Role of intestinal dysbacteriosis in the pathogenesis of acute-on-chronic hepatitis B liver failure
-
摘要: 慢加急性肝衰竭是在慢性肝病的基础上急性发作,引发肝功能严重受损,使得肝脏合成、解毒、代谢以及生物转化等功能障碍的临床综合征。其中,肠道菌群失调是加速肝衰竭的重要因素。因此,通过改善肠道菌群失调以促进肝功能好转,对于防止或延缓肝衰竭进展具有重要作用。Abstract: Acute-on-chronic liver failure is a clinical syndrome with acute exacerbation on the basis of chronic liver disease and cancause severe liver injury and dysfunctions of liver synthesis, detoxification, metabolism, and biotransformation. Intestinal dysbacteriosis is animportant factor for the acceleration of liver failure. Therefore, it is important to prevent or delay the progression of liver failure by improvingintestinal dysbacteriosis and liver function.
-
Key words:
- hepatitis B, chronic /
- liver failure /
- enterobacteriaceae /
- review
-
[1] XIAO L, YANG L. Gut microbiota and nonalcoholic fatty liverdisease[J]. J Clin Hepatol, 2017, 33 (4) :774-779. (inChinese) 肖丽, 杨玲.肠道菌群与非酒精性脂肪性肝病的关系[J].临床肝胆病杂志, 2017, 33 (4) :774-779. [2] FOWLER JC, ZECCHINI VR, JONES PH. Intestinal activationof notch signaling induces rapid onset hepatic steatosis and in-sulin resistance[J]. PLo S One, 2011, 6 (6) :e20767. [3] SHENG GG. Change in intestinal microecology in patients withliver failure and related intervention measures[J]. Chin J Inte-gr Tradit West Med Liver Dis, 2016, 26 (5) :257-259. (inChinese) 盛国光.肝衰竭患者肠道微生态变化及其干预措施[J].中西医结合肝病杂志, 2016, 26 (5) :257-259. [4] CHASSAING B, ETIENNE MESMIN L, GEWIRTZ AT. Microbio-ta liver axisin hepatic disease[J]. Hepatology, 2014, 59 (1) :328-339. [5] LOZUPONE CA, STOMBAUGH JI, GORDON JI, et al. Divem-ity, stability and resilience of the human gut micmbiota[J].Nature, 2012, 489 (7415) :220-230. [6] YANG J, NIE QH. Liver failure and intestinal barrier dysfunction[J]. J Pract Hepatol, 2010, 13 (1) :66-69. (in Chinese) 杨洁, 聂青和.肝衰竭与肠道屏障功能障碍[J].实用肝脏病杂志, 2010, 13 (1) :66-69. [7] ZOCCO MA, AINORA ME, GASBARRINI G, et al. Bacteroidesthetaiotaomicron in the gut:Molecular aspects of their interaction[J]. Dig liver Dis, 2007, 39 (8) :707-712. [8] ZHANG Y, ZHANG J, XU T, et al. Allicin ameliorates intraint-estinal bacterial translocation after trauma/hemorrhagic shockin rats:The role of mesenteric lymph node dendritic cell[J].Surgery, 2017, 161 (2) :546-555. [9] JU BL, LI X, GUI JQ, et al. Experimental study about the in-testinal barrier dysfunction in the acute liver failure mice[J]. JTrop Med, 2011, 10:9. [10] GE JH, ZENG XQ, LIAN YB. The influence of probiotic to theintestinal flora in patients with chronic liver failure[J]. Chin JMicroecol, 2013, 25 (12) :1415-1418. (in Chinese) 葛金华, 曾祥铨, 连豫苞.微生态制剂对慢性肝衰竭患者肠道菌群的影响[J].中国微生态学杂志, 2013, 25 (12) :1415-1418. [11] LI LJ. Hepatic failure complicated with infection and intestinalbacterial translocation[J]. Chin J Microecol, 2001, 13 (2) :63-65. (in Chinese) 李兰娟.肝功能衰竭并发感染与肠道细菌易位[J].中国微生态学杂志, 2001, 13 (2) :63-65. [12] LIU CG, MAO DW. Intestinal dysbacteriosis and liver cirrhosis[J]. Mod J Integr Tradit Chin West Med, 2014, 23 (26) :2959-2961. (in Chinese) 刘春光, 毛德文.肠道菌群失调与肝硬化[J].