肠道衰竭相关的肝病的发病和管理
Sasha-Jane Abi-Aad1, Mark Lovell2, Racha T Khalaf1
1Division of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, Florida.
Seminars in liver disease
|February 27, 2025
概括
亲肠道营养 (PN) 有助于肠道衰竭 (IF),但有可能导致肝损伤,称为IFALD. 新兴疗法的目标是IFALD.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 胃肠病学 胃肠病学
- 儿科胃肠病学 儿科胃肠病学
背景情况:
- 长期的亲肠营养 (PN) 对于治疗肠衰竭 (IF),特别是短肠综合征至关重要.
- PN与显著的肝毒性有关,称为肠衰竭相关的肝病 (IFALD) 或PN相关的肝病.
研究的目的:
- 审查最新的IFALD病原体的理解.
- 讨论新兴疗法和IFALD管理中的持续挑战.
主要方法:
- 审查关于IFALD的当前文献.
- 对参与IFALD发展的病理生理路径的分析.
- 对潜在疗法的临床前和临床试验的总结.
主要成果:
- IFALD的发病包括PN脂质乳液,植物,失生症,改变肠肝轴和败血症,破坏胆酸平衡,促进肝炎.
- 这些因素有助于PN相关胆固醇症 (PNAC) 和带有纤维化的慢性脂肪肝炎.
- 目前正在研究的潜在疗法包括改性脂质乳液,FXR/LRH-1激动剂,TNF抑制剂,GLP-2类型,微生物组调节和抗氧化剂/胆补充剂.
结论:
- IFALD的发病过程很复杂,在FI的PN依赖患者中存在持续的挑战.
- 有效的管理需要解决多种贡献因素和推进治疗策略.
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