摘要
肝纤维化是慢性肝病的重要病理过程,在世界范围内有较高的发病率。近年来发现肠道菌群与肝纤维化联系密切,有研究显示,在肝纤维化进程中,大肠杆菌、乳酸菌等的丰度发生明显改变,普氏粪杆菌的抗炎和保护肠道屏障功能作用及乳酸杆菌抑制有害细菌生成和保护肠道屏障功能作用对肝纤维化的发展起到抑制作用,雷氏普鲁威登斯菌和大肠杆菌分别通过产生三甲胺和酒精等促进肝纤维化的发展;另外,根据脂多糖与Toll样受体4(TLR4)结合引发炎症反应,促进肝纤维化发展,以及细菌DNA与TLR9结合诱导肝星状细胞活化,加快肝纤维化进程的机制。本文从丰度和多样性以及炎症反应等方面阐述了肠道菌群促进或延缓肝纤维化的作用。同时,基于以上机制,提出了肠道菌群作为肝纤维化潜在标志物的作用及使用抗生素、益生菌等影响肠道菌群丰度变化而治疗肝纤维化的方法,以期为临床治疗肝纤维化提供新的方向。
Liver fibrosis is an important pathological process in chronic liver diseases and is prevalent worldwide. In recent years, intestinal floras have been found to be closely linked to liver fibrosis,and significant changes in the abundance of Escherichia coli or lactic acid bacteria in the process of liver fibrosis. It has also been found that the anti-inflammatory and intestinal barrier-protecting effects of E. faecalis and the inhibitory effects of Lactobacillus on the production of harmful bacteria and the protection of intestinal barrier function can both inhibit the development of liver fibrosis. Prevotella and Escherichia coli promote the progression of liver fibrosis by producing trimethylamine and alcohol, respectively.This paper illustrates the signaling pathways by which lipopolysaccharide binds to Toll-like receptor 4(TLR4) to trigger inflammatory responses and bacterial DNA binds to TLR9 to promote liver fibrosis.The mechanism by which hepatic stellate cells(HSCs) are activated by the binding of HSCs accelerate the process of liver fibrosis is discussed. This paper outlines the role of gut microbiota in promoting or delaying liver fibrosis in terms of abundance and diversity as well as inflammatory response. Besides,based on the above mechanisms, the role of intestinal flora as a potential marker of liver fibrosis and ways to use antibiotics and probiotics to influence the changes in the abundance of intestinal flora to treat liver fibrosis are explored in this paper for the purpose of contributing to the treatment of liver fibrosis in the clinical setting.
作者
郑博文
王佳慧
罗淑娟
赵铁建
郭新华
郑洋
ZHENG Bo-wen;WANG Jia-hui;LUO Shu-juan;ZHAO Tie-jian;GUO Xin-hua;ZHENG Yang(Department of Physiology,College of Basic Medicine,Faculty of Chinese Medicine Science Guangxi University of Chinese Medicine,Nanning 530222,China;Department of Medicine,Faculty of Chinese Medicine Science Guangxi University of Chinese Medicine,Nanning 530222,China)
出处
《中国药理学与毒理学杂志》
CAS
北大核心
2022年第3期217-224,共8页
Chinese Journal of Pharmacology and Toxicology
基金
广西壮族自治区自然科学基金(2020GXNSFBA297094)。
关键词
肠道菌群
肝纤维化
肠-肝轴
gut microbiota
liver fibrosis
gut-liver axis
