Chen Ping, Yang Chengchen, Ren Ke, Xu Mingzhi, Pan Chenwei, Ye Xuewei, Li Lanjuan
Key Laboratory of Artificial Organs and Computational Medicine of Zhejiang Province, Shulan (Hangzhou) Hospital, Shulan International Medical College, Zhejiang Shuren University, Hangzhou, China.
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
Front Immunol. 2024 Nov 22;15:1504948. doi: 10.3389/fimmu.2024.1504948. eCollection 2024.
Hepatocellular carcinoma, a common malignancy of the digestive system, typically progresses through a sequence of hepatitis, liver fibrosis, cirrhosis and ultimately, tumor. The interaction between gut microbiota, the portal venous system and the biliary tract, referred to as the gut-liver axis, is crucial in understanding the mechanisms that contribute to the progression of hepatocellular carcinoma. Mechanisms implicated include gut dysbiosis, alterations in microbial metabolites and increased intestinal barrier permeability. Imbalances in gut microbiota, or dysbiosis, contributes to hepatocellular carcinoma by producing carcinogenic substances, disrupting the balance of the immune system, altering metabolic processes, and increasing intestinal barrier permeability. Concurrently, accumulating evidence suggests that gut microbiota has the ability to modulate antitumor immune responses and affect the efficacy of cancer immunotherapies. As a new and effective strategy, immunotherapy offers significant potential for managing advanced stages of hepatocellular carcinoma, with immune checkpoint inhibitors achieving significant advancements in improving patients' survival. Probiotics play a vital role in promoting health and preventing diseases by modulating metabolic processes, inflammation and immune responses. Research indicates that they are instrumental in boosting antitumor immune responses through the modulation of gut microbiota. This review is to explore the relationship between gut microbiota and the emergence of hepatocellular carcinoma, assess the contributions of probiotics to immunotherapy and outline the latest research findings, providing a safer and more cost-effective potential strategy for the prevention and management of hepatocellular carcinoma.
肝细胞癌是消化系统常见的恶性肿瘤，通常会经历肝炎、肝纤维化、肝硬化，最终发展为肿瘤。肠道微生物群、门静脉系统和胆道之间的相互作用，即肠-肝轴，对于理解肝细胞癌进展的机制至关重要。涉及的机制包括肠道菌群失调、微生物代谢产物的改变以及肠道屏障通透性增加。肠道微生物群的失衡，即菌群失调，通过产生致癌物质、破坏免疫系统平衡、改变代谢过程以及增加肠道屏障通透性，促进肝细胞癌的发生。同时，越来越多的证据表明，肠道微生物群有能力调节抗肿瘤免疫反应并影响癌症免疫治疗的疗效。作为一种新的有效策略，免疫疗法在治疗晚期肝细胞癌方面具有巨大潜力，免疫检查点抑制剂在提高患者生存率方面取得了重大进展。益生菌通过调节代谢过程、炎症和免疫反应，在促进健康和预防疾病方面发挥着至关重要的作用。研究表明，它们通过调节肠道微生物群，有助于增强抗肿瘤免疫反应。这篇综述旨在探讨肠道微生物群与肝细胞癌发生之间的关系，评估益生菌对免疫治疗的贡献，并概述最新研究结果，为肝细胞癌的预防和管理提供一种更安全、更具成本效益的潜在策略。
