肝硬化门静脉高压症的肠道微生物群和代谢物:治疗调节的新靶点。

IF 6.9 2区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Journal of Gastroenterology Pub Date : 2024-09-01 Epub Date: 2024-07-19 DOI:10.1007/s00535-024-02134-7
Yarong Hao, Zhiyuan Hao, Xin Zeng, Yong Lin
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引用次数: 0

摘要

背景:肠道微生物群和肠道衍生代谢物通过肠道-肝脏轴在肝硬化门脉高压症(PH)发病中的调控作用日益受到关注:方法:该综述总结了一系列关于微生物群代谢产物和针对微生物群的药物(包括利福昔明、VSL#3、他汀类药物、普萘洛尔、FXR 激动剂以及胆汁酸(BA)衍生药物)对 PH 进展影响的研究:结果:PH 患者的肠道微生物丰富度和整体微生物群落差异发生了改变,一些结果清楚地表明 PH 与 Veillonella dispar 的富集或 Clostridiales、Peptostreptococcaceae、Alistipes putredinis、Roseburia faecis 和 Clostridium cluster IV 的减少相关。肠道来源的代谢物包括硫化氢、色氨酸代谢物、丁酸、次级生物碱和苯乙酸(PAA),它们通过调节与 PH 的形成和发展相关的肝内血管阻力和门静脉血流,参与 PH 的一系列病理生理学过程。通过调节肠道炎症、脾动脉血管扩张和内皮功能障碍,针对细菌转运和肠道濡养的成熟药物和新兴药物逐渐被确定为治疗肝硬化和 PH 的潜在策略:未来的探索应进一步描述 PH 中粪便微生物组和代谢物特征的改变,并阐明 PH 所涉及的肠道微生物组、肠道衍生代谢物和肠道微生物组靶向药物治疗的调控机制。
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Gut microbiota and metabolites of cirrhotic portal hypertension: a novel target on the therapeutic regulation.

Background: The regulatory role of gut microbiota and gut-derived metabolites through the gut-liver axis in the development of cirrhotic portal hypertension (PH) has received increasing attention.

Methods: The review summarized a series of investigations on effects of metabolites derived from microbiota and medicines targeting microbiome including rifaximin, VSL#3, statins, propranolol, FXR agonists as well as drugs derived from bile acids (BAs) on PH progression.

Results: Patients with PH exhibit alterations in gut microbial richness and differential overall microbiota community, and several results clearly displayed the correlation of PH with enrichment of Veillonella dispar or depletion of Clostridiales, Peptostreptococcaceae, Alistipes putredinis, Roseburia faecis and Clostridium cluster IV. The gut-derived metabolites including hydrogen sulfide, tryptophan metabolites, butyric acid, secondary BAs and phenylacetic acid (PAA) participate in a range of pathophysiology process of PH through modulating intrahepatic vascular resistance and portal blood flow associated with the formation and progression of PH. Established and emerging drugs targeting on bacterial translocation and intestinal eubiosis are gradually identified as potential strategies for treatments of liver cirrhosis and PH by modulating intestinal inflammation, splanchnic arterial vasodilation and endothelial dysfunction.

Conclusions: Future explorations should further characterize the alteration of the fecal microbiome and metabolite profiles in PH and elucidate the regulatory mechanism of the intestinal microbiome, gut-derived metabolites and gut microbiota targeted pharmaceutical treatments involved in PH.

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来源期刊
Journal of Gastroenterology
Journal of Gastroenterology 医学-胃肠肝病学
CiteScore
12.20
自引率
1.60%
发文量
99
审稿时长
4-8 weeks
期刊介绍: The Journal of Gastroenterology, which is the official publication of the Japanese Society of Gastroenterology, publishes Original Articles (Alimentary Tract/Liver, Pancreas, and Biliary Tract), Review Articles, Letters to the Editors and other articles on all aspects of the field of gastroenterology. Significant contributions relating to basic research, theory, and practice are welcomed. These publications are designed to disseminate knowledge in this field to a worldwide audience, and accordingly, its editorial board has an international membership.
期刊最新文献
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