以肠道菌群为靶点治疗原发性胆汁性胆管炎的临床应用
DOI: 10.3969/j.issn.1001-5256.2023.01.029
利益冲突声明:所有作者均声明不存在利益冲突。
作者贡献声明:马铭涵负责撰写文章及修改;刘彦琦负责指导及校正。
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摘要: 原发性胆汁性胆管炎(PBC)是一种以胆管上皮细胞为特征性靶标的进行性胆汁淤积性肝病。“疾病肠治”是近年的研究热点。未来或可通过益生菌改善肠道菌群丰度及分布,重塑肠道微环境,进而干预PBC疾病进展。本文从肠道菌群角度及益生菌的临床应用方面进行综述,为PBC寻找新的治疗策略提供思路。Abstract: Primary biliary cholangitis (PBC) is a progressive cholestatic liver disease targeting biliary epithelial cells, and the concept of "treating diseases by intervening with the gut" has become a research hotspot in recent years. In the future, probiotics may be used to improve the abundance and distribution of intestinal flora, reshape the intestinal microenvironment, and intervene against the progression of PBC. This article reviews the gut microbiota and the clinical application of probiotics, so as to provide ideas for finding new treatment strategies for PBC.
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Key words:
- Liver Cirrhosis, Biliary /
- Gastrointestinal Microbiome /
- Therapeutics
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[1] YOU H, MA X, EFE C, et al. APASL clinical practice guidance: the diagnosis and management of patients with primary biliary cholangitis[J]. Hepatol Int, 2022, 16(1): 1-23. DOI: 10.1007/s12072-021-10276-6. [2] GULAMHUSEIN AF, HIRSCHFIELD GM. Primary biliary cholangitis: pathogenesis and therapeutic opportunities[J]. Nat Rev Gastroenterol Hepatol, 2020, 17(2): 93-110. DOI: 10.1038/s41575-019-0226-7. [3] Chinese Society of Hepatology, Chinese Medical Association. Guidelines on the diagnosis and management of primary biliary cholangitis(2021)[J]. J Clin Hepatol, 2022, 38(1): 35-41. DOI: 10.3760/cma.j.cn112138-20211112-00794中华医学会肝病学分会. 原发性胆汁性胆管炎的诊断和治疗指南(2021)[J]. 临床肝胆病杂志, 2022, 38(1): 35-41. DOI: 10.3760/cma.j.cn112138-20211112-00794 [4] SHIMOYAMA S, KAWATA K, OHTA K, et al. Ursodeoxycholic acid impairs liver-infiltrating T-cell chemotaxis through IFN-γ and CX3CL1 production in primary biliary cholangitis[J]. Eur J Immunol, 2021, 51(6): 1519-1530. DOI: 10.1002/eji.202048589. [5] European Association for the Study of the Liver. EASL Clinical Practice Guidelines on non-invasive tests for evaluation of liver disease severity and prognosis - 2021 update[J]. J Hepatol, 2021, 75(3): 659-689. DOI: 10.1016/j.jhep.2021.05.025. [6] ZENG Y, CHEN S, FU Y, et al. Gut microbiota dysbiosis in patients with hepatitis B virus-induced chronic liver disease covering chronic hepatitis, liver cirrhosis and hepatocellular carcinoma[J]. J Viral Hepat, 2020, 27(2): 143-155. DOI: 10.1111/jvh.13216. [7] XIAO LY, XING AW, TAN SZ. Research advances in the association between liver failure and intestinal barrier injury[J]. J Clin Hepatol, 2021, 37(11): 2710-2714. DOI: 10.3969/j.issn.1001-5256.2021.11.049.肖玲燕, 邢阿雯, 谭善忠. 肝衰竭与肠道屏障损害关系的研究进展[J]. 临床肝胆病杂志, 2021, 37(11): 2710-2714. DOI: 10.3969/j.issn.1001-5256.2021.11.049. [8] GIORDANO DM, PINTO C, MARONI L, et al. Inflammation and the gut-liver axis in the pathophysiology of cholangiopathies[J]. Int J Mol Sci, 2018, 19(10): 3003. DOI: 10.3390/ijms19103003. [9] MA HD, ZHAO ZB, MA WT, et al. Gut microbiota translocation promotes autoimmune cholangitis[J]. J Autoimmun, 2018, 95: 47-57. DOI: 10.1016/j.jaut.2018.09.010. [10] LI Y, TANG R, LEUNG P, et al. Bile acids and intestinal microbiota in autoimmune cholestatic liver diseases[J]. Autoimmun Rev, 2017, 16(9): 885-896. DOI: 10.1016/j.autrev.2017.07.002. [11] GRAHAM JJ, MUKHERJEE S, YUKSEL M, et al. Aberrant hepatic trafficking of gut-derived T cells is not specific to primary sclerosing cholangitis[J]. Hepatology, 2022, 75(3): 518-530. DOI: 10.1002/hep.32193. [12] LI B, SELMI C, TANG R, et al. The microbiome