Nandi Nicoletta, Verdu Elena F, Schuppan Detlef, Gomez-Aldana Andres Jose, Pinto-Sanchez Maria Ines, Conforti Francesco Simone, Maggioni Marco, Caprioli Flavio, Elli Luca
Gastroenterology and Endoscopy Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.
Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milano, Italy.
Liver Int. 2025 Aug;45(8):e70206. doi: 10.1111/liv.70206.
Disorders of the hepatobiliary system are commonly associated with gastrointestinal (GI) diseases. The GI and hepatobiliary systems interact through the portal vein system and enterohepatic circulation, creating a gut-liver axis that allows for a complex multidirectional interplay between immune, hormonal, dietary and environmental luminal factors that include the gut microbiota. This interaction may underlie the liver affection in autoimmune and immune-mediated small bowel diseases through a variety of pathways that include autoimmune, metabolic, immune-mediated, and/or iatrogenic mechanisms. Despite evidence of a gut-liver axis and co-morbid liver associations with small bowel diseases, the clinical implications and how these conditions should be clinically managed remain unclear. In this narrative review, we describe the hepato-biliary manifestations associated with chronic immune-mediated enteropathies of the small bowel in adults, with particular focus on CeD and Crohn's disease.
肝胆系统疾病通常与胃肠道（GI）疾病相关。胃肠道和肝胆系统通过门静脉系统和肠肝循环相互作用，形成了一个肠-肝轴，使得免疫、激素、饮食和环境腔道因素（包括肠道微生物群）之间能够进行复杂的多向相互作用。这种相互作用可能通过多种途径，包括自身免疫、代谢、免疫介导和/或医源性机制，成为自身免疫性和免疫介导的小肠疾病中肝脏受累的基础。尽管有证据表明存在肠-肝轴以及肝脏与小肠疾病的共病关联，但临床意义以及这些疾病应如何进行临床管理仍不明确。在这篇叙述性综述中，我们描述了与成人慢性免疫介导的小肠病相关的肝胆表现，特别关注乳糜泻（CeD）和克罗恩病。
