基于“调和肝脾”论述肝纤维化与肠道菌群的关系
DOI: 10.3969/j.issn.1001-5256.2023.02.005
利益冲突声明:所有作者均声明不存在利益冲突。
作者贡献声明:刘云霄负责课题设计,撰写论文;窦婧参与论文修改;王晓忠负责拟定写作思路,指导撰写文章并最后定稿。
Association between liver fibrosis and gut microbiota based on "harmonizing liver and spleen"
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摘要: 肝纤维化是全球肝病发病和死亡的主要原因,已成为国内外学者研究慢性肝病的焦点问题之一。越来越多的证据表明肠道菌群失调在肝纤维化发生、发展中的核心作用,改善肠道菌群失衡成为抗纤维化治疗的新靶点。目前中医药在改善肠道菌群方面的相关研究备受瞩目。研究表明,“调和肝脾”在减轻纤维化程度、延缓肝纤维化进展中发挥重要作用。因此,本文基于“调和肝脾”理论分析利用现代分子生物学技术研究肠肝轴与肠道菌群的成果,为临床从“调和肝脾”论治肝纤维化提供有利的理论基础,为中医药抗肝纤维化提供新方向和新思路。Abstract: Liver fibrosis is the leading cause of the morbidity and mortality of liver diseases worldwide and has become one of the key issues in the research on chronic liver diseases among domestic and foreign scholars. An increasing amount of evidence has shown that gut microbiota dysbiosis plays a crucial role in the development and progression of liver fibrosis, and improvement of gut microbiota dysbiosis has become a new target for anti-fibrotic treatment. At present, traditional Chinese medicine has attracted much attention in improving gut microbiota. Studies have shown that "harmonizing liver and spleen" plays an important role in reducing fibrosis degree and delaying the progression of liver fibrosis. Therefore, based on the theory of "harmonizing liver and spleen", the achievements in liver-gut axis and gut microbiota by modern molecular biological techniques can provide a theoretical basis for the treatment of liver fibrosis from "harmonizing liver and spleen" in clinical practice, as well as new directions and ideas for anti-fibrotic treatment with traditional Chinese medicine.
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[1] BREITKOPF-HEINLEIN K, SYN WK. Harnessing liver progenitors in the treatment of liver fibrosis: a step in the right direction?[J]. Gut, 2020, 69(6): 975-976. DOI: 10.1136/gutjnl-2019-320203. [2] QI X, YANG M, STENBERG J, et al. Gut microbiota mediated molecular events and therapy in liver diseases[J]. World J Gastroenterol, 2020, 26(48): 7603-7618. DOI: 10.3748/wjg.v26.i48.7603. [3] LIU S, WU J, CHEN P, et al. TAK-242 ameliorates hepatic fibrosis by regulating the liver-gut axis[J]. Biomed Res Int, 2022, 2022: 4949148. DOI: 10.1155/2022/4949148. [4] HRNCIR T, HRNCIROVA L, KVERKA M, et al. Gut microbiota and NAFLD: Pathogenetic mechanisms, microbiota signatures, and therapeutic interventions[J]. Microorganisms, 2021, 9(5): 957. DOI: 10.3390/microorganisms9050957. [5] LIU J, YANG D, WANG X, et al. Gut microbiota targeted approach in the management of chronic liver diseases[J]. Front Cell Infect Microbiol, 2022, 12: 774335. DOI: 10.3389/fcimb.2022.774335. [6] LI MM, ZHOU Y, ZUO L, et al. Dietary fiber regulates intestinal flora and suppresses liver and systemic inflammation to alleviate liver fibrosis in mice[J]. Nutrition, 2021, 81: 110959. DOI: 10.1016/j.nut.2020.110959. [7] WOODHOUSE C, SINGANAYAGAM A, PATEL VC. Modulating the gut-liver axis and the pivotal role of the faecal microbiome in cirrhosis[J]. Clin Med (Lond), 2020, 20(5): 493-500. DOI: 10.7861/clinmed.2020-0676. [8] MACCIONI L, GAO B, LECLERCQ S, et al. Intestinal permeability, microbial translocation, changes in duodenal and fecal microbiota, and their associations with alcoholic liver disease progression in humans[J]. Gut Microbes, 2020, 12(1): 1782157. DOI: 10.1080/19490976.2020.1782157. [9] NISHIMURA N, KAJI K, KITAGAWA K, et al. Intestinal permeability is a mechanical rheostat in the pathogenesis of liver cirrhosis[J]. Int J Mol Sci, 2021, 22(13): 6921. DOI: 10.3390/ijms22136921. [10] YAMAZAKI