肠道微生物失衡在肝性脑病中的研究进展
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摘要
<正>肝性脑病(hepatic encephalopathy, HE)是临床上常见的一种以代谢紊乱为基础的神经精神异常综合征,其临床表现可从亚临床改变,如轻微肝性脑病(minimal hepatic encephalopathy, MHE),进展到明显昏迷。研究证实,肠道微生物(gut microbiota, GM)及有害副产物如氨、吲哚、羟吲哚和内毒素参与HE的发生发展,尤其肠-肝-脑轴功能失调在HE的疾病进展中处于核心环节。本文就GM在H
引文
[1]Kang DJ,Betrapally NS,Ghosh SA,et al.Gut microbiota drive the development of neuroinflammatory response in cirrhosis in mice.Hepatology,2016,64:1232-1248.
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[13]Teltschik Z,Wiest R,Beisner J,et al.Intestinal bacterial translocation in rats with cirrhosis is related to compromised Paneth cell antimicrobial host defense.Hepatology,2012,55:1154-1163.
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[15]McMillin M,Frampton G,Grant S,et al.Bile acid-mediated sphingosine-1-phosphate receptor 2 signaling promotes neuroinflammation during hepatic encephalopathy in mice.Front Cell Neurosci,2017,11:191.
[16]Arab JP,Karpen SJ,Dawson PA,et al.Bile acids and nonalcoholic fatty liver disease:Molecular insights and therapeutic perspectives.Hepatology,2017,65:350-362.
[17]Parseus A,Sommer N,Sommer F,et al.Microbiota-induced obesity requires farnesoid X receptor.Gut,2017,66:429-437.
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[20]Lunia MK,Sharma BC,Sharma P,et al.Probiotics prevent hepatic encephalopathy in patients with cirrhosis:a randomized controlled trial.Clin Gastroenterol Hepatol,2014,12:1003-1008e1001.
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[2]Ahluwalia V,Betrapally NS,Hylemon PB,et al.Impaired gutliver-brain axis in patients with cirrhosis.Sci Rep,2016,6:26800.
[3]Riggio O,Mannaioni G,Ridola L,et al.Peripheral and splanchnic indole and oxindole levels in cirrhotic patients:a study on the pathophysiology of hepatic encephalopathy.Am JGastroenterol,2010,105:1374-1381.
[4]Montagnese S,Biancardi A,Schiff S,et al.Different biochemical correlates for different neuropsychiatric abnormalities in patients with cirrhosis.Hepatology,2011,53:558-566.
[5]Shawcross DL,Sharifi Y,Canavan JB,et al.Infection and systemic inflammation,not ammonia,are associated with Grade3/4hepatic encephalopathy,but not mortality in cirrhosis.JHepatol,2011,54:640-649.
[6]Butterworth RF.The liver-brain axis in liver failure:neuroinflammation and encephalopathy.Nat Rev Gastroenterol Hepatol,2013,10:522-528.
[7]Zemtsova I,Gorg B,Keitel V,et al.Microglia activation in hepatic encephalopathy in rats and humans.Hepatology,2011,54:204-215.
[8]Rothhammer V,Borucki DM,Tjon EC,et al.Microglial control of astrocytes in response to microbial metabolites.Nature,2018,557:724-728.
[9]Shah A,Shanahan E,Macdonald GA,et al.Systematic review and meta-analysis:prevalence of small intestinal bacterial overgrowth in chronic liver disease.Semin Liver Dis,2017,37:388-400.
[10]Gupta A,Dhiman RK,Kumari S,et al.Role of small intestinal bacterial overgrowth and delayed gastrointestinal transit time in cirrhotic patients with minimal hepatic encephalopathy.JHepatol,2010,53:849-855.
[11]Wiest R,Lawson M,Geuking M.Pathological bacterial translocation in liver cirrhosis.J Hepatol,2014,60:197-209.
[12]Wang Q,Wang B,Saxena V,et al.The gut-liver axis:impact of a mouse model of small-bowel bacterial overgrowth.J Surg Res,2018,221:246-256.
[13]Teltschik Z,Wiest R,Beisner J,et al.Intestinal bacterial translocation in rats with cirrhosis is related to compromised Paneth cell antimicrobial host defense.Hepatology,2012,55:1154-1163.
[14]Ryan KK,Tremaroli V,Clemmensen C,et al.FXR is a molecular target for the effects of vertical sleeve gastrectomy.Nature,2014,509:183-188.
[15]McMillin M,Frampton G,Grant S,et al.Bile acid-mediated sphingosine-1-phosphate receptor 2 signaling promotes neuroinflammation during hepatic encephalopathy in mice.Front Cell Neurosci,2017,11:191.
[16]Arab JP,Karpen SJ,Dawson PA,et al.Bile acids and nonalcoholic fatty liver disease:Molecular insights and therapeutic perspectives.Hepatology,2017,65:350-362.
[17]Parseus A,Sommer N,Sommer F,et al.Microbiota-induced obesity requires farnesoid X receptor.Gut,2017,66:429-437.
[18]Gluud LL,Vilstrup H,Morgan MY.Nonabsorbable disaccharides for hepatic encephalopathy:A systematic review and meta-analysis.Hepatology,2016,64:908-922.
[19]Vilstrup H,Amodio P,Bajaj J,et al.Hepatic encephalopathy in chronic liver disease:2014Practice Guideline by the American association for the study of liver diseases and the european association for the study of the liver.Hepatology,2014,60:715-735.
[20]Lunia MK,Sharma BC,Sharma P,et al.Probiotics prevent hepatic encephalopathy in patients with cirrhosis:a randomized controlled trial.Clin Gastroenterol Hepatol,2014,12:1003-1008e1001.
[21]Kang SH,Lee YB,Lee JH,et al.Rifaximin treatment is associated with reduced risk of cirrhotic complications and prolonged overall survival in patients experiencing hepatic encephalopathy.Aliment Pharmacol Ther,2017,46:845-855.
[22]Bajaj JS.Review article:potential mechanisms of action of rifaximin in the management of hepatic encephalopathy and other complications of cirrhosis.Aliment Pharmacol Ther,2016,43Suppl 1:11-26.