切换至 "中华医学电子期刊资源库"
高级检索
中华消化病与影像杂志(电子版)

中华消化病与影像杂志(电子版) ›› 2023, Vol. 13 ›› Issue (01) : 1 -4. doi: 10.3877/cma.j.issn.2095-2015.2023.01.001

述评

微生态调节剂治疗非酒精性脂肪性肝病的现状和困境
朱国英1, 陈利2, 舍玲3, 白洁3, 丁永年3, 朱风尚4,†()   
  1. 1. 200060　上海，同济大学附属普陀人民医院临床营养科
    2. 830011　乌鲁木齐，省部共建中亚高发病成因与防治国家重点实验室；200065　上海，同济大学附属同济医院消化科
    3. 830063　乌鲁木齐，新疆医科大学第二附属医院消化科
    4. 830011　乌鲁木齐，省部共建中亚高发病成因与防治国家重点实验室；200065　上海，同济大学附属同济医院消化科；830063　乌鲁木齐，新疆医科大学第二附属医院消化科
  • 收稿日期:2022-03-07 出版日期:2023-02-01
  • 通信作者: 朱风尚
  • 基金资助:
    省部共建中亚高发病成因与防治国家重点实验室项目(SKL-HIDCA-2021-DX9); 新疆维吾尔自治区科技厅科技援疆项目(2021E02075)

Therapeutic reality and dilemma of microecological modulators in patients with non-alcoholic fatty liver disease

Guoying Zhu1, Li Chen2, Ling She3, Jie Bai3, Yongnian Ding3, Fengshang Zhu4,†()   

  1. 1. Department of Clinical Nutrition, Putuo People′s Hospital, Tongji University, Shanghai 200060, China
    2. State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi 830011, China; Department of Gastroenterology, Tongji Hospital of Tongji University, Shanghai 200065, China
    3. Department of Gastroenterology, Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830063, China
    4. State Key Laboratory of Pathogenesis, Prevention and Treatment of High Incidence Diseases in Central Asia, Urumqi 830011, China; Department of Gastroenterology, Tongji Hospital of Tongji University, Shanghai 200065, China; Department of Gastroenterology, Second Affiliated Hospital of Xinjiang Medical University, Urumqi 830063, China
  • Received:2022-03-07 Published:2023-02-01
  • Corresponding author: Fengshang Zhu
全文 ( ) 下载PDF ( ) 导出引用
引用本文：

朱国英, 陈利, 舍玲, 白洁, 丁永年, 朱风尚. 微生态调节剂治疗非酒精性脂肪性肝病的现状和困境[J]. 中华消化病与影像杂志(电子版), 2023, 13(01): 1-4.

Guoying Zhu, Li Chen, Ling She, Jie Bai, Yongnian Ding, Fengshang Zhu. Therapeutic reality and dilemma of microecological modulators in patients with non-alcoholic fatty liver disease[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2023, 13(01): 1-4.

肠菌失调和代谢产物(类型、含量和比例)紊乱以及随后的代谢、免疫和炎症稳态失衡在非酒精性脂肪性肝病(NAFLD)进展中有潜在因果作用。广泛的基础和临床研究揭示了益生菌的保护作用，并导致有益微生物群及其活性代谢物分类成各种功能的微生态调节剂概念(益生菌、益生元、合生元和后生元)。本文概述了微生态调节剂对NAFLD患者的保护作用和机制，评述了其治疗NAFLD的临床现状和困境，提出了更前瞻、更高质量的临床对照研究的必要性和期待真实世界研究结果的理念。

关键词: 非酒精性脂肪性肝病, 肠道菌群, 肠菌失调, 微生态调节剂, 治疗

Gut microbiota dysbiosis and metabolic disorders(type, content and proportion)and subsequent imbalance of metabolic, immune and inflammatory homeostasis have potential causal roles in the progression of non-alcoholic fatty liver disease(NAFLD). Extensive basic and clinical researches have revealed the protective effect of probiotics and led to the classification of beneficial microflora and their bioactive metabolites into the concepts of microecological modulators with various functions(probiotics, prebiotics, synbiotics and postbiotics). This review summarizes the protective effect and mechanism of microecological modulators on patients with NAFLD, reviews the clinical status and dilemma of their treatment of NAFLD, and proposes the necessity of more prospective and higher quality clinical controlled studies and the concept of expecting the results of real-world studies.

