肠道微生物群在治疗脂肪性肝病方面的进展与挑战
Ernesto Saenz , Nathally Espinosa Montagut , Baohong Wang , Christoph Stein-Thöringer , Kaicen Wang , Honglei Weng , Matthias Ebert , Kai Markus Schneider , Lanjuan Li , Andreas Teufel
工程（英文） ›› 2024, Vol. 40 ›› Issue (9) : 55 -66.
肠道微生物群在治疗脂肪性肝病方面的进展与挑战
# These authors share the senior authorship.
代谢功能障碍相关脂肪性肝病（MASLD）拥有惊人的发病率。据估计，全球有高达四分之一的人群受到该疾病的困扰，这也使其成为全世界最常见的肝病。MASLD的特征为肝脏脂肪的过度堆积，通常与肥胖、血脂异常和胰岛素抵抗等合并症相关；然而，该病同样也发病于瘦人群体。因此，开发针对这种复杂疾病的有效疗法至关重要。目前，尚无获得批准的MASLD相关治疗药物，因此研究替代方法迫在眉睫。大量研究表明，MASLD为多面性疾病，通常与饮食习惯导致的代谢紊乱有关。有证据表明，在MASLD从单纯脂肪变性到脂肪性肝炎，甚至肝细胞癌（HCC）的发生和发展过程中，肠道微生物群的变化起着根本性作用。在本文中，我们对基于肠道微生物群治疗MASLD和代谢功能障碍相关脂肪性肝炎（MASH）方面这一新兴领域相关的文献进行了批判性研究，包括粪便微生物群移植（FMT）、益生菌、益生元、短链脂肪酸、抗生素、靶向代谢途径和免疫检查点激酶阻断等干预措施。
The prevalence of metabolic-dysfunction-associated steatotic liver disease (MASLD) is alarmingly high; it is estimated to affect up to a quarter of the global population, making it the most common liver disorder worldwide. MASLD is characterized by excessive hepatic fat accumulation and is commonly associated with comorbidities such as obesity, dyslipidemia, and insulin resistance; however, it can also manifest in lean individuals. Therefore, it is crucial to develop effective therapies for this complex condition. Currently, there are no approved medications for MASLD treatment, so there is a pressing need to investigate alternative approaches. Extensive research has characterized MASLD as a multifaceted disease, frequently linked to metabolic disorders that stem from dietary habits. Evidence suggests that changes in the gut microbiome play a fundamental role in the development and progression of MASLD from simple steatosis to steatohepatitis and even hepatocellular carcinoma (HCC). In this review, we critically examine the literature on the emerging field of gut-microbiota-based therapies for MASLD and metabolic-dysfunction-associated steatohepatitis (MASH), including interventions such as fecal microbiota transplantation (FMT), probiotics, prebiotics, short-chain fatty acids, antibiotics, metabolic pathway targeting, and immune checkpoint kinase blockade.
微生物群 / 粪便微生物群移植 / 代谢功能障碍相关脂肪性肝病 / 脂肪肝
Microbiome / Fecal microbiota transplantation / Metabolic-dysfunction-associated steatotic liver disease / Fatty liver
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