The role of the microbiome in liver disease.

IF 2.6 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Current Opinion in Gastroenterology Pub Date : 2024-05-01 Epub Date: 2024-02-16 DOI:10.1097/MOG.0000000000001013

David Schöler, Bernd Schnabl

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Abstract

Purpose of review: The intestinal microbiome and the gut-liver axis play a major role in health and disease. The human gut harbors trillions of microbes and a disruption of the gut homeostasis can contribute to liver disease. In this review, the progress in the field within the last 3 years is summarized, focusing on metabolic dysfunction-associated steatotic liver disease (MASLD), alcohol-associated liver disease (ALD), autoimmune liver disease (AILD), and hepatocellular carcinoma (HCC).

Recent findings: Changes in the fecal virome and fungal mycobiome have been described in patients with various liver diseases. Several microbial derived metabolites including endogenous ethanol produced by bacteria, have been mechanistically linked to liver disease such as MASLD. Virulence factors encoded by gut bacteria contribute to ALD, AILD and HCC. Novel therapeutic approaches focused on the microbiome including phages, pre- and postbiotics have been successfully used in preclinical models. Fecal microbiota transplantation has been effective in attenuating liver disease. Probiotics are safe in patients with alcohol-associated hepatitis and improve liver disease and alcohol addiction.

Summary: The gut-liver axis plays a key role in the pathophysiology of liver diseases. Understanding the microbiota in liver disease can help to develop precise microbiota centered therapies.

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微生物组在肝病中的作用。

综述的目的：肠道微生物群和肠道-肝脏轴在健康和疾病中发挥着重要作用。人类肠道中蕴藏着数万亿的微生物，肠道平衡的破坏可导致肝脏疾病。在这篇综述中，我们总结了过去三年中该领域的研究进展，重点关注代谢功能障碍相关性脂肪性肝病（MASLD）、酒精相关性肝病（ALD）、自身免疫性肝病（AILD）和肝细胞癌（HCC）：最近的研究结果：各种肝病患者的粪便病毒组和真菌微生物组都发生了变化。包括细菌产生的内源性乙醇在内的几种微生物衍生代谢物与 MASLD 等肝病存在机理联系。肠道细菌编码的病毒因子可导致 ALD、AILD 和 HCC。以微生物组为重点的新型治疗方法，包括噬菌体、生前和生后药已成功用于临床前模型。粪便微生物群移植在减轻肝病方面很有效。益生菌对酒精相关性肝炎患者是安全的，并能改善肝病和酒瘾。了解肝病中的微生物群有助于开发以微生物群为中心的精确疗法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Gastroenterology 医学-胃肠肝病学

CiteScore

5.30

自引率

0.00%

发文量

137

审稿时长

6-12 weeks

期刊介绍： Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Gastroenterology features hand-picked review articles from our team of expert editors. With twelve disciplines published across the year – including gastrointestinal infections, nutrition and inflammatory bowel disease – every issue also contains annotated references detailing the merits of the most important papers.

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