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Abstract：
Autoimmune hepatitis (AIH) is a chronic inflammatory disease of the liver that is mediated by autoimmunity and has complex pathogenesis. Its prevalence has increased globally. Since the liver is the first organ to be exposed to harmful substances, such as gut-derived intestinal microbiota and its metabolites, gut health is closely related to liver health, and the \"liver-gut axis\" allows abnormalities in the gut microbiota to influence the development of liver-related diseases such as AIH. Changes in the composition of the intestinal microbiota and its resultant disruption of the intestinal barrier and microbial transport are involved in multiple ways in the disruption of immune homeostasis and inflammation, thereby influencing the development of AIH. In terms of the mechanisms involved in immune, the gut microbiota or its metabolites, which is decreased in secondary bile acids, short-chain fatty acids (SCFAs), and polyamines, and increased in lipopolysaccharide (LPS), branched-chain amino acids (BCAA), tryptophan metabolite, amino acid, and bile acid, can disrupt immune homeostasis by activating various immune cells and immune-related signaling pathways, resulting in aberrant activation of the immune system. Clarifying this mechanism has significant clinical implications for the treatment of AIH with drugs that target intestinal microbiota and related signaling pathways. Therefore, this narrative review summarizes the progress in exploring the involvement of gut microbiota in the pathogenesis of AIH, with the aim of helping to improve the precise targeting of therapeutic treatments against AIH for the benefit of clinical AIH treatment.
摘要：
自身免疫性肝炎(AIH)是一种由自身免疫介导的肝脏慢性炎症性疾病,发病机制复杂。其患病率在全球范围内有所增加。由于肝脏是第一个接触有害物质的器官，如肠道微生物群及其代谢产物，肠道健康与肝脏健康密切相关,和“肝肠轴”允许肠道微生物群的异常影响肝脏相关疾病的发展，如AIH。肠道微生物群组成的变化及其对肠屏障和微生物运输的破坏以多种方式参与免疫稳态和炎症的破坏，从而影响AIH的发展。就涉及免疫的机制而言，肠道微生物群或其代谢物，次级胆汁酸减少，短链脂肪酸（SCFA），和多胺，并增加脂多糖（LPS），支链氨基酸（BCAA），色氨酸代谢产物,氨基酸,和胆汁酸，可以通过激活各种免疫细胞和免疫相关的信号通路来破坏免疫稳态，导致免疫系统的异常激活。阐明这种机制对于使用靶向肠道微生物群和相关信号通路的药物治疗AIH具有重要的临床意义。因此,本文综述了肠道菌群参与AIH发病机制的研究进展,目的是帮助改善针对AIH的治疗性治疗的精确靶向性，以使临床AIH治疗受益。