K, KATO T, TSUBOI Y, et al. Oral pathobiont-induced changes in gut microbiota aggravate the pathology of nonalcoholic fatty liver disease in mice[J]. Front Immunol, 2021, 12: 766170. DOI: 10.3389/fimmu.2021.766170. [11] GIUFFRÈ M, CAMPIGOTTO M, CAMPISCIANO G, et al. A story of liver and gut microbes: how does the intestinal flora affect liver disease? A review of the literature[J]. Am J Physiol Gastrointest Liver Physiol, 2020, 318(5): G889-G906. DOI: 10.1152/ajpgi.00161.2019. [12] PARK JW, KIM SE, LEE NY, et al. Role of microbiota-derived metabolites in alcoholic and non-alcoholic fatty liver diseases[J]. Int J Mol Sci, 2021, 23(1): 426. DOI: 10.3390/ijms23010426. [13] WAN S, NIE Y, ZHANG Y, et al. Gut microbial dysbiosis is associated with profibrotic factors in liver fibrosis mice[J]. Front Cell Infect Microbiol, 2020, 10: 18. DOI: 10.3389/fcimb.2020.00018. [14] AN L, WIRTH U, KOCH D, et al. The role of gut-derived lipopolysaccharides and the intestinal barrier in fatty liver diseases[J]. J Gastrointest Surg, 2022, 26(3): 671-683. DOI: 10.1007/s11605-021-05188-7. [15] XIANG H, LIU Z, XIANG H, et al. Dynamics of the gut-liver axis in rats with varying fibrosis severity[J]. Int J Biol Sci, 2022, 18(8): 3390-3404. DOI: 10.7150/ijbs.69833. [16] WANG R, TANG R, LI B, et al. Gut microbiome, liver immunology, and liver diseases[J]. Cell Mol Immunol, 2021, 18(1): 4-17. DOI: 10.1038/s41423-020-00592-6. [17] LI Z, NI M, YU H, et al. Gut microbiota and liver fibrosis: One potential biomarker for predicting liver fibrosis[J]. Biomed Res Int, 2020, 2020: 3905130. DOI: 10.1155/2020/3905130. [18] HUANG HC, TSAI MH, CHANG CC, et al. Microbiota transplants from feces or gut content attenuated portal hypertension and portosystemic collaterals in cirrhotic rats[J]. Clin Sci (Lond), 2021, 135(24): 2709-2728. DOI: 10.1042/CS20210602. [19] KHAN A, DING Z, ISHAQ M, et al. Understanding the effects of gut microbiota dysbiosis on nonalcoholic fatty liver disease and the possible probiotics role: recent updates[J]. Int J Biol Sci, 2021, 17(3): 818-833. DOI: 10.7150/ijbs.56214. [20] ZHENG Y, WANG J, WANG J, et al. Gut microbiota combined with metabolomics reveal the mechanism of curcumol on liver fibrosis in mice[J]. Biomed Pharmacother, 2022, 152: 113204. DOI: 10.1016/j.biopha.2022.113204. [21] WAN S, HUANG C, WANG A, et al. Ursolic acid improves the bacterial community mapping of the intestinal tract in liver fibrosis mice[J]. PeerJ, 2020, 8: e9050. DOI: 10.7717/peerj.9050. [22] FU K, MA C, WANG C, et al. Forsythiaside A alleviated carbon tetrachloride-induced liver fibrosis by modulating gut microbiota composition to increase short-chain fatty acids and restoring bile acids metabolism disorder[J]. Biomed Pharmacother, 2022, 151: 113185. DOI: 10.1016/j.biopha.2022.113185. [23] WANG C, MA C, FU K, et al. Phillygenin attenuates carbon tetrachloride-induced liver fibrosis via modulating inflammation and gut microbiota[J]. Front Pharmacol, 2021, 12: 756924. DOI: 10.3389/fphar.2021.756924. [24] ZHUANG Z, YANG R, WANG W, et al. Associations between gut microbiota and Alzheimer's disease, major depressive disorder, and schizophrenia[J]. J Neuroinflammation, 2020, 17(1): 288. DOI: 10.1186/s12974-020-01961-8. [25] NIKOLOVA VL, SMITH M, HALL LJ, et al. Perturbations in gut microbiota composition in psychiatric disorders: a review and meta-analysis[J]. JAMA Psychiatry, 2021, 78(12): 1343-1354. DOI: 10.1001/jamapsychiatry.2021.2573. [26] SORBONI SG, MOGHADDAM HS, JAFARZADEH-ESFEHANI R, et al. A comprehensive review on the role of the gut microbiome in human neurological