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ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 36 Issue 10
Oct.  2020
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Article Contents

Mechanism of action of intestinal flora in hepatic encephalopathy and related treatment methods

DOI: 10.3969/j.issn.1001-5256.2020.10.047
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  • Received Date: 2020-04-15
  • Published Date: 2020-10-20
  • At present,hepatic encephalopathy has a relatively high mortality and thus greatly affects patients' quality of life. This article describes the changes of intestinal flora in patients with hepatic encephalopathy and analyzes the mechanism of action of intestinal flora in hepatic encephalopathy and related treatment methods. It is pointed out that the development of hepatic encephalopathy is closely associated with intestinal flora,and clinical treatment by regulating intestinal flora has achieved a marked effect in patients with hepatic encephalopathy. In the future,the research on intestinal flora in patients with hepatic encephalopathy can be deepened to provide better regimens for the treatment of hepatic encephalopathy.

     

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  • [1] PATEL VC,WHITE H,STY S,et al. Clinical science workshop:Targeting the gut-liver-brain axis[J]. Metab Brain Dis,2016,31(6):1327-1337.
    [2] VILSTRUP H,AMODIO P,BAJAJ J,et al. Hepatic encephalopathy in chronic liver disease:2014 Practice Guideline by the American Association for the Study of Liver Diseases and the European Association for the Study of the Liver[J]. Hepatology,2014,60(2):715-735.
    [3] DAM G,AAMANN L,VISTRUP H,et al. The role of branched chain amino acids in the treatment of hepatic encephalopathy[J]. J Clin Exp Hepatol,2018,8(4):448-451.
    [4] QIN J,LI R,RAES J,et al. A human gut microbial gene catalogue established by metagenomic sequencing[J]. Nature,2010,464(7285):59-65.
    [5] Human Microbiome Project Consortium. A framework for human microbiome research[J]. Nature,2012,486(7402):215-221.
    [6] GALLAND L. The gut microbiome and the brain[J]. J Med Food,2014,17(12):1261-1272.
    [7] ECKBURG PB,BIK EM,BERNSTEIN CN,et al. Diversity of the human intestinal microbial flora[J]. Science,2005,308(5728):1635-1638.
    [8] DAVID LA,MAURICE CF,CARMODY RN,et al. Diet rapidly and reproducibly alters the human gut microbiome[J]. Nature,2014,505(7484):559-563.
    [9] YATSUNENKO T,REY FE,MANARY MJ,et al. Human gut microbiome viewed across age and geography[J]. Nature,2012,486(7402):222-227.
    [10] LIU Q,DUAN ZP,HA DK,et al. Synbiotic modulation of gut flora:Effect on minimal hepatic encephalopathy in patients with cirrhosis[J]. Hepatology,2004,39(5):1441-1449.
    [11] ZHANG Z,ZHAI H,GENG J,et al. Large-scale survey of gut microbiota associated with MHE via 16S rRNA-based pyrosequencing[J]. Am J Gastroenterol,2013,108(10):1601-1611.
    [12] BAJAJ JS,RIDLON JM,HYLEMON PB,et al. Linkage of gut microbiome with cognition in hepatic encephalopathy[J]. Am J Physiol Gastrointest Liver Physiol,2012,302(1):g168-g175.
    [13] AHLUWALIA V,BETRAPALLY NS,HYLEMON PB,et al. Impaired gut-liver-brain axis in patients with cirrhosis[J]. Sci Rep,2016,6:26800.
    [14] SUNG CM,LIN YF,CHEN KF,et al. Predicting clinical outcomes of cirrhosis patients with hepatic encephalopathy from the fecal microbiome[J]. Cell Mol Gastroenterol Hepatol,2019,8(2):301-318.
    [15] DASANI BM,SIGAL SH,LIEBER CS. Analysis of risk factors for chronic hepatic encephalopathy:The role of helicobacter pylori infection[J]. Am J Gastroenterol,1998,93(5):726-731.
    [16] HUBER M,RSSLE M,SIEGERSTETTER V,et al. Helicobacter pylori infection does not correlate with plasma ammonia concentration and hepatic encephalopathy in patients with cirrhosis[J].Hepatogastroenterology,2001,48(38):541-544.
    [17] NAVA GM,STAPPENBECK TS. Diversity of the autochthonous colonic microbiota[J]. Gut Microbes,2011,2(2):99-104.
    [18] CLARKE G,STILLING RM,KENNEDY PJ,et al. Minireview:Gut microbiota:The neglected endocrine organ[J]. Mol Endocrinol,2014,28(8):1221-1238.
