肝硬化患者肠道屏障与细菌易位的关系

李佩波; 秦凡博; 龚建平

doi:10.3969/j.issn.1001-5256.2019.08.046

肝硬化患者肠道屏障与细菌易位的关系

DOI: 10.3969/j.issn.1001-5256.2019.08.046

重庆市秀山县人民医院感染科
重庆医科大学附属第二医院肝胆外科

基金项目:

重庆市卫生计生委医学科研项目(2018MSXM048)；

详细信息

中图分类号: R575.2
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- 被引次数: 0
出版历程
- 收稿日期: 2019-04-08
- 出版日期: 2019-08-20

Association between intestinal barrier and bacterial translocation in patients with liver cirrhosis

Department of Infectious Diseases, The People's Hospital of Xiushan County

Research funding:

摘要

摘要: 失代偿期肝硬化常并发多种威胁生命的并发症,如自发性细菌性腹膜炎、肝性脑病、脓毒症等,而肝硬化并发症的发生与细菌易位有着密切的关系。肝硬化患者发生病理性细菌易位的原因在于肠道屏障功能受损,导致细菌能够穿越肠道屏障进入肠系膜淋巴结或其他部位。因此,更好地理解肝硬化时肠道屏障与细菌易位的关系,将会为肝硬化的治疗提供新的理论支持。主要讨论了肠道屏障的4个主要构成成份,即肠道的机械屏障、免疫屏障、化学屏障、生物屏障,以及它们各自在肝硬化细菌易位时发生的变化。
- 肝硬化 /
- 细菌移位 /
- 胃肠道微生物组
Abstract: Decompensated liver cirrhosis has various life-threatening complications such as spontaneous bacterial peritonitis, hepatic encephalopathy, and sepsis, and the development of such complications is closely associated with bacterial translocation. Pathological bacterial translocation in patients with liver cirrhosis is caused by the impairment of intestinal barrier function, and thus bacteria can cross the intestinal barrier and enter the mesenteric lymph nodes or other sites. Therefore, a better understanding of the association between intestinal barrier and bacterial translocation in liver cirrhosis can provide new theoretical support for the treatment of liver cirrhosis. This article discusses the four major components of the intestinal barrier, namely the mechanical barrier, the immune barrier, the chemical barrier, and the biological barrier, as well as their changes during bacterial translocation.
- liver cirrhosis /
- bacterial translocation /
- gastrointestinal microbiome

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参考文献(31)

[1] LIU JQ, ZHOU SM. Research advances in intestinal flora in nonalcoholic fatty liver disease[J]. J Clin Hepatol, 2017, 33 (12) :2453-2456. (in Chinese) 刘嘉琪, 周少明.非酒精性脂肪性肝病肠道菌群的研究进展[J].临床肝胆病杂志, 2017, 33 (12) :2453-2456.

[2] WIEST R, LAWSON M, GEUKING M. Pathological bacterial translocation in liver cirrhosis[J]. J Hepatol, 2014, 60 (1) :197-209.

[3] OIKONOMOU T, PAPATHEODORIDIS GV, SAMARKOS M, et al. Clinical impact of microbiome in patients with decompensated cirrhosis[J]. World J Gastroenterol, 2018, 24 (34) :3813-3820.

[4] ZHANG J, FENG Z, LIU P, et al. Research advances in the association between gut microbiota and complications after liver transplantation[J]. Ogran Transplantation, 2017, 8 (5) :399-401. (in Chinese) 张静, 冯哲, 刘鹏, 等.肠道菌群与肝移植相互作用研究进展[J].器官移植, 2017, 8 (5) :399-401.

[5] LU BJ, ZHAO YH, AN YT, et al. Research advances in gut microbiota in liver cirrhosis and related complications[J]. J Clin Hepatol, 2018, 34 (11) :2433-2437. (in Chinese) 鲁冰洁, 赵亚红, 安泳潼, 等.肠道微生物在肝硬化及相关并发症中的研究进展[J].临床肝胆病杂志, 2018, 34 (11) :2433-2437.

[6] SPADONI I, ZAGATO E, BERTOCCHI A, et al. A gut-vascular barrier controls the systemic dissemination of bacteria[J].Science, 2015, 350 (6262) :830-834.

[7] FOUTS DE, TORRALBA M, NELSON KE, et al. Bacterial translocation and changes in the intestinal microbiome in mouse models of liver disease[J]. J Hepatol, 2012, 56 (6) :1283-1292.

[8] ASSIMAKOPOULOS SF, TSAMANDAS AC, TSIAOUSSIS GI, et al. Altered intestinal tight junctions’expression in patients with liver cirrhosis:A pathogenetic mechanism of intestinal hyperpermeability[J]. Eur J Clin Invest, 2012, 42 (4) :439-446.

[9] KARTHIKEYAN A, MOHAN P, CHINNAKALI P, et al. Elevated systemic zonula occludens 1 is positively correlated with inflammation in cirrhosis[J]. Clin Chim Acta, 2018, 480:193-198.

[10] RAPARELLI V, BASILI S, CARNEVALE R, et al. Low-grade endotoxemia and platelet activation in cirrhosis[J]. Hepatology, 2017, 65 (2) :571-581.