disorders[J]. Clin Microbiol Rev, 2022, 35(1): e0033820. DOI: 10.1128/CMR.00338-20. [27] LIU J, GORBOVSKAYA I, HAHN MK, et al. The gut microbiome in schizophrenia and the potential benefits of prebiotic and probiotic treatment[J]. Nutrients, 2021, 13(4): 1152. DOI: 10.3390/nu13041152. [28] GUO L, XIAO P, ZHANG X, et al. Inulin ameliorates schizophrenia via modulation of the gut microbiota and anti-inflammation in mice[J]. Food Funct, 2021, 12(3): 1156-1175. DOI: 10.1039/d0fo02778b. [29] YIN QJ, TIAN XM. Clinical study on Shugan Jieyu capsules combined with ziprasidone for schizophrenia[J]. J New Chin Med, 2022, 54(10): 87-91. DOI: 10.13457/j.cnki.jncm.2022.10.021.尹秋静, 田晓满. 舒肝解郁胶囊联合齐拉西酮治疗精神分裂症临床研究[J]. 新中医, 2022, 54(10): 87-91. DOI: 10.13457/j.cnki.jncm.2022.10.021. [30] WANG H, WANG SX. Discussion of correlation between chronic psychological stress induced liver depression and spleen deficiency syndrome and microbiota-gut-brain axis and study on intervention mechanism of Xiaoyaosan[J]. Chin J Exp Med Formul, 2020, 26(24): 193-200. DOI: 10.13422/j.cnki.syfjx.20201877.王浩, 王少贤. 慢性心理应激肝郁脾虚证与微生物-脑-肠轴相关性及逍遥散干预机制研究进展[J]. 中国实验方剂学杂志, 2020, 26(24): 193-200. DOI: 10.13422/j.cnki.syfjx.20201877. [31] JIA XY, LIU J. Discussion on treatment of macular degeneration in spleen deficiency syndrome based on intestinal flora[J]. J Tradit Chin Ophthalmol, 2022, 32(7): 567-570. DOI: 10.13444/j.cnki.zgzyykzz.2022.07.013.贾茜钰, 刘军. 基于肠道菌群论治脾虚型年龄相关性黄斑变性[J]. 中国中医眼科杂志, 2022, 32(7): 567-570. DOI: 10.13444/j.cnki.zgzyykzz.2022.07.013. [32] XIAO J, ZHANG R, WU Y, et al. Rice bran phenolic extract protects against alcoholic liver injury in mice by alleviating intestinal microbiota dysbiosis, barrier dysfunction, and liver inflammation mediated by the endotoxin-TLR4-NF-κB pathway[J]. J Agric Food Chem, 2020, 68(5): 1237-1247. DOI: 10.1021/acs.jafc.9b04961. [33] YANG C, LIAO AM, CUI Y, et al. Wheat embryo globulin protects against acute alcohol-induced liver injury in mice[J]. Food Chem Toxicol, 2021, 153: 112240. DOI: 10.1016/j.fct.2021.112240. [34] FAN J, WANG Y, YOU Y, et al. Fermented ginseng improved alcohol liver injury in association with changes in the gut microbiota of mice[J]. Food Funct, 2019, 10(9): 5566-5573. DOI: 10.1039/c9fo01415b. [35] YAN XD, ZHANG F, ZHENG XH, et al. Effect of Erchen decoction on intestinal flora of obese mice induced by high-fat diet[J]. Lishizhen Med Mater Med Res, 2021, 32(8): 1868-1871. DOI: 10.3969/j.issn.1008-0805.2021.08.21.严晓丹, 张斐, 郑雪花, 等. 二陈汤对高脂饮食诱导的肥胖小鼠肠道菌群的影响[J]. 时珍国医国药, 2021, 32(8): 1868-1871. DOI: 10.3969/j.issn.1008-0805.2021.08.21. [36] LI S, CHEN F, ZOU Y, et al. Yinzhihuang oral liquid protects against non-alcoholic steatohepatitis via modulation of the gut-liver axis in mice[J]. Ann Transl Med, 2022, 10(11): 631. DOI: 10.21037/atm-21-4809. [37] XU L, FU J, FANG F, et al. Effect of modfied Yinchen Wuling San in treating non-alcoholic fatty liver disease with moisture and heat implication and on intestinal microflora[J]. Chin J Exp Med Formul, 2019, 25(12): 127-132. DOI: 10.13422/j.cnki.syfjx.201901232.徐立, 符晶, 方芳, 等. 加味茵陈五苓散治疗湿热蕴结型非酒精性脂肪性肝病的疗效及对肠道菌群的影响[J]. 中国实验方剂学杂志, 2019, 25(12): 127-132. DOI: 10.13422/j.cnki.syfjx.201901232. [38] GUO HH, SHEN HR, ZHANG HJ, et al. Dengzhan Shengmai inhibits nonalcoholic fatty liver disease via regulating intestinal microenvironment[J]. Acta Pharm Sin, 2022, 57(12): 3524-3534. DOI: 10.16438/j.0513-4870.2022-0908.郭慧慧, 申浩然, 张红娟, 等. 灯盏生脉通过调节肠道微环境抑制非酒精性脂肪肝进程[J]. 药学学报, 2022, 57(12): 3524-3534. DOI: 10.16438/j.0513-4870.2022-0908.
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