Andreas H Lange, Miriam G Pedersen, Anne-Marie Ellegaard, Henriette H Nerild, Andreas Brønden, David P Sonne, Filip K Knop
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引用次数: 0
摘要
胆石症和胆囊炎影响着各个年龄段的人,通常通过手术切除胆囊(胆囊切除术)来治疗,这被认为是一种安全、低风险的手术。然而,最近的研究结果表明,胆汁及其调节储存和排泄可能会对新陈代谢产生重要影响,胆囊切除术术后与多种新陈代谢疾病相关。众所周知,胆汁酸是同化脂质和吸收脂溶性维生素所必需的乳化剂,但最近也有报道称胆汁酸是代谢信号转导物。核受体法尼类固醇 X 受体(FXR)和 G 蛋白偶联膜受体武田 G 蛋白偶联受体 5(TGR5)对胆汁酸具有特异性。通过激活这些受体,胆汁酸可控制多种代谢功能。胆囊切除术会影响胆汁酸的储存和排泄,进而影响 FXR 和 TGR5 的活化及其对新陈代谢的影响,包括导致代谢功能障碍相关性脂肪肝和代谢综合征等代谢疾病的过程。在此,为了阐明胆囊切除术相关代谢紊乱背后的机制,我们回顾了可能将胆囊切除术和胆汁酸介导的代谢效应联系起来的研究,并讨论了胆囊切除术相关代谢紊乱背后可能的病理生理机制。
The bile-gut axis and metabolic consequences of cholecystectomy.
Cholelithiasis and cholecystitis affect individuals of all ages and are often treated by surgical removal of the gallbladder (cholecystectomy), which is considered a safe, low-risk procedure. Nevertheless, recent findings show that bile and its regulated storage and excretion may have important metabolic effects and that cholecystectomy is associated with several metabolic diseases postoperatively. Bile acids have long been known as emulsifiers essential to the assimilation of lipids and absorption of lipid-soluble vitamins, but more recently, they have also been reported to act as metabolic signaling agents. The nuclear receptor, farnesoid X receptor (FXR), and the G protein-coupled membrane receptor, Takeda G protein-coupled receptor 5 (TGR5), are specific to bile acids. Through activation of these receptors, bile acids control numerous metabolic functions. Cholecystectomy affects the storage and excretion of bile acids, which in turn may influence the activation of FXR and TGR5 and their effects on metabolism including processes leading to metabolic conditions such as metabolic dysfunction-associated steatotic liver disease and metabolic syndrome. Here, with the aim of elucidating mechanisms behind cholecystectomy-associated dysmetabolism, we review studies potentially linking cholecystectomy and bile acid-mediated metabolic effects and discuss possible pathophysiological mechanisms behind cholecystectomy-associated dysmetabolism.
期刊介绍:
European Journal of Endocrinology is the official journal of the European Society of Endocrinology. Its predecessor journal is Acta Endocrinologica.
The journal publishes high-quality original clinical and translational research papers and reviews in paediatric and adult endocrinology, as well as clinical practice guidelines, position statements and debates. Case reports will only be considered if they represent exceptional insights or advances in clinical endocrinology.
Topics covered include, but are not limited to, Adrenal and Steroid, Bone and Mineral Metabolism, Hormones and Cancer, Pituitary and Hypothalamus, Thyroid and Reproduction. In the field of Diabetes, Obesity and Metabolism we welcome manuscripts addressing endocrine mechanisms of disease and its complications, management of obesity/diabetes in the context of other endocrine conditions, or aspects of complex disease management. Reports may encompass natural history studies, mechanistic studies, or clinical trials.
Equal consideration is given to all manuscripts in English from any country.