[11] RAM AK, POTTAKAT B, VAIRAPPAN B. Increased systemic zonula occludens 1 associated with inflammation and independent biomarker in patients with hepatocellular carcinoma[J]. BMC Cancer, 2018, 18 (1) :572.

[12] ARAB JP, MARTIN-MATEOS RM, SHAH VH. Gut-liver axis, cirrhosis and portal hypertension:The chicken and the egg[J]. Hepatol Int, 2018, 12 (Suppl 1) :24-33.

[13] TSIAOUSSIS GI, PAPAIOANNOU EC, KOUREA EP, et al. Expression ofα-defensins, CD20+B-lymphocytes, and intraepithelial CD3+T-lymphocytes in the intestinal mucosa of patients with liver cirrhosis:Emerging mediators of intestinal barrier function[J]. Dig Dis Sci, 2018, 63 (10) :2582-2592.

[14] SHI H, LV L, CAO H, et al. Bacterial translocation aggravates CCl4-induced liver cirrhosis by regulating CD4+T cells in rats[J]. Sci Rep, 2017, 7:40516.

[15] WANG S, CHARBONNIER LM, NOVAL RIVAS M, et al. My D88adaptor-dependent microbial sensing by regulatory T cells promotes mucosal tolerance and enforces commensalism[J]. Immunity, 2015, 43 (2) :289-303.

[16] MUOZ L, BORRERO MJ, U'BEDA M, et al. Intestinal immune dysregulation driven by dysbiosis promotes barrier disruption and bacterial translocation in rats with cirrhosis[J]. Hepatology, 2018.[Epub ahead of print]

[17] HARTMANN P, CHEN P, WANG HJ, et al. Deficiency of intestinal mucin-2 ameliorates experimental alcoholic liver disease in mice[J]. Hepatology, 2013, 58 (1) :108-119.

[18] TELTSCHIK Z, WIEST R, BEISNER J, et al. Intestinal bacterial translocation in rats with cirrhosis is related to compromised Paneth cell antimicrobial host defense[J]. Hepatology, 2012, 55 (4) :1154-1163.

[19] WANG J, HUANG N, XIONG J, et al. Caprylic acid and nonanoic acid upregulate endogenous host defense peptides to enhance intestinal epithelial immunological barrier function via histone deacetylase inhibition[J]. Int Immunopharmacol, 2018, 65:303-311.

[20] U'BEDA M, LARIO M, MUOZ L, et al. Obeticholic acid reduces bacterial translocation and inhibits intestinal inflammation in cirrhotic rats[J]. J Hepatol, 2016, 64 (5) :1049-1057.

[21] SINGH J, METRANI R, SHIVANAGOUDRA SR, et al. Review on bile acids:Effects of the gut microbiome, interactions with dietary fiber, and alterations in the bioaccessibility of bioactive compounds[J]. J Agric Food Chem, 2019.[Epub ahead of print]

[22] LU LG, HU JF. Research advances in the association between gut microbiota and bile acid[J]. J Intern Med Concepts Pract, 2018, 13 (6) :329-333. (in Chinese) 陆伦根, 胡江峰.肠道菌群与胆汁酸的研究进展[J].内科理论与实践, 2018, 13 (6) :329-333.

[23] KAKIYAMA G, PANDAK WM, GILLEVET PM, et al. Modulation of the fecal bile acid profile by gut microbiota in cirrhosis[J]. J Hepatol, 2013, 58 (5) :949-955.

[24] GIANNELLI V, DI GREGORIO V, IEBBA V, et al. Microbiota and the gut-liver axis:Bacterial translocation, inflammation and infection in cirrhosis[J]. World J Gastroenterol, 2014, 20 (45) :16795-16810.

[25] RIDLON JM, ALVES JM, HYLEMON PB, et al. Cirrhosis, bile acids and gut microbiota:Unraveling a complex relationship[J]. Gut Microbes. 2013. 4 (5) :382-387.

[26] BAJAJ JS, HEUMAN DM, HYLEMON PB, et al. Altered profile of human gut microbiome is associated with cirrhosis and its complications[J]. J Hepatol, 2014, 60 (5) :940-947.

[27] SARANGI AN, GOEL A, SINGH A, et al. Faecal bacterial microbiota in patients with cirrhosis and the effect of lactulose administration[J]. BMC Gastroenterol, 2017, 17 (1) :125.

[28] MASLENNIKOV R, PAVLOV C, IVASHKIN V. Small intestinal bacterial overgrowth in cirrhosis:Systematic review and meta-analysis[J]. Hepatol Int, 2018, 12 (6) :567-576.

[29] THEOCHARIDOU E, DHAR A, PATCH D. Gastrointestinal motility disorders and their clinical implications in cirrhosis[J].Gastroenterol Res Pract, 2017, 2017:8270310.

[30] TETZ GV, RUGGLES KV, ZHOU H, et al. Bacteriophages as potential new mammalian pathogens[J]. Sci Rep, 2017, 7 (1) :7043.

[31] YANG AM, INAMINE T, HOCHRATH K, et al. Intestinal fungi contribute to development of alcoholic liver disease[J]. J Clin Invest, 2017, 127 (7) :2829-2841.

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