肠道微生物组及其在肝硬化中的代谢物:机制和临床影响
Luyuan Chang1, Yang Liu1, Haipeng Li2
1The First Department of Clinical Medicine, Bengbu Medical University, Bengbu, Anhui, China.
肝硬化进展是由肠肝轴功能障碍驱动的,其特点是微生物多样性减少和代谢物改变. 针对微生物组的治疗方法在恢复肠道健康和帮助肝硬化管理方面表现有前途.
科学领域:
- 胃肠病学和肝病学 胃肠学和肝病学
- 微生物组研究 微生物组研究
- 代谢学 代谢学 代谢学
背景情况:
- 肝硬化是全球主要的健康问题,每年造成数百万人的死亡和严重的残疾.
- 肠肝轴在肝硬化进展中发挥着关键作用,肠道失调和改变的代谢物加剧了肝损伤.
研究的目的:
- 综合关于肝硬化时微生物组和代谢物变化的证据.
- 评估针对肝硬化的微生物向干预措施的有效性.
- 探索微生物组-代谢组综合模型在肝硬化检测方面的潜力.
主要方法:
- 对40多项关于肝硬化的肠道微生物群的研究进行了系统审查和元分析.
- 分析代谢物概况,包括短链脂肪酸和胆酸.
- 对微生物向干预的临床试验的审查.
- 评估综合微生物组-代谢组模型的诊断准确性.
主要成果:
- 肠道微生物α多样性的显著下降 (30-60%) 和SCFA生产细菌的枯竭.
- 减少了便中的丁酸盐水平 (40-70%) 和增加了内毒素.
- 改变胆汁酸概况和托代谢的转变.
- 针对微生物组的干预措施在70-85%的试验中恢复了肠道平衡.
- 综合模型实现高AUC (0.82-0.90) 的非侵入性肝硬化检测.
结论:
- 可复制的微生物组-代谢物改变是肝硬化的主要驱动因素.
- 针对微生物组的干预措施提供了一个有希望的治疗途径.
- 综合的微生物组-代谢组方法可以早期和非侵入性地检测肝硬化.
- 进一步的纵向和多民族验证对于临床应用至关重要.
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