期刊
HEPATOLOGY INTERNATIONAL
卷 12, 期 -, 页码 S24-S33出版社
SPRINGER
DOI: 10.1007/s12072-017-9798-x
关键词
Gut-liver axis; Cirrhosis; Portal hypertension; Microbiota; Translocation; LPS; Endotoxemia; Bile acids
资金
- NIH, Clinical Core of the Mayo Clinic Center for Cell Signaling in Gastroenterology [DK59615, AA021171, P30DK084567]
- AASLD Foundation (AASLD/LIFER Clinical and Translational Research Fellowship in Liver Diseases)
- NATIONAL INSTITUTE OF DIABETES AND DIGESTIVE AND KIDNEY DISEASES [R01DK059615, P30DK084567] Funding Source: NIH RePORTER
- NATIONAL INSTITUTE ON ALCOHOL ABUSE AND ALCOHOLISM [R01AA021171, R37AA021171] Funding Source: NIH RePORTER
The term gut-liver axis is used to highlight the close anatomical and functional relationship between the intestine and the liver. The intestine has a highly specialized epithelial membrane which regulates transport across the mucosa. Due to dysbiosis, impairment of the intestinal barrier and altered immunity status, bacterial products can reach the liver through the portal vein, where they are recognized by specific receptors, activate the immune system and lead to a proinflammatory response. Gut microbiota and bacterial translocation play an important role in the pathogenesis of chronic liver diseases, including alcoholic and non-alcoholic fatty liver disease, cirrhosis, and its complications, such as portal hypertension, spontaneous bacterial peritonitis and hepatic encephalopaty. The gut microbiota also plays a critical role as a modulator of bile acid metabolism which can also influence intestinal permeability and portal hypertension through the farnesoid-X receptor. On the other hand, cirrhosis and portal hypertension affect the microbiota and increase translocation, leading to a chicken and egg situation, where translocation increases portal pressure, and vice versa. A myriad of therapies targeting gut microbiota have been evaluated specifically in patients with chronic liver disease. Further studies targeting intestinal microbiota and its possible hemodynamic and metabolic effects are needed. This review summarizes the current knowledge about the role of gut microbiota in the pathogenesis of chronic liver diseases and portal hypertension.
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