholic hepatitis, and alcoholic cirrhosis, posing a significant threat to human health. Currently, ALD pathogenesis has not been completely clarified, which is likely to be related to the direct damage caused by alcohol and its metabolic products, oxidative stress, gut dysbiosis, and exosomes.
The existing studies suggest that both the gut microbiota and exosomes contribute to the development of ALD. Moreover, there exists an interaction between the gut microbiota and exosomes. We discuss whether this interaction plays a role in the pathogenesis of ALD and whether it can be a potential therapeutic target for ALD treatment.
Chronic alcohol intake alters the diversity and composition of gut microbiota, which greatly contributes to ALD's progression. Some approaches targeting the gut microbiota, including probiotics, fecal microbiota transplantation, and phage therapy, have been confirmed to effectively ameliorate ALD in many animal experiments and/or several clinical trials. In ALD, the levels of exosomes and the expression profile of microRNA have also changed, which affects the pathogenesis of ALD. Moreover, there is an interplay between exosomes and the gut microbiota, which also putatively acts as a pathogenic factor of ALD.
酒精滥用所致的肝脏疾病被称为酒精相关性肝病（ALD），包括酒精性脂肪变性、酒精性脂肪性肝炎、酒精性肝炎和酒精性肝硬化，对人类健康构成重大威胁。目前，ALD的发病机制尚未完全阐明，这可能与酒精及其代谢产物造成的直接损伤、氧化应激、肠道菌群失调和外泌体有关。
现有研究表明，肠道微生物群和外泌体均参与ALD的发展。此外，肠道微生物群与外泌体之间存在相互作用。我们探讨这种相互作用是否在ALD的发病机制中起作用，以及它是否可以成为ALD治疗的潜在靶点。
长期饮酒会改变肠道微生物群的多样性和组成，这对ALD的进展有很大影响。一些针对肠道微生物群的方法，包括益生菌、粪便微生物群移植和噬菌体疗法，已在许多动物实验和/或一些临床试验中被证实可有效改善ALD。在ALD中，外泌体水平和微小RNA的表达谱也发生了变化，这影响了ALD的发病机制。此外，外泌体与肠道微生物群之间存在相互作用，这也可能是ALD的致病因素。