    [19] LYTE M. Microbial endocrinology in the microbiome-gutbrain axis:How bacterial production and utilization of neurochemicals influence behavior[J]. PLo S Pathog,2013,9(11):e1003726.
    [20] PONZETTO A,VAIRA D. Hepatic encephalopathy and helicobacter pylori[J]. Dig Dis Sci,2018,63(5):1368-1369.
    [21] JIAO N,BAKER SS,CHAPA-RODRIGUEZ A,et al. Suppressed hepatic bile acid signalling despite elevated production of primary and secondary bile acids in NAFLD[J]. Gut,2018,67(10):1881-1891.
    [22] RIDLON JM,HARRIS SC,BHOWMIK S,et al. Consequences of bile salt biotransformations by intestinal bacteria[J]. Gut Microbes,2016,7(1):22-39.
    [23] WANG Q,WANG B,SAXENA V,et al. The gut-liver axis:Impact of a mouse model of small-bowel bacterial overgrowth[J]. J Surg Res,2018,221:246-256.
    [24] AGUIRRE VALADEZ JM,RIVERA-ESPINOSA L,MNDEZGUERRERO O,et al. Intestinal permeability in a patient with liver cirrhosis[J]. Ther Clin Risk Manag,2016,12:1729-1748.
    [25] SPADONI I,ZAGATO E,BERTOCCHI A,et al. A gut-vascular barrier controls the systemic dissemination of bacteria[J].Science,2015,350(6262):830-834.
    [26] GAUTREAUX MD,DEITCH EA,BERG RD. Bacterial translocation from the gastrointestinal tract to various segments of the mesenteric lymph node complex[J]. Infect Immun,1994,62(5):2132-2134.
    [27] CHIEPPA M,RESCIGNO M,HUANG AY,et al. Dynamic imaging of dendritic cell extension into the small bowel lumen in response to epithelial cell TLR engagement[J]. J Exp Med,2006,203(13):2841-2852.
    [28] NIESS JH,BRAND S,GU X,et al. CX3CR1-mediated dendritic cell access to the intestinal lumen and bacterial clearance[J]. Science,2005,307(5707):254-258.
    [29] FARACHE J,KOREN I,MILO I,et al. Luminal bacteria recruit CD103+dendritic cells into the intestinal epithelium to sample bacterial antigens for presentation[J]. Immunity,2013,38(3):581-595.
    [30] FUNG TC,BESSMAN NJ,HEPWORTH MR,et al. Lymphoid-tissue-resident commensal bacteria promote members of the IL-10 cytokine family to establish mutualism[J]. Immunity,2016,44(3):634-646.
    [31] DORAN KS,BANERJEE A,DISSON O,et al. Concepts and mechanisms:Crossing host barriers[J]. Cold Spring Harb Perspect Med,2013,3(7):a010090.
    [32] HILDEBRAND GJ,WOLOCHOW H. Translocation of bacteriophage across the intestinal wall of the rat[J]. Proc Soc Exp Biol Med,1962,109:183-185.
    [33] BAJAJ JS,HEUMAN DM,HYLEMON PB,et al. Altered profile of human gut microbiome is associated with cirrhosis and its complications[J]. J Hepatol,2014,60(5):940-947.
    [34] MORATALLA A,AMPUERO J,BELLOT P,et al. Lactulose reduces bacterial DNA translocation,which worsens neurocognitive shape in cirrhotic patients with minimal hepatic encephalopathy[J]. Liver Int,2017,37(2):212-223.
    [35] CHEN YF,LI LJ,CHEN CL. Intestinal bacterial translocation and cirrhosis[J]. Chin J Pract Intern Med,2007,27(19):1545-1547.(in Chinese)陈燕飞,李兰娟,陈春雷.肠道细菌移位与肝硬化[J].中国实用内科杂志,2007,27(19):1545-1547.
    [36] MIHARA T,OTSUBO W,HORIGUCHI K,et al. The anti-inflammatory pathway regulated via nicotinic acetylcholine receptors in rat intestinal mesothelial cells[J]. J Vet Med Sci,2017,79(11):1795-1802.
    [37] HANSLIN K,SJLIN J,SKORUP P,et al. The impact of the systemic inflammatory response on hepatic bacterial elimination in experimental abdominal sepsis[J]. Intensive Care Med Exp,2019,7(1):52.
    [38] BUTTERWORTH RF. The liver-brain axis in liver failure:Neuroinflammation and encephalopathy[J]. Nat Rev Gastroenterol Hepatol,2013,10(9):522-528.
    [39] LICINIO J,WONG ML. Pathways and mechanisms for cytokine signaling of the central nervous system[J]. J Clin Invest,1997,100(12):2941-2947.