Key words: Non-alcoholic fatty liver disease, Gut microbiota, Dysbiosis, Microecological modulator, Drug therapy
1
陈利，朱风尚，杨长青．非酒精性脂肪性肝炎相关肝细胞癌特征及诊治进展[J/OL]．中华消化病与影像杂志(电子版)，2020，10(6)：49-51.
2
He LH，Yao DH，Wang LY，et al.Gut Microbiome-Mediated Alteration of Immunity，Inflammation，and Metabolism Involved in the Regulation of Non-alcoholic Fatty Liver Disease[J]．Front Microbiol，2021，12：761836.
3
Quesada-Vázquez S，Aragonès G，Del Bas JM，et al.Diet，Gut Microbiota and Non-Alcoholic Fatty Liver Disease：Three Parts of the Same Axis[J]．Cells，2020，9(1)：176.
4
Castillo V，Figueroa F，González-Pizarro K，et al.Probiotics and Prebiotics as a Strategy for Non-Alcoholic Fatty Liver Disease，a Narrative Review[J]．Foods，2021，10(8)：1719.
5
Chen J，Vitetta L．Gut Microbiota Metabolites in NAFLD Pathogenesis and Therapeutic Implications[J]．Int J Mol Sci，2020，21(15)：5214.
6
Aron-Wisnewsky J，Vigliotti C，Witjes J，et al.Gut microbiota and human NAFLD：disentangling microbial signatures from metabolic disorders[J]．Nat Rev Gastroenterol Hepatol，2020，17(5)：279-297.
7
Crommen S，Rheinwalt KP，Plamper A，et al.A Specifically Tailored Multistrain Probiotic and Micronutrient Mixture Affects Nonalcoholic Fatty Liver Disease-Related Markers in Patients with Obesity after Mini Gastric Bypass Surgery[J]．J Nutr，2022，152(2)：408-418.
8
Sherf-Dagan S，Zelber-Sagi S，Zilberman-Schapira G，et al.Probiotics administration following sleeve gastrectomy surgery：a randomized double-blind trial[J]．Int J Obes(Lond)，2018，42(2)：147-155.
9
Vallianou N，Christodoulatos GS，Karampela I，et al.Understanding the Role of the Gut Microbiome and Microbial Metabolites in Non-Alcoholic Fatty Liver Disease：Current Evidence and Perspectives[J]．Biomolecules，2021，12(1)：56.
10
Anstee QM，Hallsworth K，Lynch N，et al.Real-world management of non-alcoholic steatohepatitis differs from clinical practice guideline recommendations and across regions[J]．JHEP Rep，2021，4(1)：100411.
11
Gibson GR，Hutkins R，Sanders ME，et al.Expert consensus document：The International Scientific Association for Probiotics and Prebiotics(ISAPP)consensus statement on the definition and scope of prebiotics[J]．Nat Rev Gastroenterol Hepatol，2017，14(8)：491-502.
12
Kerry RG，Das G，Golla U，et al.Engineered Probiotic and Prebiotic Nutraceutical Supplementations in Combating Non-communicable Disorders：A Review[J]．Curr Pharm Biotechnol，2022，23(1)：72-97.
13
Beserra BT，Fernandes R，do Rosario VA，et al.A systematic review and meta-analysis of the prebiotics and synbiotics effects on glycaemia，insulin concentrations and lipid parameters in adult patients with overweight or obesity[J]．Clin Nutr，2015，34(5)：845-858.
14
Stachowska E，Portincasa P，Jamio-Milc D，et al.The Relationship between Prebiotic Supplementation and Anthropometric and Biochemical Parameters in Patients with NAFLD-A Systematic Review and Meta-Analysis of Randomized Controlled Trials[J]．Nutrients，2020，12(11)：3460.
15
Nagashimada M，Honda M．Effect of Microbiome on Non-Alcoholic Fatty Liver Disease and the Role of Probiotics，Prebiotics，and Biogenics[J]．Int J Mol Sci，2021，22(15)：8008.
16
Keulers L，Dehghani A，Knippels L，et al.Probiotics，prebiotics，and synbiotics to prevent or combat air pollution consequences：The gut-lung axis[J]．Environ Pollut，2022，302：119066.
17
Eslamparast T，Poustchi H，Zamani F，et al.Synbiotic supplementation in nonalcoholic fatty liver disease：a randomized，double-blind，placebo-controlled pilot study[J]．Am J Clin Nutr，2014，99(3)：535-542.
18
Malaguarnera M，Vacante M，Antic T，et al.Bifidobacterium longum with fructo-oligosaccharides in patients with non alcoholic steatohepatitis[J]．Dig Dis Sci，2012，57(2)：545-553.
