Research advances in the mechanism of action of intestinal microecology in intrahepatic cholestasis
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摘要: 肝内胆汁淤积是由遗传、免疫、炎症、结石、肿瘤等多种原因引起的胆汁生成、分泌、排泄功能障碍,不能正常排入十二指肠而逆流入血,引起一系列器质性损害、代谢失调和功能紊乱的临床疾病。近年来,随着临床和基础研究的不断深入,揭示出肠道微生态在肝脏疾病发生发展中扮演着重要角色。综述了肠道微生态及炎症因子在肝内胆汁淤积中的作用机制,探究益生菌在调节肠道菌群稳态,改善肠道微环境等方面进展,为临床治疗、科研研究和药物研发等提供借鉴。Abstract: Intrahepatic cholestasis(IHC) is a dysfunction of bile production,secretion,and excretion caused by various factors including genetics,immunity,inflammation,stones,and tumors,and therefore,the bile is not normally discharged into the duodenum and reversely flows into blood,which causes a series of clinical diseases with organic damage,metabolic disorders,and dysfunction. In recent years,with the deepening of clinical and basic research,intestinal microecology is found to play an important role in the development and progression of liver diseases. This article reviews the mechanism of action of intestinal microecology and inflammatory factors in intrahepatic cholestasis and explores the research advances in the role of probiotics in regulating intestinal flora stability and improving intestinal microenvironment,so as to provide a basis for clinical treatment,scientific research,and drug research and development.
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Key words:
- cholestasis,intrahepatic /
- gastrointestinal microbiome /
- therapeutics
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[1] ZHANG HB,WANG Y. Research progress of non-alcoholic fatty liver disease[J]. Hainan Med,2017,28(10):1651-1653.(in Chinese)张海博,王宇.非酒精性脂肪肝的现代研究进展[J].海南医学,2017,28(10):1651-1653. [2] SHE QM,MAO H. Research progress of the relationship between gut microbiome and chronic liver diseases[J]. World J complex Med,2019,5(3):163-165.(in Chinese)佘秋敏,毛华.肠道菌群与慢性肝脏疾病关系的研究进展[J].世界复合医学,2019,5(3):163-165. [3] WANG K,LI JT,YAN SG,et al. Effects of intestinal microecology on malignant transformation of liver cirrhosis-liver precancerous lesion[J]. Chin J Gastroenterol Hepatol,2018,27(1):111-114.(in Chinese)王轲,李京涛,闫曙光,等.肠道微生态对肝硬化-肝癌癌前病变恶性转变的影响[J].胃肠病学和肝病学杂志,2018,27(1):111-114. [4] LI XL,SUN FX,SUI JL,et al. Association between gut microbiota and cholestasis[J]. Chin J Integr Trad West Med Dig,2016,24(11):886-887,890.李晓玲,孙凤霞,隋京利,等.肠道微生态与胆汁淤积的关系[J].中国中西医结合消化杂志,2016,24(11):886-887,890. [5] MINEMURA M,SHIMIZU Y. Gut microbiota and liver diseases[J]. World J Gastroenterol,2015,21(6):1691-1702. [6] HAN ML,GONG ZH. Mechanism of action of gut microbiota in hepatobiliary diseases[J]. J Clin Hepatol,2017,33(2):384-388.(in Chinese)韩美林,龚振华.肠道菌群在肝胆疾病中的作用机制[J].临床肝胆病杂志,2017,33(2):384-388. [7] STALEY C,WEINGARDEN AR,KHORUTS A,et al. Interaction of gut microbiota with bile acid metabolism and its influence on disease states[J]. Appl Microbiol Biotechnol,2017,101(1):47-64. [8] ZHAO L. Change in Paneth cells in the intestinal epithelium and its association with intestinal mucosal barrier in rats with obstructive jaundice[D]. Binzhou:Binzhou Medical University,2016.