PDF(Pubmed)
Abstract：
Hepatic encephalopathy (HE) is a clinical manifestation of neurological and psychiatric abnormalities that are caused by complications of liver dysfunction including hyperammonemia, hyperuricemia, and portal hypertension. Accumulating evidence suggests that HE could be reversed through therapeutic modifications of gut microbiota. Multiple preclinical and clinical studies have indicated that gut microbiome affects the physiological function of the liver, such as the regulation of metabolism, secretion, and immunity, through the gut-liver crosstalk. In addition, gut microbiota also influences the brain through the gut-brain crosstalk, altering its physiological functions including the regulation of the immune, neuroendocrine, and vagal pathways. Thus, key molecules that are involved in the microbiota-gut-liver-brain axis might be able to serve as clinical biomarkers for early diagnosis of HE, and could be effective therapeutic targets for clinical interventions. In this review, we summarize the pathophysiology of HE and further propose approaches modulating the microbiota-gut-liver-brain axis in order to provide a comprehensive understanding of the prevention and potential clinical treatment for HE with a microbiota-targeted therapy.
摘要：
肝性脑病（HE）是由肝功能异常包括高氨血症的并发症引起的神经和精神异常的临床表现，高尿酸血症,和门静脉高压症。越来越多的证据表明，HE可以通过肠道微生物群的治疗修饰来逆转。多项临床前和临床研究表明，肠道菌群影响肝脏的生理功能，比如新陈代谢的调节，分泌，和豁免权,通过肠-肝串扰。此外,肠道微生物群也通过肠道-大脑串扰影响大脑，改变其生理功能，包括免疫调节，神经内分泌,和迷走神经通路。因此，参与微生物群-肠-肝-脑轴的关键分子可能能够作为早期诊断HE的临床生物标志物，并可能成为临床干预的有效治疗目标。在这次审查中,我们总结了HE的病理生理学，并进一步提出了调节微生物群-肠-肝-脑轴的方法，以便全面了解微生物群靶向治疗对HE的预防和潜在临床治疗。
