肠道菌群在肝硬化及肝细胞癌中的重要作用

Title：
The gut microbiota: A new potential driving force in liver cirrhosis and hepatocellular carcinoma

DOI：
10.1177/2050640617705576

Abstract：
The gut microbiota has recently been recognized as a major environmental factor in the pathophysiology of many human diseases. The anatomical and function connection existing between gut and liver provides the theoretical basis to assume the liver is a major target for gut microbes. In the last decades, numerous studies reported an altered composition of gut microbiota in patients with liver cirrhosis and a progressively marked dysbiosis with worsening of the liver disease. The risk of developing hepatocellular carcinoma, the deadliest complication of liver cirrhosis, is widely variable among cirrhotic patients, thus suggesting a complexity of genetic and environmental factors implicated in hepatocarcinogenesis. Gut microbiota is now emerging as a plausible candidate to explain this variability. In this manuscript we review the human and the experimental evidence supporting the potential implication of gut microbiota in the promotion, progression and complication of liver disease.

All Authors：
Marco Sanduzzi Zamparelli, Alba Rocco, Debora Compare, Gerardo Nardone

First Authors：
Marco Sanduzzi Zamparelli

Correspondence：
Gerardo Nardone

内容要点：

1、肝硬化患者的肠道菌群发生改变，且肠道菌群的失调与肝脏疾病的加重相关；

2、肝硬化患者的肝细胞癌发病风险存在较大差异，肠道菌群可能是造成这种差异的因素；

3、本综述介绍了在人体及动物模型中，支持肠道菌群在肝脏疾病中发挥重要作用的实验证据；

4、在肝脏中，TLR及NLR等受体识别细菌产物而引起炎症，细菌产物的低水平暴露导致肝脏细胞难以通过TLR活化，称为“内毒素耐受性”；

5、肠道屏障的完整性对于肝-肠轴的连接十分关键。