(in Chinese)赵亮.梗阻性黄疸大鼠肠粘膜上皮潘氏细胞变化及其与肠粘膜屏障的关系[D].滨州:滨州医学院,2016. [9] ZHANG LJ. HO-1/CO repairs intestinal barrier injury in cholestasis and liver injury by regulating TLR4/NF-κB[D]. Dalian:Dalian Medical University,2017.(in Chinese)张丽静. HO-1/CO通过调控TLR4/NF-κB修复胆汁淤积肝损伤肠屏障破坏的研究[D].大连:大连医科大学,2017. [10] MA WP. Effect of internal and external bile drainage on the expression of MUC2 protein in the intestinal mucosa in rats with obstructive jaundice[D]. Shijiazhuang:Hebei Medical University,2016.(in Chinese)马伟平.胆汁内外引流术对梗阻性黄疸大鼠肠黏膜MUC2蛋白表达的影响[D].石家庄:河北医科大学,2016. [11] SIPKA S,BRUCKNER G. The immunomodulatory role of bileacids[J]. Clin Gastroenterol,2015,49(1):s69-s73. [12] SARAC F,SALMAN T,GUN F,et al. Effect of probiotic supplemen-tation on bacterial translocation in common bile duct obstruc-tion[J]. Pediatr Surg Int,2015,31(2):155-161. [13] GUO S,SHU SN. Application of probiotics in children with hepatobiliary diseases[J]. Chin J Pract Pediatr,2017,32(2):110-114.(in Chinese)郭珊,舒赛男.益生菌在儿童肝胆疾病的应用[J].中国实用儿科杂志,2017,32(2):110-114. [14] KO MT,HUANG HC,LEE WS,et al. Metformin reduces intrahepatic fibrosis and intrapulmonary shunts in biliary cirrhotic rats[J]. J Chin Med Assoc,2017,80(8):467-475. [15] YANG L,CAO Y,YANG CQ. Pathogenesis and related diseases of cholestasis[J]. J Intern Med Concepts Pract,2014,9(5):308-312.(in Chinese)杨丽,曹燕,杨长青.胆汁淤积的发生机制及相关疾病[J].内科理论与实践,2014,9(5):308-312. [16] HUANG JR. Interpretation of the expert consensus on the diagnosis and treatment of intrahepatic cholestasis[J/CD].Chin J Front Med Sci:Electronic Version,2016,8(3):9-11.(in Chinese)黄建荣.肝内胆汁淤积症诊治专家共识解读[J/CD].中国医学前沿杂志:电子版,2016,8(3):9-11. [17] CHAPMAN R,CULLEN S. Etiopathogenesis of primary sclerosing cholangitis[J]. World J Gastroenterol,2008,14(21):3350-3359. [18] LIU XJ. Clinical effect of S-adenosylmethionine in treatment of viral hepatitis with intrahepatic cholestasis[J]. J Clin Med,2015,2(27):5736.(in Chinese)刘现军.腺苷蛋氨酸治疗肝内胆汁淤积性病毒性肝炎疗效观察[J].临床医药文献杂志,2015,2(27):5736. [19] JNGST C,BERG T,CHENG J,et al. Intrahepatic cholestasis in common chronic liver diseases[J]. Eur J Clin Invest,2013,43(10):1069-1083. [20] WANG XL,WANG L,JIANG XH. Protective effect of anethol trithione against drug-induced liver injury due to rifampicin and related mechanism[J]. West China J Pharm Sci,2018,33(5):501-503.(in Chinese)叶晓莉,王凌,蒋学华.茴三硫对利福平致药物性肝损伤的保护作用及机制[J].华西药学杂志,2018,33(5):501-503. [21] CHEN J,WANG JL,MA GW. Studyon characteristics and mechanism of liver function damaged in using simvastatin combined with HRZ[J]. Anti Infect Pharm,2016,13(4):729-735.(in Chinese)陈洁,王俊龙,马国伟.抗结核药与辛伐他汀联用致肝损伤的特征及其机制研究[J].抗感染药学,2016,13(4):729-735. [22] XIE JF,WANG YQ,YUAN CG. Research advances in the role of bile acid,gut microbiota,and their interaction in liver regeneration[J]. J Hepatol Pan Surg,2018,30(1):87-89.(in Chinese)谢经丰,王永芹,袁晟光.胆汁酸与肠道菌群及其相互影响在肝再生中的作用研究进展[J].