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本文引用的文献

1
Gut microbiome profiles to exclude the diagnosis of hepatic encephalopathy in patients with cirrhosis.肠道微生物组谱排除肝硬化患者肝性脑病的诊断。
Gut Microbes. 2024 Jan-Dec;16(1):2392880. doi: 10.1080/19490976.2024.2392880. Epub 2024 Aug 27.
2
Substitution of One Meat-Based Meal With Vegetarian and Vegan Alternatives Generates Lower Ammonia and Alters Metabolites in Cirrhosis: A Randomized Clinical Trial.用素食和纯素替代物替代一顿肉食可降低肝硬化患者的氨水平并改变其代谢物:一项随机临床试验。
Clin Transl Gastroenterol. 2024 Jun 1;15(6):e1. doi: 10.14309/ctg.0000000000000707.
3
High-dose proton pump inhibitor treatment is associated with a higher mortality in cirrhotic patients: A multicentre study.大剂量质子泵抑制剂治疗与肝硬化患者死亡率升高相关:一项多中心研究。
Aliment Pharmacol Ther. 2024 Apr;59(8):973-983. doi: 10.1111/apt.17909. Epub 2024 Feb 22.
4
The RIVET RCT: Rifamycin SV MMX improves muscle mass, physical function, and ammonia in cirrhosis and minimal encephalopathy.RIVET随机对照试验:利福霉素SV MMX可改善肝硬化合并轻微肝性脑病患者的肌肉量、身体功能及血氨水平。
Hepatol Commun. 2024 Feb 3;8(2). doi: 10.1097/HC9.0000000000000384. eCollection 2024 Feb 1.
5
The Multi-dimensional Challenge of Poor Oral Health in Cirrhosis-Disparities and Solutions.肝硬化患者口腔健康状况不佳的多维度挑战——差异与解决方案
Gastroenterology. 2024 May;166(5):717-722. doi: 10.1053/j.gastro.2024.01.010. Epub 2024 Jan 13.
6
The contributions of bacteria metabolites to the development of hepatic encephalopathy.细菌代谢产物对肝性脑病发展的作用。
Liver Res. 2023 Dec;7(4):296-303. doi: 10.1016/j.livres.2022.11.005. Epub 2022 Nov 15.
7
Post-Transjugular Intrahepatic Portosystemic Shunt (TIPS) Hepatic Encephalopathy-A Review of the Past Decade's Literature Focusing on Incidence, Risk Factors, and Prophylaxis.经颈静脉肝内门体分流术(TIPS)相关性肝性脑病——基于发病率、危险因素及预防的过去十年文献综述
J Clin Med. 2023 Dec 19;13(1):14. doi: 10.3390/jcm13010014.
8
The Current and Future State of Microbiome Therapeutics in Liver Disease.肝病中微生物组疗法的现状与未来
Am J Gastroenterol. 2024 Jan 1;119(1S):S36-S41. doi: 10.14309/ajg.0000000000002581.
9
Frailty in end-stage liver disease: Understanding pathophysiology, tools for assessment, and strategies for management.终末期肝病中的衰弱:了解病理生理学、评估工具和管理策略。
World J Gastroenterol. 2023 Dec 14;29(46):6028-6048. doi: 10.3748/wjg.v29.i46.6028.
10
Proton Pump Inhibitors Increases Longitudinal Risk of Mortality, Decompensation, and Infection in Cirrhosis: A Meta-Analysis.质子泵抑制剂增加肝硬化患者死亡、失代偿和感染的长期风险:一项荟萃分析。
Dig Dis Sci. 2024 Jan;69(1):289-297. doi: 10.1007/s10620-023-08150-6. Epub 2023 Nov 15.

治疗和预防肝性脑病的微生物学方法

Microbial Approaches to Treat and Prevent Hepatic Encephalopathy.

作者信息

Munk Lauridsen Mette, Jonasson Elise, Bajaj Jasmohan S

机构信息

Department for Regional Health Research, University Hospital of Southern Denmark, Finsensgade 35 6700, Esbjerg, Denmark.

Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA.

出版信息

Gastroenterol Clin North Am. 2025 Jun;54(2):429-451. doi: 10.1016/j.gtc.2024.12.006. Epub 2025 Jan 23.

DOI:10.1016/j.gtc.2024.12.006
PMID:40348497
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12066833/
Abstract

This review articulates the significance of the gut-liver-brain axis in understanding hepatic encephalopathy (HE), emphasizing the role of gut microbiota in influencing liver and brain health. Key treatments like lactulose, rifaximin, probiotics, and fecal microbiota transplantation are examined for their ability to modulate the gut microbiome, thereby mitigating HE symptoms through reduced neurotoxin production and enhanced gut barrier integrity. The synopsis highlights both established and emerging microbial therapies, presenting them as crucial to the management and future strategies of HE. This comprehensive overview explores current therapeutic approaches alongside promising future interventions, suggesting that personalized microbiome-focused treatments may revolutionize HE management.

摘要

本综述阐明了肠-肝-脑轴在理解肝性脑病(HE)中的重要性,强调了肠道微生物群在影响肝脏和大脑健康方面的作用。研究了乳果糖、利福昔明、益生菌和粪便微生物群移植等关键治疗方法调节肠道微生物组的能力,从而通过减少神经毒素产生和增强肠道屏障完整性来减轻HE症状。本综述突出了既定的和新兴的微生物疗法,将它们视为HE管理和未来策略的关键。这一全面概述探讨了当前的治疗方法以及未来有前景的干预措施,表明以微生物组为重点的个性化治疗可能会彻底改变HE的管理方式。