and autoimmunity: a paradigm from the gut-liver axis[J]. Cell Mol Immunol, 2018, 15(6): 595-609. DOI: 10.1038/cmi.2018.7. [13] MORO-SIBILOT L, BLANC P, TAILLARDET M, et al. Mouse and human liver contain immunoglobulin a-secreting cells originating from peyer's patches and directed against intestinal antigens[J]. Gastroenterology, 2016, 151(2): 311-323. DOI: 10.1053/j.gastro.2016.04.014. [14] LLEO A, LEUNG P, HIRSCHFIELD GM, et al. The pathogenesis of primary biliary cholangitis: A comprehensive review[J]. Semin Liver Dis, 2020, 40(1): 34-48. DOI: 10.1055/s-0039-1697617. [15] YANG Y, CHOI J, CHEN Y, et al. E. coli and the etiology of human PBC: Antimitochondrial antibodies and spreading determinants[J]. Hepatology, 2022, 75(2): 266-279. DOI: 10.1002/hep.32172. [16] TANAKA A, LEUNG P, GERSHWIN ME. Pathogen infections and primary biliary cholangitis[J]. Clin Exp Immunol, 2019, 195(1): 25-34. DOI: 10.1111/cei.13198. [17] BERTOLINI A, FIOROTTO R, STRAZZABOSCO M. Bile acids and their receptors: modulators and therapeutic targets in liver inflammation[J]. Semin Immunopathol, 2022, 44(4): 547-564. DOI: 10.1007/s00281-022-00935-7. [18] MAYO MJ. Mechanisms and molecules: What are the treatment targets for primary biliary cholangitis?[J]. Hepatology, 2022, 76(2): 518-531. DOI: 10.1002/hep.32405. [19] XIANG J, ZHANG Z, XIE H, et al. Effect of different bile acids on the intestine through enterohepatic circulation based on FXR[J]. Gut Microbes, 2021, 13(1): 1949095. DOI: 10.1080/19490976.2021.1949095. [20] TANG R, WEI Y, LI Y, et al. Gut microbial profile is altered in primary biliary cholangitis and partially restored after UDCA therapy[J]. Gut, 2018, 67(3): 534-541. DOI: 10.1136/gutjnl-2016-313332. [21] SUN L, CAI J, GONZALEZ FJ. The role of farnesoid X receptor in metabolic diseases, and gastrointestinal and liver cancer[J]. Nat Rev Gastroenterol Hepatol, 2021, 18(5): 335-347. DOI: 10.1038/s41575-020-00404-2. [22] LI B, ZHANG J, CHEN Y, et al. Alterations in microbiota and their metabolites are associated with beneficial effects of bile acid sequestrant on icteric primary biliary cholangitis[J]. Gut Microbes, 2021, 13(1): 1946366. DOI: 10.1080/19490976.2021.1946366. [23] CHEN W, WEI Y, XIONG A, et al. Comprehensive analysis of serum and fecal bile acid profiles and interaction with gut microbiota in primary biliary cholangitis[J]. Clin Rev Allergy Immunol, 2020, 58(1): 25-38. DOI: 10.1007/s12016-019-08731-2. [24] SEHGAL R, BEDI O, TREHANPATI N. Role of microbiota in pathogenesis and management of viral hepatitis[J]. Front Cell Infect Microbiol, 2020, 10: 341. DOI: 10.3389/fcimb.2020.00341. [25] MASLENNIKOV R, IVASHKIN V, EFREMOVA I, et al. Probiotics in hepatology: An update[J]. World J Hepatol, 2021, 13(9): 1154-1166. DOI: 10.4254/wjh.v13.i9.1154. [26] FOLEY MH, O'FLAHERTY S, ALLEN G, et al. Lactobacillus bile salt hydrolase substrate specificity governs bacterial fitness and host colonization[J]. Proc Natl Acad Sci U S A, 2021, 118(6): e2017709118. DOI: 10.1073/pnas.2017709118. [27] LIU Y, CHEN K, LI F, et al. Probiotic lactobacillus rhamnosus GG prevents liver fibrosis through inhibiting hepatic bile acid synthesis and enhancing bile acid excretion in mice[J]. Hepatology, 2020, 71(6): 2050-2066. DOI: 10.1002/hep.30975. [28] QI JC, XING WJ, DU Y, et al. Effect of ursodeoxycholic acid and microecological agents on intestinal flora in patients with primary biliary cholangitis[J]. J Pract Hepatol, 2020, 23(4): 524-527. DOI: 10.3969/j.issn.1672-5069.2020.04.018.齐敬聪, 邢文静, 杜洋, 等. 熊去氧胆酸联合微生态制剂治疗原发性胆汁性胆管炎患者对肠道菌群的影响[J]. 实用肝脏病杂志, 2020, 23(4): 524-527. DOI: 10.3969/j.issn.1672-5069.2020.04.018. -

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