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肠道菌群在慢性肝病和肝细胞癌中的作用及临床意义
冯锦凯1,陈振华1,武宇轩2,程树群1*
0
(1. 海军军医大学(第二军医大学)东方肝胆外科医院肝外六科, 上海 200438;
2. 海军军医大学(第二军医大学)基础医学院, 上海 200433
*通信作者)
摘要:
肠道菌群是人体消化道内复杂、动态的微生态系统,生理条件下与宿主之间存在着平衡的共生关系。然而,在慢性肝病和肝癌等病理状态下,肠道菌群的组成和肠道通透性会发生显著变化,导致肠道菌群失调和细菌移位。肠道细菌及其代谢产物一方面进入肝脏激活炎症相关信号通路,另一方面进入体循环形成内毒素血症,共同促使慢性肝病和肝癌进展。目前,针对肠道菌群治疗慢性肝病和肝癌的策略包括使用抗生素、益生菌或益生元和粪便微生物移植。本文就肠道菌群在慢性肝病和肝癌中的潜在作用及临床意义进行综述。
关键词:  肠道菌群  慢性肝病  肝细胞癌  益生菌  粪便微生物移植
DOI:10.16781/j.0258-879x.2020.11.1246
投稿时间:2020-02-10修订日期:2020-05-13
基金项目:国家自然科学基金重点项目(81730097).
Role and clinical significance of gut microbiota in chronic liver diseases and hepatocellular carcinoma
FENG Jin-kai1,CHEN Zhen-hua1,WU Yu-xuan2,CHENG Shu-qun1*
(1. Department of Hepatic Surgery(Ⅵ), Eastern Hepatobiliary Surgery Hospital, Naval Medical University(Second Military Medical University), Shanghai 200438, China;
2. College of Basic Medical Sciences, Naval Medical University(Second Military Medical University), Shanghai 200433, China
*Corresponding author)
Abstract:
Gut microbiota is a complex and dynamic micro-ecosystem in human intestinal tract, and it has a balanced symbiotic relationship with the host under physiological conditions. However, in pathological conditions such as chronic liver diseases and hepatocellular carcinoma, the composition of gut microbiota and intestinal permeability will significantly change, leading to dysbiosis and bacterial translocation. Intestinal bacteria and their metabolites enter the liver to activate the inflammation associated signalling pathways, and flow into the systemic circulation to form endotoxemia, which jointly promote the progress of chronic liver diseases and hepatocellular carcinoma. Currently, therapeutic strategies aiming at gut microbiota for the treatment of chronic liver diseases and hepatocellular carcinoma include rational administration of antibiotics, probiotics or prebiotics, and fecal microbiota transplantation. This paper reviews the potential role and clinical significance of gut microbiota in chronic liver diseases and hepatocellular carcinoma.
Key words:  gut microbiota  chronic liver diseases  hepatocellular carcinoma  probiotics  fecal microbiota transplantation