慢性HBV感染肠道菌群与IFN-α治疗策略研究

摘要/Abstract

摘要： 慢性乙型肝炎病毒(HBV)感染与肠道菌群通过肠肝轴形成动态互作,加剧肝病进展。慢性HBV感染导致肠道菌群多样性降低、变形菌门/放线菌门比例升高,其机制涉及补体异常、胆汁酸代谢紊乱及肠道屏障损伤。菌群失调通过短链脂肪酸匮乏、内毒素易位及肝星状细胞活化等方式促进肝纤维化。α干扰素(IFN-α)通过抑制病毒复制、激活免疫及表观调控发挥抗病毒作用,但其疗效受菌群代谢物(如次级胆汁酸抑制STAT1磷酸化)和白介素(IL-10)介导的免疫抑制负向调控。菌群易位会削弱T细胞应答,而IFN-α治疗可部分恢复菌群稳态。靶向肠道微生态干预(如益生菌、粪菌移植等)可通过增强肠道屏障功能、调节胆汁酸代谢及抑制炎症因子释放,改善IFN-α疗效并降低副作用。未来需探索菌群/IFN-α双向调控机制及转化潜力,为优化HBV临床治愈策略提供新思路。

关键词: 慢性乙型肝炎, 乙型肝炎病毒, 肠道菌群, α干扰素

刘春雪, 屈莉红. 慢性HBV感染肠道菌群与IFN-α治疗策略研究[J]. 肝脏, 2025, 30(11): 1579-1582.

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