Altered Microbiome in Patients With Cirrhosis and Complications.
Altered Microbiome in Patients With Cirrhosis and Complications.
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DOI：
10.1016/j.cgh.2018.08.008
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发表时间：
2019-01
期刊：
影响因子：
--
通讯作者：
Bajaj JS
中科院分区：
文献类型：
--
作者：
Acharya C;Bajaj JS
肝硬化中的微生物组受到肠道和全身水平发生的多个过程的影响。这种生态失调或不利的微生物群分布存在于几个身体部位，并与更高的全身性炎症，细菌感染和不良结局相关。肝硬化发病率的增加源于免疫瘫痪状态，部分原因与这种生态失调对免疫系统的持续刺激有关。生态失调作为一种动态事件，伴随着代偿失调，如肝性脑病、感染或慢加急性肝功能衰竭（ACLF）。这些微生物学模式可作为门诊和住院患者肝硬化的诊断和预后指标。目前肝硬化的治疗方法对肠道微生物组成和功能有不同的影响。饮食调整和口腔已经成为调节微生物组的新的靶向因素，这可能会影响炎症，并可能改善结果。此外，越来越多地研究粪便微生物移植以提供微生物组的组成和功能调节。最终，可能需要靶向治疗的组合来提供最佳的肠道环境，以改善肝硬化的结局。
The microbiome in cirrhosis is affected by multiple processes occurring at the level of the gut and systemically. This dysbiosis, or unfavorable microbiota profile, is present at several body sites and is associated with higher systemic inflammation, bacterial infections and poor outcomes. This increased morbidity in cirrhosis stems from an immune paralysis state that is partly related to the constant stimulation of the immune system by this dysbiosis. Dysbiosis as a dynamic event worsens with decompensation such as with hepatic encephalopathy, infections or acute-on-chronic liver failure (ACLF). These microbial patterns could be applied as diagnostic and prognostic measures in cirrhosis in the outpatient and inpatient setting. Current therapies for cirrhosis have differing impacts on gut microbial composition and functionality. Dietary modifications and the oral cavity have emerged as newer targetable factors to modulate the microbiome, which could affect inflammation and, potentially improve outcomes. Additionally, fecal microbial transplant is being increasingly studied to provide compositional and functional modulation of the microbiome. Ultimately, a combination of targeted therapies may be needed to provide an optimal gut milieu to improve outcomes in cirrhosis.
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影响因子：
3.7
作者：
Bajaj JS;Heuman DM;Sanyal AJ;Hylemon PB;Sterling RK;Stravitz RT;Fuchs M;Ridlon JM;Daita K;Monteith P;Noble NA;White MB;Fisher A;Sikaroodi M;Rangwala H;Gillevet PM
通讯作者：
Gillevet PM
影响因子：
8
作者：
Bajaj, Jasmohan S.;Thacker, Leroy R.;Gillevet, Patrick M.
通讯作者：
Gillevet, Patrick M.
影响因子：
4.2
作者：
Aberg, Fredrik;Helenius-Hietala, Jaana;Isoniemi, Helena
通讯作者：
Isoniemi, Helena
影响因子：
13.5
作者：
Bajaj, Jasmohan S.;Kakiyama, Genta;Gillevet, Patrick M.
通讯作者：
Gillevet, Patrick M.
DOI：
10.1152/ajpgi.00268.2014
发表时间：
2014-11-15
影响因子：
4.5
作者：
Bajaj, Jasmohan S.;Cox, I. Jane;Gillevet, Patrick M.
通讯作者：
Gillevet, Patrick M.