肠道菌群在非酒精性脂肪性肝病中的研究进展

Research progress of gut microbiota in non-alcoholic fatty liver disease

摘要:

非酒精性脂肪性肝病(non-alcoholic fatty liver disease, NAFLD)是全球最常见的慢性肝病，其疾病进展过程复杂。肠道菌群(gut microbiota, GM)在NAFLD的发病过程中起着重要作用，肠-肝轴理论为理解GM与肝脏之间的关系奠定了理论基础。GM失调可导致免疫功能紊乱及炎症反应、肠道屏障受损和胰岛素抵抗等，从而促进NAFLD的发生与发展。此外，GM还可通过内毒素血症、短链脂肪酸代谢异常、胆汁酸和胆碱代谢异常等机制参与NAFLD的发生发展。基于GM靶向治疗NAFLD已成为当前的研究重点，包括粪便菌群移植、补充益生菌或益生元、使用中草药以及生活方式干预等。本综述主要关注GM失调状态下对NAFLD的影响，并探讨GM靶向治疗NAFLD的研究进展，为NAFLD的预防和治疗提供了最新的策略和靶点。

Abstract:

Non-alcoholic fatty liver disease (NAFLD) is a common chronic liver disease around the world, and it has a complex disease progression. Recent studies have demonstrated that gut microbiota (GM) plays a crucial role in the pathogenesis of NAFLD. The theory of gut-liver axis provides a theoretical basis for understanding the relationship between GM and the liver. Dysbiosis of GM leads to immune dysfunction, inflammatory responses, damaged gut barrier, and insulin resistance, all of which promote the development and progression of NAFLD. Furthermore, GM can participate in the development and progression of NAFLD through endotoxemia and abnormal metabolism of short chain fatty acids, bile acids, and choline. How to mitigate NAFLD by modifying GM has become the focus of current research, and the measures include fecal microbiota transplantation, probiotics, prebiotics, Chinese herbal medicines, and lifestyle interventions. The review focuses on the impact of the pathological state of GM on NAFLD and discusses the research progress in GM-targeted therapy for NAFLD. It is expected to provide new strategies and targets for the prevention and treatment of NAFLD.