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Pharmacy Information 2024
基于“肠–肝”轴学说探讨肠道菌群在代谢性疾病中的作用
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Abstract:
代谢性疾病包括高脂血症、肥胖症、非酒精性脂肪性肝病和动脉粥样硬化等疾病，因高发病率和慢性可持续性已成为人类主要的健康问题。代谢性疾病的发生、发展与胰岛素功能受损、糖脂代谢异常、炎症因子过度表达、肠屏障功能紊乱等显著相关，是由全身代谢失调和多种相互关联的过程共同作用的结果。肠道菌群在上述病理机制中发挥着举足轻重的作用，因此基于“肠–肝”轴学说综述肠道菌群在代谢性疾病中的相关作用，为代谢性疾病的诊断、发病机制和治疗带来开启新的篇章。肠道菌群是肠道微生态系统中密不可分的一部分，参与宿主新陈代谢、维持肠道稳态及免疫调节等诸多生理过程。肝脏和肠道主要通过胆道、门静脉系统紧密联系在一起，两者在免疫、代谢、宿主防御等方面相互联系、相互协作。本文对肠道菌群及其代谢产物与代谢性疾病之间密切且复杂的联系，以及肠道菌群失调对代谢性疾病的影响进行概述，从而探讨肠道菌群与代谢性疾病发生、发展的相关机制。此外，也对肠道菌群通过“肠–肝”轴改善代谢性疾病的最新研究进展进行综述，为代谢性疾病的预防和临床诊疗提供参考。
Metabolic diseases, such as hyperlipidemia, obesity, non-alcoholic fatty liver disease, and atherosclerosis, have emerged as significant health concerns in humans due to their high prevalence and chronic nature. The occurrence and progression of metabolic diseases are attributed to systemic metabolic imbalance and the interplay of various interconnected processes, notably linked to impaired insulin function, abnormal glucose, and lipid metabolism, excessive expression of inflammatory factors, and disruption of intestinal barrier function. The gut microbiota (GM) plays a pivotal role in these pathological mechanisms. Therefore, investigating the relevance of gut microbiota in metabolic diseases based on the “gut-liver” axis theory can offer novel perspectives for comprehending the pathogenesis as well as diagnosing and treating metabolic diseases. GM constitutes an essential component of the intestinal microbial ecosystem that actively participates in regulating host metabolism, maintaining intestinal homeostasis, and modulating immune responses, among other physiological functions. The liver and intestines are closely interconnected through bile ducts and portal vein systems; they interact synergistically with each other concerning immunity regulation, metabolism, and host defense mechanisms. This article provides an overview of the intricate interactions between GM and its metabolites with respect to metabolic diseases while discussing the effect of GM dysbiosis on metabolic diseases. Additionally, this review also encompasses the latest advancements in research on the modulation of metabolic diseases through the “gut-liver” axis by GM, thereby offering valuable insights for clinical diagnosis and management of metabolic disorders.
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