现代中西医结合杂志, 2014, 23 (26) :2959-2961. [13] LI YT, WANG L, CHEN Y, et al. Effects of gut microflora onhepatic damage after acute liver injury in rats[J]. J Trauma, 2010, 68 (1) :76-83. [14] ALAM A, SUEN KC, MA D. Acute-on-chronic liver failure:Recent update[J]. J Biomed Res, 2017, 31 (3) :1-18. [15] WANG B, LI L. Who determines the outcomes of HBV expo-sure?[J]. Trends Microbiol, 2015, 23 (6) :328-329. [16] LI LJ, WU ZW, MA WH, et al. The changes of intestinal floraof patients with chronic severe hepatitis[J]. Chin J Infect Dis, 2001, 19 (6) :345-347. (in Chinese) 李兰娟, 吴仲文, 马伟杭, 等.慢性重型肝炎患者肠道菌群的变化[J].中华传染病杂志, 2001, 19 (6) :345-347. [17] WU XF, LIAN NQ, LU CF, et al. Research progress on effectof intestinal flora on chronic liver diseases[J]. Chin PharmacolBull, 2013, 29 (12) :1644-1647. (in Chinese) 吴夏飞, 连娜琦, 陆春风, 等.肠道菌群对慢性肝脏疾病影响的研究进展[J].中国药理学通报, 2013, 29 (12) :1644-1647. [18] ZHANG HL, YU LX, YANG W, et al. Profound impact of guthomeostasis on chemically-induced pro-tumorigenic inf Iam-mation and hepatocarcinogenesis in rats[J]. J Hepatol, 2012, 57 (4) :803-812. [19] WANG QC, BU ZH, LI QS. The current role of gut-liver axisin liver diseases[J]. Chin J Gastroenterol Hepatol, 2015, 24 (9) :1155-1158. (in Chinese) 王全楚, 步子恒, 李青上.肠肝轴的现代概念及其在肝脏疾病中的作用[J].胃肠病学和肝病学杂志, 2015, 24 (9) :1155-1158. [20] HAKANSSON A, MOLIN G. Gut microbiota and inflammation[J]. Nutrients, 2011, 3 (6) :637-682. [21] ALDABA-MURUATO LR, MORENO MG, SHIBAYAMA M, etal. Protective effects of allopurinol against acute liver damageand cirrhosis induced by carbon tetrachloride:Modulation ofNF-κB, cytokine production and oxidative stress[J]. Bio-chim Biophys Acta, 2012, 1820 (2) :65-75. [22] HUANG R, NI JJ, GAO Y. The association between the intes-tinal microbiota-lipopolysaccharide-Toll-like receptor 4 ax-is and hepatocellular carcinoma[J]. J Clin Hepatol, 2018, 34 (6) :1325-1328. (in Chinese) 黄蓉, 倪加加, 高毅.肠道菌群-脂多糖-Tol样受体4轴与肝细胞癌的关系[J].临床肝胆病杂志, 2018, 34 (6) :1325-1328. [23] SCHUBERT K, OLDE DAMINK SWM, von BERGEN M, et al.Interactions between bile salts, gut microbiota, and hepatic in-nate immunity[J]. Immunol Rev, 2017, 279 (1) :23-35. [24] CAO ZJ, XIE Q. Recent advances in the study of chronic a-cute liver failure:Definition, pathogenesis and clinical man-agement[J]. Chin Hepatol, 2017, 22 (7) :569-573. (inChinese) 曹竹君, 谢青.慢加急性肝衰竭研究最新进展———定义、发病机制及临床管理[J].肝脏, 2017, 22 (7) :569-573. [25] ARROYO V, MOREAU R, KAMATH PS, et al. Acute-on-chronic liver failure in cirrhosis[J]. Nat Rev Dis Primers, 2016, 2:16041. [26] HUANG WX, WANG HP, WANG YL, et al. High-throughputsequencing reveals the change of gut microbiota in infants withpneumonia following antibiotic treatment[J]. Chin J Micro-ecol, 2016, 28 (5) :497-500. (in Chinese) 黄文献, 王和平, 王玉蕾, 等.高通量测序检测肺炎婴幼儿抗生素治疗前后肠道菌群变化[J].中国微生态学杂志, 2016, 28 (5) :497-500. [27] MA LQ, CHEN DC, LIU SZ. Influence of broad-spectrum an-tibiotics on the gut microflora in sepsis in rats[J]. Chin CritCare Med, 2008, 20 (9) :520-522. (in Chinese) 马丽琼, 陈德昌, 刘绍泽.广谱抗生素对脓毒症大鼠肠道微生态环境的影响[J].中国危重急救医学, 2008, 20 (9) :520-522. [28] QIN QF, LI HF. The progress of researches on chronic liverdisease and intestinal flora[J]. Chin J Microecol, 2012, 24 (5) :476-477. (in Chinese) 秦庆福, 李洪福.慢性肝病与肠道菌群的研究进展[J].