Small metabolites, possible big changes: a microbiota-centered view of non-alcoholic fatty liver disease
Small metabolites, possible big changes: a microbiota-centered view of non-alcoholic fatty liver disease
复制标题
小代谢物，可能发生大变化：以微生物群为中心的非酒精性脂肪肝疾病观点
DOI：
10.1136/gutjnl-2018-316307
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发表时间：
2019-02-01
期刊：
影响因子：
24.5
通讯作者：
Schnabl, Bernd
中科院分区：
文献类型：
--
作者：
Chu, Huikuan;Duan, Yi;Schnabl, Bernd
非酒精性脂肪性肝病（NAFLD）的范围从通常与肥胖相关的单纯性肝脂肪变性到可进展为纤维化、肝硬化和肝细胞癌的非酒精性脂肪性肝炎。NAFLD病理生理学涉及环境、遗传和代谢因素，以及肠道微生物群及其产物的变化。肠屏障功能障碍可导致NAFLD的发展和进展。虽然在评估人体肠道通透性方面存在技术限制，并且这些研究中的患者数量相当少，但只有不到一半的患者肠道通透性增加，细菌产物移位。微生物源性代谢产物及其影响的信号通路可能在NAFLD的发展中发挥更重要的作用。本文综述了导致NAFLD发生的微生物代谢产物，如三甲胺、胆汁酸、短链脂肪酸和乙醇。我们讨论了微生物产生的代谢物可能影响疾病进展和/或作为NAFLD的治疗靶点或生物标志物的机制。
The spectrum of non-alcoholic fatty liver disease (NAFLD) ranges from simple hepatic steatosis, commonly associated with obesity, to non-alcoholic steatohepatitis, which can progress to fibrosis, cirrhosis and hepatocellular carcinoma. NAFLD pathophysiology involves environmental, genetic and metabolic factors, as well as changes in the intestinal microbiota and their products. Dysfunction of the intestinal barrier can contribute to NAFLD development and progression. Although there are technical limitations in assessing intestinal permeability in humans and the number of patients in these studies is rather small, fewer than half of the patients have increased intestinal permeability and translocation of bacterial products. Microbe-derived metabolites and the signalling pathways they affect might play more important roles in development of NAFLD. We review the microbial metabolites that contribute to the development of NAFLD, such as trimethylamine, bile acids, short-chain fatty acids and ethanol. We discuss the mechanisms by which metabolites produced by microbes might affect disease progression and/or serve as therapeutic targets or biomarkers for NAFLD.