Role of intestinal mucosal barrier in the development and progression of nonalcoholic fatty liver disease
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摘要: 非酒精性脂肪性肝病(NAFLD)在我国的发病率逐年上升。肠道黏膜是人体内最大的细菌储存器官,肠道黏膜屏障包括生物屏障、机械屏障、免疫屏障和化学屏障。探讨了肠道黏膜屏障功能在NAFLD发病机制中的重要作用。肠道生物屏障方面,肠道菌群的异常早于肥胖等代谢异常的发生;小肠细菌过度生长可以影响能量代谢、促进胰岛素抵抗等,可能参与了NAFLD的发病过程;调节肠道菌群对于治疗NAFLD具有一定疗效。肠道机械屏障功能受损,黏膜通透性增加,与肠道菌群失调有关;肠道免疫屏障的变化可能与肥胖、代谢紊乱以及肝脏炎症状态相关;肠道化学屏障的改变可抑制肝细胞极低密度脂蛋白及低密度脂蛋白的合成和分泌,可能会导致肝脏TG沉积。指出了肠道黏膜屏障功能的研究为NAFLD的预防和治疗提供了广阔的前景。Abstract: The incidence of non- alcoholic fatty liver disease( NAFLD) has been increasing year by year in China. Intestinal mucosa is the largest organ for bacterial storage,and intestinal mucosal barrier includes biological barrier,mechanical barrier,immunological barrier,and chemical barrier. This article investigates the important role of intestinal mucosal barrier function in the pathogenesis of NAFLD. As for the intestinal biological barrier,abnormalities in gut microbiota occur earlier than obesity and other metabolic disorders; small intestinal bacterial overgrowth may affect energy metabolism,promote insulin resistance,and get involved in the pathogenesis of NAFLD; regulation of gut microbiota has a certain clinical effect in the treatment of NAFLD. Intestinal mechanical barrier impairment increases the mucosal permeability and is associated with intestinal dysbacteriosis. The changes in intestinal immunological barrier may be associated with obesity,metabolic disorders,and liver inflammation. The changes in intestinal chemical barrier can inhibit the synthesis and secretion of very low- density lipoprotein and low- density lipoprotein in hepatocytes and may result in triglyceride deposition in the liver. It is pointed out that the research on intestinal mucosal barrier function provides promising prospects for the prevention and treatment of NAFLD.
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Key words:
- fatty liver /
- interobacteriaceae /
- review
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