微生物-肠-肝轴与酒精性肝病及其营养干预研究进展

Research Progress in Microbe-Gut-Liver Axis and Alcoholic Liver Disease and Nutritional Interventions for It

酒精性肝病(alcoholic liver disease,ALD)是全球最普遍的慢性肝病类型,早期表现为脂肪肝,进而演变成脂肪性肝炎,随着饮酒时间延长会发展成肝纤维化和肝硬化。肠-肝轴是指肠道及其微生物群与肝脏之间的双向作用,由门静脉和胆道建立。酒精会破坏这一双向作用,导致肠道微生物群紊乱和病原体易位到肝脏,造成肝损伤。本文以肠道屏障、肠道微生物组成、肠道微生物成分和肠道微生物代谢产物为主,综述了肠-肝轴介导ALD发生发展的作用机制以及ALD的营养干预措施,尤其是靶向噬菌体干预肠道微生物群以及三甲胺、溶细胞素、念珠菌溶素在ALD中的作用,以期为以肠-肝轴为靶点抗ALD功能物质的发现、营养干预和功能性食品的开发提供基础。

Alcoholic liver disease(ALD)is the most common type of chronic liver disease worldwide,manifesting as fatty liver at the early stage,and then evolving into steatohepatitis.ALD can further develop into liver fibrosis and cirrhosis with increasing alcohol consumption.The gut-liver axis refers to the bidirectional interaction between the gut and its microbiota and the liver,established through the portal vein and the biliary tract.Alcohol can disrupt this bidirectional effect,leading to the disturbance of the gut microbiota and the translocation of pathogens to the liver,and finally causing liver damage.In this article,the mechanism of action of the gut-liver axis in mediating the occurrence and development of ALD and the nutritional interventions for ALD are reviewed mainly from the following aspects:the intestinal barrier,intestinal microbial composition,and intestinal microbial metabolites.Particular focus is placed on the intervention of targeted phages in the gut microbiota and the role of trimethylamine,cytolysin and candidin in ALD.It is our hope that this review will provide basic data for the discovery of anti-ALD substances targeting the gut-liver axis and for the development of new nutritional interventions and functional foods.