Tarantino Giovanni, Cataldi Mauro, Citro Vincenzo
Department of Clinical Medicine and Surgery, "Federico II" University Medical School of Naples, Naples, Italy.
Section of Pharmacology, Department of Neuroscience, Reproductive Sciences and Dentistry, Federico II University of Naples, Naples, Italy.
Front Microbiol. 2024 Dec 2;15:1319897. doi: 10.3389/fmicb.2024.1319897. eCollection 2024.
Among illicit drugs, addiction from opioids and synthetic opioids is soaring in an unparalleled manner with its unacceptable amount of deaths. Apart from these extreme consequences, the liver toxicity is another important aspect that should be highlighted. Accordingly, the chronic use of these substances, of which fentanyl is the most frequently consumed, represents an additional risk of liver damage in patients with underlying chronic liver disease. These observations are drawn from various preclinical and clinical studies present in literature. Several downstream molecular events have been proposed, but recent pieces of research strengthen the hypothesis that dysbiosis of the gut microbiota is a solid mechanism inducing and worsening liver damage by both alcohol and illicit drugs. In this scenario, the gut flora modification ascribed to non-alcoholic fatty liver disease performs an additive role. Interestingly enough, HBV and HCV infections impact gut-liver axis. In the end, the authors tried to solicit the attention of operators on this major healthcare problem.
在非法药物中，阿片类药物和合成阿片类药物成瘾现象正以前所未有的速度飙升，导致了令人无法接受的死亡人数。除了这些极端后果外，肝脏毒性是另一个需要强调的重要方面。因此，长期使用这些物质（其中芬太尼是最常被使用的）会给潜在慢性肝病患者带来额外的肝损伤风险。这些观察结果来自文献中各种临床前和临床研究。虽然已经提出了几种下游分子事件，但最近的研究进一步支持了这样一种假设，即肠道微生物群失调是酒精和非法药物诱导和加重肝损伤的一个可靠机制。在这种情况下，非酒精性脂肪性肝病引起的肠道菌群改变起到了累加作用。有趣的是，乙肝病毒和丙肝病毒感染会影响肠肝轴。最后，作者试图引起从业者对这一重大医疗问题的关注。
