肠-肝轴与非酒精性脂肪性肝病

Gut-liver axis and non-alcoholic fatty liver disease

肠道菌群组成和数量的改变影响宿主的能量代谢、免疫应答和炎症反应状态。非酒精性脂肪性肝病患者常伴有小肠细菌过度生长或某些菌群种类和数量的改变,以及肠道黏膜通透性增加。肠道细菌通过增强肝脏脂肪合成、诱导机体胰岛素抵抗、激活天然免疫系统相关分子模式等机制,诱发肝脏炎症反应,启动纤维化进程,促进单纯性脂肪变向脂肪性肝炎发展。鉴定影响机体能量代谢和炎症反应的肠道菌群及其产物将为阐明肠-肝轴对肝脏炎症发生、发展所起的作用奠定基础,为揭示非酒精性脂肪性肝病发生、发展的机制开辟新思路,为该病的防治探索新策略。

Changes in phylotypes and composition of intestinal bacterial community affect host metabolism , inflammatory and immunogenic responses .In non-alcoholic fatty liver disease （NAFLD） ,small intestinal bacterial overgrowth , changes in colony composition and quantity , and increased intestinal permeability promote the development of liver inflammation and fibrogenesis through enhancing hepatic lipogenesis , causing insulin resistance and stimulating innate immune response .Identification of specific bacterial species and their products that alter metabolic status and cause sustained but low-grade inflammatory and immune responses will advance our understanding of the critical role of “gut-liver axis” in promoting the initiation and progression of non-alcoholic steatohepatitis （NASH ） ,and explore novel therapeutic strategies for its prevention and treatment .