19
Khan MY，Mihali AB，Rawala MS，et al.The promising role of probiotic and synbiotic therapy in aminotransferase levels and inflammatory markers in patients with nonalcoholic fatty liver disease-a systematic review and meta-analysis[J]．Eur J Gastroenterol Hepatol，2019，31(6)：703-715.
20
Asgharian A，Askari G，Esmailzade A，et al.The Effect of Symbiotic Supplementation on Liver Enzymes，C-reactive Protein and Ultrasound Findings in Patients with Non-alcoholic Fatty Liver Disease：A Clinical Trial[J]．Int J Prev Med，2016，7：59.
21
Scorletti E，Afolabi PR，Miles EA，et al.Synbiotics Alter Fecal Microbiomes，But Not Liver Fat or Fibrosis，in a Randomized Trial of Patients With Nonalcoholic Fatty Liver Disease[J]．Gastroenterology，2020，158(6)：1597-1610.
22
Salminen S，Collado MC，Endo A，et al.The International Scientific Association of Probiotics and Prebiotics(ISAPP)consensus statement on the definition and scope of postbiotics[J]．Nat Rev Gastroenterol Hepatol，2021，18(9)：649-667.
23
Liu Y，Wang J，Wu C．Modulation of Gut Microbiota and Immune System by Probiotics，Pre-biotics，and Post-biotics[J]．Front Nutr，2022，8：634897.
24
Zhou D，Pan Q，Xin FZ，et al.Sodium butyrate attenuates high-fat diet-induced steatohepatitis in mice by improving gut microbiota and gastrointestinal barrier[J]．World J Gastroenterol，2017，23(1)：60-75.
25
Jin H，Xu X，Pang B，et al.Probiotic and prebiotic interventions for non-alcoholic fatty liver disease：a systematic review and network meta-analysis[J]．Benef Microbes，2021，12(6)：517-529.
26
Sakurai Y，Watanabe T，Miura Y，et al.Clinical and Bacteriologic Characteristics of Six Cases of Bifidobacterium breve Bacteremia Due to Probiotic Administration in the Neonatal Intensive Care Unit[J]．Pediatr Infect Dis J，2022，41(1)：62-65.
27
Colosimo S，Ravaioli F，Petroni ML，et al.Effects of antidiabetic agents on steatosis and fibrosis biomarkers in type 2 diabetes：A real-world data analysis[J]．Liver Int，2021，41(4)：731-742.
[1] 中华医学会骨科学分会关节外科学组, 广东省医学会骨质疏松和骨矿盐疾病分会, 广东省佛山市顺德区第三人民医院. 中国髋部脆性骨折术后抗骨质疏松药物临床干预指南(2023年版)[J]. 中华关节外科杂志(电子版), 2023, 17(06): 751-764.
[2] 许正文, 李振, 侯振扬, 苏长征, 朱彪. 富血小板血浆联合植骨治疗早期非创伤性股骨头坏死[J]. 中华关节外科杂志(电子版), 2023, 17(06): 773-779.
[3] 李培杰, 乔永杰, 张浩强, 曾健康, 谭飞, 李嘉欢, 王静, 周胜虎. 细菌培养阴性的假体周围感染诊治的最新进展[J]. 中华关节外科杂志(电子版), 2023, 17(06): 827-833.
[4] 江泽莹, 王安婷, 王姣丽, 陈慈, 周秋玲, 黄燕娟, 周芳, 薛琰, 周剑烽, 谭文勇, 杜美芳. 多种植物油组分预防肿瘤放化疗相关毒性反应的效果分析[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 523-527.
[5] 朴广昊, 李屹洲, 刘瑞, 赵建民, 王凌峰. 皮肤撕脱伤撕脱皮瓣活力早期评估与修复的研究进展[J]. 中华损伤与修复杂志(电子版), 2023, 18(06): 528-532.
[6] 彭旭, 邵永孚, 李铎, 邹瑞, 邢贞明. 结肠肝曲癌的诊断和外科治疗[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 108-110.
[7] 马伟强, 马斌林, 吴中语, 张莹. microRNA在三阴性乳腺癌进展中发挥的作用[J]. 中华普外科手术学杂志(电子版), 2024, 18(01): 111-114.
[8] 杨瑞洲, 李国栋, 吴向阳. 腹股沟疝术后感染的治疗方法探讨[J]. 中华疝和腹壁外科杂志(电子版), 2023, 17(06): 715-719.
[9] 何吉鑫, 杨燕妮, 王继伟, 李建国, 谢铭. 肠道菌群及肠道代谢产物参与慢性便秘发生机制的研究进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 495-499.
[10] 蓝冰, 王怀明, 王辉, 马波. 局部晚期结肠癌膀胱浸润的研究进展[J]. 中华结直肠疾病电子杂志, 2023, 12(06): 505-511.
[11] 王宁, 刘彦哲, 吴紫莺, 曾超, 雷光华, 沙婷婷, 王伊伦. 基于孟德尔随机化研究探讨肠道菌群与肌少症表型的因果关联[J]. 中华老年骨科与康复电子杂志, 2023, 09(06): 333-342.
[12] 陆志峰, 周佳佳, 梁舒. 虚拟现实技术在治疗弱视中的临床应用研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(08): 891-895.
[13] 李田, 徐洪, 刘和亮. 尘肺病的相关研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(08): 900-905.
[14] 岳瑞雪, 孔令欣, 郝鑫, 杨进强, 韩猛, 崔国忠, 王建军, 张志生, 孔凡庭, 张维, 何文博, 李现桥, 周新平, 徐东宏, 胡崇珠. 乳腺癌HER2蛋白表达水平预测新辅助治疗疗效的真实世界研究[J]. 中华临床医师杂志(电子版), 2023, 17(07): 765-770.
[15] 张大涯, 陈世锔, 陈润祥, 张晓冬, 李达, 白飞虎. 肠道微生物群对代谢相关脂肪性肝病发展的影响[J]. 中华临床医师杂志(电子版), 2023, 17(07): 828-833.
阅读次数
全文


摘要

版权所有 中华医学会 中华医学电子音像出版社有限责任公司  京ICP备14006079号-1  网络出版服务许可证：(署)网出证(京)字第075号