针对肠道微生物群的治疗是否可以改善肝硬化患者的肝功能? 一个系统的审查和元分析
Honglin Jiang1,2,3, Ning Xu1,2,3, Wei Zhang4
1School of Public Health, Fudan University, Shanghai, China.
Journal of gastroenterology and hepatology
|August 15, 2023
概括
针对微生物组的向疗法 (MTTs) 通过改善肝功能和减少肝脏脑病变等并发症来减缓肝硬化进展. 这些肠道健康干预措施为治疗肝病提供了新的途径.
科学领域:
- 胃肠病学和肝病学 胃肠学和肝病学
- 微生物学 微生物学
- 临床医学 临床医学
背景情况:
- 肝硬化管理仍然是一个挑战,肠道微生物组失调发挥着重要作用.
- 针对微生物组的向疗法 (MTT) 正在成为潜在的干预措施,但它们的临床影响需要彻底评估.
研究的目的:
- 在被诊断为肝硬化患者中全面评估微生物组向治疗 (MTT) 的疗效.
- 评估肠道微生物组调节对肝功能和肝硬化患者疾病严重程度的影响.
主要方法:
- 对随机对照试验 (RCT) 进行了系统的元分析,搜索主要数据库到2023年2月.
- 来自21个涉及1699名患者的RCT的数据被聚合在一起,以分析使用风险比率和平均差异的临床结果.
- 使用试验顺序分析来确保研究结果的稳定性和可靠性.
主要成果:
- MTT显著降低了阿斯巴酸胺转移酶水平,肝脏脑病风险,MELD得分,氨和内毒素水平.
- 通过试验序列分析验证了观察到的益处,证实了可靠的结果.
- 在其他肝功能指标上没有发现显著影响.
结论:
- 针对微生物组的向疗法显示出减缓肝硬化恶化的潜力.
- 这些发现为考虑在肝硬化患者治疗中使用MTT的临床医生提供了宝贵的见解.
相关概念视频
Inflammatory Bowel Disease IV: Pharmacological Management
152
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
152
Hepatic Drug Clearance: Role of Transporters
86
In the liver and bile canaliculi, influx and efflux transporters modification can influence intrinsic clearance. Transporters play a significant role in moving drugs within liver cells. Elaborate models, such as the Biopharmaceutical Classification System (BCS), are essential to relate transporters to drug disposition. This system categorizes drugs into four classes based on solubility and permeability, providing insights into elimination routes and the effects of transporters following oral...
86
Microorganisms in Medicine and Therapeutics
54
Microorganisms play a fundamental role in vaccine development, gene therapy, and therapeutic production. Their biological properties are harnessed to advance medicine and public health. Beyond immunization, microorganisms contribute to gut health, antibiotic synthesis, and genetic disease treatment.Live Attenuated and Inactivated VaccinesLive attenuated vaccines, such as the measles, mumps, and rubella (MMR) vaccine, utilize weakened forms of pathogens to closely resemble natural infections.
54
Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
173
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
173
Diseases of the Liver and Gallbladder
631
Liver and gallbladder diseases are a significant health concern, with prominent conditions including cirrhosis, hepatitis, non-alcoholic fatty liver disease (NAFLD), and gallstones. Jaundice is a common manifestation of liver and biliary disease.
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
Cirrhosis is characterized by the scarring of hepatic lobules in the liver, which are replaced by fibrous tissue, affecting the liver's normal functioning. NAFLD, on the other hand, is caused by an excessive build-up of fat in the liver, not...
631
Hepatic Drug Excretion: Influencing Factors
154
The biliary system of the liver, crucial for bile secretion and drug excretion, comprises intrahepatic bile ducts that merge to form the common hepatic duct. This duct, carrying hepatic bile, combines with the cystic duct, draining the gallbladder and forming the common bile duct, which empties into the duodenum. Bile, produced by hepatic cells lining the bile canaliculi, is composed primarily of water, bile salts, pigments, electrolytes, and lesser amounts of cholesterol and fatty acids. Bile...
154