肝胆胰外科杂志,2018,30(1):87-89. [23] LECHUGA S,IVANOV AI. Disruption of the epithelial barrier during intestinal inflammation:Quest for new molecules and mechanisms[J]. Biochim Biophys Acta Mol Cell Res,2017,1864(7):1183-1194. [24] ODENWALD MA,CHOI W,KUO WT,et al. The scaffolding protein ZO-1 coordinates actomyosin and epithelial apical specializations in vitro and in vivo[J]. J Biol Chem,2018,293(45):17317-17335. [25] ZIHNI C,MILLS C,MATTER K,et al. Tight junctions:From simple barriers to multifunctional molecular gates[J]. Nat Rev Mol Cell Biol,2016,7(9):564-580. [26] ABUFADDAN NH,SHERIF TM,MOHAMMED OA,et al. Intestinal barrier integrity and function in infants with cholestasis[J]. Intest Res,2017,15(1):118-123. [27] TANAKA K,NAKAMURA Y,TERAHARA M,et al. Poor bifidobacterial colonization is associated with late provision of colostrum and improved with probiotic supplementation in low birth weight infants[J]. Nutrients,2019,11(4):839. [28] SONG JC,GAO H,QIU HB,et al. The pharmacokinetics of dexmedetomidine in patients with obstructive jaundice:A clinical trial[J]. PLo S One,2018,13(11):e0207427. [29] CAVE MC,CLAIR HB,HARDESTY JE,et al. Nuclear receptors and nonalcoholic fatty liver disease[J]. Biochim Biophys Acta,2016,1859(9):1083-1099. [30] CARIELLO M,PICCININ E,GARCIA-IRIGOYEN O,et al.Nuclear receptor FXR,bile acids and liver damage:Introducing the progressive familial intrahepatic cholestasis with FXR mutations[J]. Biochim Biophys Acta Mol Basis Dis,2018,1864(4):1308-1318. [31] WANG J,FU T,DONG R,et al. Hepatoprotection of auraptene from the peels of citrus fruits against 17alpha-ethinylestradiol-induced cholestasis in mice by activating farnesoid X receptor[J]. Food Funct,2019,10(7):3839-3850. [32] SCHMITT J,KONG B,STIEGER B,et al. Protective effects of farnesoid X receptor(FXR)on hepatic lipid accumulation are mediated by hepatic FXR and independent of intestinal FGF15signal[J]. Liver Int,2015,35(4):1133-1144. [33] XIONG XL,DING Y,CHEN ZL,et al. Emodin rescues intrahepatic cholestasis via stimulating FXR/BSEP pathway in promoting the canalicular export of accumulated bile[J]. Front Pharmacol,2019,10:522. [34] FRIEDMAN ES,LI Y,SHEN TD,et al. FXR-dependent modulation of the human small intestinal microbiome by the bile acid derivative obeticholic acid[J]. Gastroenterology,2018,155(6):1741-1752. [35] ALAMDARY SZ,BAKHSHI B,SOUDI S. The anti-apoptotic and anti-inflammatory effect of Lactobacillus acidophilus on Shigella sonnei and Vibrio cholerae interaction with intestinal epithelial cells:A comparison between invasive and non-invasive bacteria[J]. PLo S One,2018,13(6):e196941. [36] VANDER HJ,GOLDSTONE RJ,HARRIS S,et al. Substantial extracellular metabolic differences found between phylogenetically closely related probiotic and pathogenic strains of escherichia coli[J]. Front Microbiol,2019,10:252. [37] CORSELLO G,CARTA M,MARINELLO R,et al. Preventive effect of cow’s milk fermented with lactobacillus paracasei CBA L74 on common infectious diseases in children:A multicenter randomized controlled trial[J]. Nutrients,2017,9(7):669. [38] MIR H,MEENA AS,CHAUDHRY KK,et al. Occludin deficiency promotes ethanol-induced disruption of colonic epithelial junctions,gut barrier dysfunction and liver damage in mice[J]. Biochim Biophys Acta,2016,1860(4):765-774. [39] JIN PF. Effect of probiotics on lipopolysaccharide-induced liver injury and expression of inflammatory factors in mice and related mechanism[D]. Hangzhou:Zhejiang University,2015.