Microbiota, a key player in alcoholic liver disease.

Microbiota, a key player in alcoholic liver disease.
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DOI:
10.3350/cmh.2017.0067
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发表时间:
2018-06
影响因子:
8.9
通讯作者:
Ciocan D
Ciocan D
中科院分区:
医学2区
文献类型:
--
作者:
Cassard AM;Ciocan D

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酒精性肝病(ALD)是世界范围内发病率和死亡率的主要原因。只有20%的重度酒精消费者发展为酒精性肝硬化。肠道微生物群(IM)最近已被确定为ALD肝损伤严重程度的关键因素。ALD的共同特征包括肠上皮紧密连接蛋白表达、粘蛋白产生和抗菌肽水平的降低。肠道屏障的破坏是ALD的先决条件,导致细菌产物进入血流(内毒素血症)。此外,由细菌产生的代谢物,例如短链脂肪酸、挥发性有机化合物(VOS)和胆汁酸(BA),参与ALD病理学。益生菌治疗、IM移植或食用膳食纤维(如果胶)(它们都改变细菌种类的比例)已被证明可改善ALD动物模型中的肝损伤,并与肠道屏障功能的改善相关。尽管ALD中微生物群和宿主之间的联系已经建立,但其潜在机制仍然是一个活跃的研究领域。通过使用益生元、益生菌和益生菌后模式来靶向微生物组可能是一种有吸引力的新方法来管理ALD。
Alcoholic liver disease (ALD) is a major cause of morbidity and mortality worldwide. Only 20% of heavy alcohol consumers develop alcoholic liver cirrhosis. The intestinal microbiota (IM) has been recently identified as a key player in the severity of liver injury in ALD. Common features of ALD include a decrease of gut epithelial tight junction protein expression, mucin production, and antimicrobial peptide levels. This disruption of the gut barrier, which is a prerequisite for ALD, leads to the passage of bacterial products into the blood stream (endotoxemia). Moreover, metabolites produced by bacteria, such as short chain fatty acids, volatile organic compounds (VOS), and bile acids (BA), are involved in ALD pathology. Probiotic treatment, IM transplantation, or the consumption of dietary fiber, such as pectin, which all alter the ratio of bacterial species, have been shown to improve liver injury in animal models of ALD and to be associated with an improvement in gut barrier function. Although the connections between the microbiota and the host in ALD are well established, the underlying mechanisms are still an active area of research. Targeting the microbiome through the use of prebiotic, probiotic, and postbiotic modalities could be an attractive new approach to manage ALD.
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