后生元(postbiotics):调节肝硬化患者肠道菌群及疾病进程的新策略

肝硬化是慢性肝炎发展的终末阶段,患者出现有不同程度的肠道菌群失调,并伴有肠道屏障功能的缺失和菌群移位,是引发肝硬化并发症的重要原因。尽管益生菌能在多个层面保护肠道屏障功能,但其在肝硬化肠道菌群紊乱中的疗效并不明确。现在的研究发现一些益生菌的组分或代谢产物有着与益生活菌类似的益生功效,包括稳定肠道菌群、加强肠上皮屏障功能和调节肠黏膜免疫反应等,其重要的优点是具有明确的分子结构和显著的生物活性,可能是未来调节肝硬化肠道菌群及疾病进程的新方向。本文主要总结了肝硬化肠道菌群失调对于肝硬化并发症及疾病进程的影响,探讨了益生菌的作用及局限性,并重点讨论后生元在调控肝硬化肠道菌群及疾病进程中的应用前景。

Postbiotics: a new orientation for modulation of the gut dysbiosis in liver cirrhosis

Alterations of intestinal microbiota, intestinal barrier dysfunction and bacterial translocation are the common pathogenetic characteristics in cirrhosis, which is an end-stage of liver disease resulting from different causal agents. Alterations of intestinal microbiota play an important role in induction and promotion of liver disease progression. Probiotics have been shown to exhibit limited efficacy in targeting gut barrier dysfunction caused by liver cirrhosis, while a vast studies attests to the beneficial effects of probiotics in the gut. Recently, more and more evidences suggests that certain probiotics components or metabolites (defined as "postbiotics") have beneficial properties as same as the viability status of probiotics. Postbiotics exert a variety of beneficial effects, including modulation of the microbiota composition, regulation of the epithelial barrier function and intestinal immune responses. The merits of probiotics include clear chemical structures and safety dose parameters. In this review, we introduced the effects of gut dysbiosis on complications and disease progression of cirrhosis. Specifically, discussion is focused on the prospect of postbiotics in modulation of the gut dysbiosis in cirrhosis and its potential role in improve the disease progression.