Gadour Eyad, Shrwani Khalid Jebril, Hassan Zeinab, Miutescu Bogdan
Multiorgan Transplant Centre of Excellence, Liver Transplantation Department, King Fahad Specialist Hospital, Dammam, Saudi Arabia.
Internal Medicine Department, School of Medicine, Zamzam University College, Khartoum, Sudan.
Front Immunol. 2025 May 16;16:1556576. doi: 10.3389/fimmu.2025.1556576. eCollection 2025.
The gut microbiota plays a crucial role in regulating immune responses and maintaining a balance within the gut-liver axis. In patients with chronic liver disease (CLD), alterations in gut microbiota have been linked to disease progression and impaired immune function. This study aimed to evaluate the impact of gut-modulating therapies on the immune responses of patients with CLD.
Two independent authors conducted a comprehensive literature search using complementary strategies to identify relevant articles published until March 2025. Review Manager Software (RevMan 5.4) was used for data analysis, and the results were presented using forest plots.
Of the 373 identified studies, 16 were included in the analysis. The findings revealed that gut microbiota-modulating therapies significantly reduced tumor necrosis factor-α (TNF-α) levels compared to control interventions (standardized mean difference [SMD], -0.60; 95% confidence interval [CI] [-0.93, -0.23] p = 0.001), with similar results observed at the 6-month follow-up (SMD -1.3; 95% CI [-2.1, -0.4] p = 0.004). Interleukin-6 (IL-6) levels showed no significant change between the groups (SMD, -0.67; 95% CI [-1.5, 0.12) p = 0.09). C-reactive protein (CRP) levels were significantly reduced by gut-modulating therapies (SMD -1.057; 95% CI [-1.493, -0.621] p = 0.0005), with consistent results at 1- and 6-month follow-up. Changes in interferon-gamma (IFN-γ) and IL-18 levels and cellular immunity were also assessed.
This study highlights the importance of gut microbiota in modulating immune responses in patients with CLD and demonstrates the effectiveness of long-term gut-modulating therapies in reducing inflammatory markers. While CRP and TNF-α levels decreased, changes in IL-6 levels were inconsistent, warranting further research to elucidate the impact of gut microbiota-modulating therapies on this biomarker.
肠道微生物群在调节免疫反应和维持肠-肝轴内的平衡方面起着关键作用。在慢性肝病（CLD）患者中，肠道微生物群的改变与疾病进展和免疫功能受损有关。本研究旨在评估肠道调节疗法对CLD患者免疫反应的影响。
两位独立作者采用互补策略进行了全面的文献检索，以识别截至2025年3月发表的相关文章。使用Review Manager软件（RevMan 5.4）进行数据分析，并使用森林图呈现结果。
在373项已识别的研究中，16项被纳入分析。研究结果显示，与对照干预措施相比，肠道微生物群调节疗法显著降低了肿瘤坏死因子-α（TNF-α）水平（标准化均值差[SMD]，-0.60；95%置信区间[CI][-0.93，-0.23]，p = 0.001），在6个月随访时观察到类似结果（SMD -1.3；95% CI [-2.1，-0.4]，p = 0.004）。两组间白细胞介素-6（IL-6）水平无显著变化（SMD，-0.67；95% CI [-1.5，0.12]，p = 0.09）。肠道调节疗法显著降低了C反应蛋白（CRP）水平（SMD -1.057；95% CI [-1.493，-0.621]，p = 0.0005），在1个月和6个月随访时结果一致。还评估了干扰素-γ（IFN-γ）和IL-18水平及细胞免疫的变化。
本研究强调了肠道微生物群在调节CLD患者免疫反应中的重要性，并证明了长期肠道调节疗法在降低炎症标志物方面的有效性。虽然CRP和TNF-α水平下降，但IL-6水平的变化不一致，需要进一步研究以阐明肠道微生物群调节疗法对该生物标志物的影响。
