Munk Lauridsen Mette, Jonasson Elise, Bajaj Jasmohan S
Department for Regional Health Research, University Hospital of Southern Denmark, Finsensgade 35 6700, Esbjerg, Denmark.
Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
Gastroenterol Clin North Am. 2025 Jun;54(2):429-451. doi: 10.1016/j.gtc.2024.12.006. Epub 2025 Jan 23.
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.
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。