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Alcohol-associated bowel disease: new insights into pathogenesis. 酒精相关肠道疾病:发病机制的新见解
Pub Date : 2023-06-01 DOI: 10.1136/egastro-2023-100013
Luca Maccioni, Yaojie Fu, Yves Horsmans, Isabelle Leclercq, Peter Stärkel, George Kunos, Bin Gao

Excessive alcohol drinking can cause pathological changes including carcinogenesis in the digestive tract from mouth to large intestine, but the underlying mechanisms are not fully understood. In this review, we discuss the effects of alcohol on small and large intestinal functions, such as leaky gut, dysbiosis and alterations of intestinal epithelium and gut immune dysfunctions, commonly referred to as alcohol-associated bowel disease (ABD). To date, detailed mechanistic insights into ABD are lacking. Accumulating evidence suggests a pathogenic role of ethanol metabolism in dysfunctions of the intestinal tract. Ethanol metabolism generates acetaldehyde and acetate, which could potentially promote functional disruptions of microbial and host components of the intestinal barrier along the gastrointestinal tract. The potential involvement of acetaldehyde and acetate in the pathogenesis of the underlying ABD, including cancer, is discussed. We also highlight some gaps in knowledge existing in the field of ABD. Finally, we discuss future directions in exploring the role of acetaldehyde and acetate generated during chronic alcohol intake in various pathologies affecting different sites of the intestinal tract.

过量饮酒可引起从口腔到大肠的消化道癌变等病理变化,但其潜在机制尚不完全清楚。在这篇综述中,我们讨论了酒精对小肠和大肠功能的影响,如肠漏、生态失调、肠上皮改变和肠道免疫功能障碍,通常被称为酒精相关肠病(ABD)。到目前为止,还缺乏对ABD的详细机制的了解。越来越多的证据表明乙醇代谢在肠道功能障碍中的致病作用。乙醇代谢产生乙醛和乙酸,这可能会促进胃肠道肠道屏障微生物和宿主成分的功能破坏。讨论了乙醛和醋酸盐在潜在ABD(包括癌症)发病机制中的潜在作用。我们还强调了ABD领域存在的一些知识空白。最后,我们讨论了探索慢性酒精摄入过程中产生的乙醛和乙酸在影响肠道不同部位的各种病理中的作用的未来方向。
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