    [40] JIANG W,DESJARDINS P,BUTTERWORTH RF. Cerebral inflammation contributes to encephalopathy and brain edema in acute liver failure:Protective effect of minocycline[J]. J Neurochem,2009,109(2):485-493.
    [41] VAQUERO J,POLSON J,CHUNG C,et al. Infection and the progression of hepatic encephalopathy in acute liver failure[J]. Gastroenterology,2003,125(3):755-764.
    [42] TANG SH,CHEN H,HAN GH. Association between gut microbiota and hepatic encephalopathy in patients with liver cirrhosis[J]. J Clin Hepatol,2019,35(5):1109-1113.(in Chinese)汤世豪,陈辉,韩国宏.肠道菌群与肝硬化肝性脑病的关系[J].临床肝胆病杂志,2019,35(5):1109-1113.
    [43] BAJAJ JS. Hepatic encephalopathy:Classification and treatment[J]. J Hepatol,2018,68(4):838-839.
    [44] BAJAJ JS,KHORUTS A. Microbiota changes and intestinal microbiota transplantation in liver diseases and cirrhosis[J]. J Hepatol,2020,72(5):1003-1027.
    [45] HUDSON M,SCHUCHMANN M. Long-term management of hepatic encephalopathy with lactulose and/or rifaximin:A review of the evidence[J]. Eur J Gastroenterol Hepatol,2019,31(4):434-450.
    [46] FENG L,PING CX,ZHANG L,et al. Observation on the efficacy of rifampicin in the treatment of liver cirrhosis encephalopathy[J].Beijing Med J,2017,39(9):965-966.(in Chinese)封莉,平春霞,张丽,等.利福昔明治疗肝硬化肝性脑病的疗效观察[J].北京医学,2017,39(9):965-966.
    [47] KALAMBOKIS G,TSIANOS EV. Endotoxaemia in the pathogenesis of cytopenias in liver cirrhosis. Could oral antibiotics raise blood counts?[J]. Med Hypotheses,2011,76(1):105-109.
    [48] CHAUTANT F,GUILLAUME M,ROBIC MA,et al. Lessons from“real life experience”of rifaximin use in the management of recurrent hepatic encephalopathy[J]. World J Hepatol,2020,12(1):10-20.
    [49] BAJAJ JS,HEUMAN DM,SANYAL AJ,et al. Modulation of the metabiome by rifaximin in patients with cirrhosis and minimal hepatic encephalopathy[J]. PLo S One,2013,8(4):e60042.
    [50] ELWIR S,RAHIMI RS. Hepatic encephalopathy:An update on the pathophysiology and therapeutic options[J]. J Clin Transl Hepatol,2017,5(2):142-151.
    [51] LI M,WANG B,ZHANG M,et al. Symbiotic gut microbes modulate human metabolic phenotypes[J]. Proc Natl Acad Sci U S A,2008,105(6):2117-2122.
    [52] SPENCER MD,HAMP TJ,REID RW,et al. Association between composition of the human gastrointestinal microbiome and development of fatty liver with choline deficiency[J].Gastroenterology,2011,140(3):976-986.
    [53] SHA W,da COSTA KA,FISCHER LM,et al. Metabolomic profiling can predict which humans will develop liver dysfunction when deprived of dietary choline[J]. FASEB J,2010,24(8):2962-2975.
    [54] MURRAY M,ZALUZNY L,FARRELL GC. Drug metabolism in cirrhosis. Selective changes in cytochrome P-450 isozymes in the choline-deficient rat model[J]. Biochem Pharmacol,1986,35(11):1817-1824.
    [55] DREKONJA D,REICH J,GEZAHEGN S,et al. Fecal microbiota transplantation for clostridium difficile infection:A systematic review[J]. Ann Intern Med,2015,162(9):630-638.
    [56] KAO D,ROACH B,PARK H,et al. Fecal microbiota transplantation in the management of hepatic encephalopathy[J].Hepatology,2016,63(1):339-340.
    [57] MEHTA R,KABRAWALA M,NANDWANI S,et al. Preliminary experience with single fecal microbiota transplant for treatment of recurrent overt hepatic encephalopathy-A case series[J].Indian J Gastroenterol,2018,37(6):559-562.
    [58] BAJAJ JS,SALZMAN NH,ACHARYA C,et al. Fecal Microbial transplant capsules are safe in hepatic encephalopathy:A phase 1,randomized,placebo-controlled trial[J]. Hepatology,2019,70(5):1690-1703.
    [59] WANG WW,ZHANG Y,HUANG XB,et al. Fecal microbiota transplantation prevents hepatic encephalopathy in rats with carbon tetrachloride-induced acute hepatic dysfunction[J].World J Gastroenterol,2017,23(38):6983-6994.
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