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从肝硬化到菌群失调(治愈还是并发症的循环?)

From Cirrhosis to the Dysbiosis (A Loop of Cure or Complications?).

作者信息

Bharti Aanchal, Sharma Isar, Mahajan Ritu, Langer Seema, Kapoor Nisha

机构信息

School of Biotechnology, University of Jammu, Jammu, Jammu and Kashmir 180006 India.

Department of Zoology, University of Jammu, Jammu, Jammu and Kashmir 180006 India.

出版信息

Indian J Microbiol. 2024 Sep;64(3):810-820. doi: 10.1007/s12088-024-01267-w. Epub 2024 Apr 3.

Abstract

Gut dysbiosis and liver cirrhosis are two corelated complications that highly disturbs the metabolism of a normal human body. Liver cirrhosis is scarring of the hepatic tissue and gut dysbiosis is the imbalance in the microbiome of the gut. Gut dysbiosis in cirrhosis occurs due to increased permeability of the intestinal membrane which might induce immune responses and damage the normal functioning of the body. Dysbiosis can cause liver damage from cirrhosis and can further lead to liver failure by hepatocellular carcinoma. In this review we discuss if eubiosis can revert the poorly functioning cirrhotic liver to normal functioning state? A normal microbiome converts various liver products into usable forms that regulates the overgrowth of microbiome in the gut. The imbalance caused by dysbiosis retards the normal functioning of liver and increases the complications. To correct this dysbiosis, measures like use of antibiotics with probiotics and prebiotics are used. This correction of the gut microbiome serves as a ray of hope to recover from this chronic illness. In case of alcohol induced liver cirrhosis, intervention of microbes can possibly be helpful in modulating the addiction as well as associated complications like depression as microbes are known to produce and consume neurotransmitters that are involved in alcohol addiction. Hence a correction of gut liver brain axis using microbiome can be a milestone achieved not only for treatment of liver cirrhosis but also for helping alcohol addicts quit and live a healthy or at least a near healthy life.

摘要

肠道菌群失调和肝硬化是两种相关的并发症,严重扰乱人体正常代谢。肝硬化是肝组织瘢痕化,而肠道菌群失调是肠道微生物群失衡。肝硬化中的肠道菌群失调是由于肠膜通透性增加所致,这可能引发免疫反应并损害身体正常功能。菌群失调可导致肝硬化引起的肝损伤,并可能通过肝细胞癌进一步导致肝衰竭。在本综述中,我们探讨了正常的肠道菌群能否使功能不佳的肝硬化肝脏恢复到正常功能状态?正常的微生物群将各种肝脏产物转化为可用形式,从而调节肠道微生物群的过度生长。菌群失调导致的失衡会阻碍肝脏正常功能并增加并发症。为纠正这种菌群失调,可采取使用抗生素与益生菌和益生元相结合的措施。肠道微生物群的这种纠正为从这种慢性病中康复带来了一线希望。对于酒精性肝硬化,微生物干预可能有助于调节成瘾以及诸如抑郁等相关并发症,因为已知微生物会产生和消耗与酒精成瘾有关的神经递质。因此,利用微生物群纠正肠道-肝脏-脑轴不仅可能成为治疗肝硬化的一个里程碑,而且有助于帮助酗酒者戒酒并过上健康或至少接近健康的生活。

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本文引用的文献

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Evidence-based clinical practice guidelines for Liver Cirrhosis 2020.2020 年肝硬化循证临床实践指南。
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