中国微生态学杂志, 2012, 24 (5) :476-477. [29] Division of Microecology, Chinese Preventive Medicine Associ-ation. Chinese consensus statements on the clinical applica-tion of digestive tract microecological modulators (Version2016) [J]. Chin J Microecol, 2016, 28 (6) :621-631. (inChinese) 中华预防医学会微生态学分会.中国消化道微生态调节剂临床应用共识 (2016版) [J].中国微生态学杂志, 2016, 28 (6) :621-631. [30] SARIN SK, CHOUDHURY A. Acute-on-chronic liver failure[J]. Curr Gastroenterol Rep, 2016, 18 (12) :61. [31] LAN QH. Probiotics treatment on liver failure[J]. Chin ForeignMed Res, 2016, 14 (8) :3-4. (in Chinese) 蓝秋华.益生茵治疗肝衰竭[J].中外医学研究, 2016, 14 (8) :3-4. [32] ZHANG L, ZHAO MJ, ZHAO W. Influence of probiotics on in-testinal flora, plasma endotoxin, and cytokines in patients withchronic liver failure[J]. Chin J Nosocomiol, 2015, 25 (2) :262-264. (in Chinese) 张霖, 赵明敬, 赵威.微生态制剂对慢性肝衰竭患者肠道菌群与血浆内毒素及细胞因子的影响[J].中华医院感染学杂志, 2015, 25 (2) :262-264. [33] DENG TZ, HAN XY, ZHANG J, et al. Effect of probiotics ongut microflora, immune function and inflammatory response inpatients with chronic liver failure[J]. J Pathogen Biol, 2018, 13 (4) :408-412. (in Chinese) 邓桃枝, 韩向阳, 张洁, 等.微生态制剂对慢性肝衰竭患者肠道微生态、免疫功能及炎症反应的影响[J].中国病原生物学杂志, 2018, 13 (4) :408-412. [34] DALAL R, McGEE RG, RIORDAN SM, et al. Probiotics for peoplewith hepatic encephalopathy[J]. Cochrane Database Syst Rev, 2017, 2:CD008716. [35] BAJAJ JS. The role of microbiota in hepatic encephalopathy[J]. Gut Microbes, 2014, 5 (3) :397-403. [36] XIE WR, HE XX. Fecal microbiota transplantation in chronic liv-er diseases[J]. J Prac Hepatol, 2017, 20 (6) :651-653. (inChinese) 谢文瑞, 何兴祥.粪菌移植与慢性肝脏疾病[J].实用肝脏病杂志, 2017, 20 (6) :651-653. [37] REN WY, ZHANG SC, FANG GT, et al. Effects of cisaprideon intestinal bacterial and endotoxin translocation in cirrhoticrats[J]. Chin J Hepatol, 2003, 11 (9) :539-541. [38] THIELE M, WIEST R, GLUUD LL, et al. Can non-selectivebeta-blockers prevent hepatocellular carcinoma in patientswith cirrhosis?[J]. Med Hypotheses, 2013, 81 (5) :871-874. [39] MOOKERJEE RP, PAVESI M, THOMSEN KL, et al. Treatmentwith non-selective beta blockers is associated with reducedseverity of systemic inflammation and improved survival of pa-tients with acute-on-chronic liver failure[J]. J Hepatol, 2016, 64 (3) :574-582. [40] WANG XL, WANG X, JIANG W, et al. Protective effect of Gh-relin against LPS-induced liver cell injury[J]. Chin Pharma-col Bull, 2013, 29 (4) :486-490. [41] WOODHOUSE CA, PATEL VC, SINGANAYAGAM A, et al. Re-view article:The gut microbiome as a therapeutic target in thepathogenesis and treatment of chronic liver disease[J]. AlimentPharm Therap, 2018, 47 (2) :192-202. [42] BAJAJ JS. Review article:Potential mechanisms of action ofrifaximin in the management of hepatic encephalopathy andother complications of cirrhosis[J]. Aliment Pharmacol Ther, 2016, 43 (Suppl 1) :11-26. [43] SCHULZ C, SCHTTE K, KROPF S, et al. Ri MINI-the influ-ence of rifaximin on minimal hepatic encephalopathy (MHE) and on the intestinal microbiome in patients with liver cirrhosis:Study protocol for a randomized controlled trial[J]. Trials, 2016, 17 (1) :111. [44] ROMEO J, NOVA E, WAMBERG J, et al. Immunomodulatoryeffect of fibres, probiotics and synbiotics in different life-sta-ges[J]. Nutr Hosp, 2010, 25 (3) :341-349.
本文二维码
计量
- 文章访问数: 1221
- HTML全文浏览量: 57
- PDF下载量: 285
- 被引次数: 0