(in Chinese)金鹏锋.益生菌对LPS诱导的小鼠肝损伤和炎症因子表达的影响作用及机制研究[D].杭州:浙江大学,2015. [40] SHUKLA PK,GANGWAR R,MANDA B,et al. Rapid disruption of intestinal epithelial tight junction and barrier dysfunction by ionizing radiation in mouse colon in vivo:protection by Nacetyl-l-cysteine[J]. Am J Physiol Gastrointest Liver Physiol,2016,310(9):g705-g715. [41] YANG R,HARAD T,LI J,et al. Bile modulates intesinal epithelial barrier function via an racellular signal related kinase 1/2dependent mechanism[J]. Intensive Care Med,2005,31(5):709-717. [42] ASSIMAKOPOULOS SF,SCOPA CD,CHARONIS A,et al. Experimental obstructive jaundice disrupts intestinal mucosal barrier by altering occludin expression:Beneficial effect of bombesin and neurotensin[J]. J Am Col Surg,2004,198(5):748-757. [43] WANG T,ZHOU ZX,et al. Resveratrol effectively attenuates alpha-naphthyl isothiocyanate-induced acute cholestasis and liver injury through choleretic and anti-inflammatory mechanisms[J]. Acta Pharmacol Sin,2014,35(12):1527-1536. [44] SABINO J,VIEIRA-SILVA S,MACHIELS K,et al. Primary sclerosing cholangitis is characterised by intestinal dysbiosis independent from IBD[J]. Gut,2016,65(10):1681-1689. [45] DENEAU M,PERITO E,RICCIUTO A,et al. Ursodeoxycholic acid therapy in pediatric primary sclerosing cholangitis:Predictors of gamma glutamyltransferase normalization and favorable clinical course[J]. J Pediatr,2019,209:92-96. [46] IWASAWA K,SUDA W,TSUNODA T,et al. Characterisation of the faecal microbiota in Japanese patients with paediatriconset primary sclerosing cholangitis[J]. Gut,2017,66(7):1344-1346. [47] BAJAJ JS,KAKIYAMA G,ZHAO D,et al. Continued alcohol misuse in human cirrhosis is associated with an impaired gutliver axis[J]. Alcohol Clin Exp Res,2017,41(11):1857-1865. [48] SAKAI F,HOSOYA T,ONO-OHMACHI A,et al. Lactobacillus gasseri SBT2055 induces TGF-beta expression in dendritic cells and activates TLR2 signal to produce IgA in the small intestine[J]. PLo S One,2014,9(8):e105370. [49] NOGACKA AM,ODDI S,SALAZAR N,et al. Intestinal immunomodulation and shifts on the gut microbiota of BALB/c mice promoted by two bifidobacterium and lactobacillus strains isolated from human samples[J]. Biomed Res Int,2019,2019:2323540. [50] KENNEDY L,FRANCIS H,INVERNIZZI P,et al. Secretin/secretin receptor signaling mediates biliary damage and liver fibrosis in early-stage primary biliary cholangitis[J]. FASEB J,33(9):10269-10279. [51] XU HB. Clinical effect of S-adenosylmethionine combined with glucocorticoids in treatment of drug-induced cholestatic liver disease[J]. Guide Chin Med,2018,16(3):118-119.(in Chinese)徐洪滨.腺苷蛋氨酸联合糖皮质激素治疗药物性胆汁淤积性肝病的疗效研究[J].中国医药指南,2018,16(3):118-119.
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