菌群重塑影响肝脏疾病的作用机制与临床应用

摘要/Abstract

摘要： 肠道菌群能够通过代谢产物对宿主生理过程产生调控作用,对人体生理健康起到重要作用,常被称为人体的“第二大脑”。近年来,菌群重塑成为研究肝病进展与治疗的重要热点,肠道菌群改变与非酒精性脂肪性肝病、病毒性肝炎、肝硬化、肝细胞癌等慢性肝病的发生与发展有密切关联。尽管不同肝脏疾病的发病机制不同,但疾病进展过程中常伴随菌群结构及代谢产物的变化。已有研究发现,通过菌群重塑改善肠道微生态对肝病的治疗具有重要意义。本文将对菌群重塑影响肝脏疾病的作用机制与临床应用进行综述。

关键词: 菌群重塑, 肝脏疾病, 作用机制, 临床应用

洪祉颐, 王倩, 李亚莉, 李莹. 菌群重塑影响肝脏疾病的作用机制与临床应用[J]. 肝脏, 2026, 31(1): 136-138.

/ 推荐

参考文献

[1] Wu G, Xu T, Zhao N, et al. A core microbiome signature as an indicator of health[J]. Cell,2024,187(23):6550-6565.
[2] Cao H, Zhu Y, Hu G, et al. Gut microbiome and metabolites, the future direction of diagnosis and treatment of atherosclerosis?[J]. Pharmacol Res,2022,187:106586.
[3] Hsu C L, Schnabl B. The gut-liver axis and gut microbiota in health and liver disease[J]. Nat Rev Microbiol,2023,21(11):719-733.
[4] Schwenger K J, Clermont-Dejean N, Allard J P. The role of the gut microbiome in chronic liver disease: the clinical evidence revised[J]. JHEP Rep,2019,1(3):214-226.
[5] Hu Y, Hu X, Jiang L, et al. Microbiome and metabolomics reveal the effect of gut microbiota on liver regeneration of fatty liver disease[J]. EBioMedicine,2024,111:105482.
[6] 李敏睿.肠道菌群失调与非酒精性脂肪肝的相关性研究[J].生命科学仪器,2024,22(06):85-87.
[7] Cai W, Qiu T, Hu W, et al. Changes in the intestinal microbiota of individuals with non-alcoholic fatty liver disease based on sequencing: an updated systematic review and meta-analysis[J]. PLoS One,2024,19(3):e0299946.
[8] Chávez-Talavera O, Tailleux A, Lefebvre P, et al. Bile acid control of metabolism and inflammation in obesity, type 2 diabetes, dyslipidemia, and nonalcoholic fatty liver disease[J]. Gastroenterology,2017,152(7):1679-1694.e3.
[9] Nie Q, Luo X, Wang K, et al. Gut symbionts alleviate MASH through a secondary bile acid biosynthetic pathway[J]. Cell,2024,187(11):2717-2734.e33.
[10] Zheng N, Gu Y, Hong Y, et al. Vancomycin pretreatment attenuates acetaminophen-induced liver injury through 2-hydroxybutyric acid[J]. J Pharm Anal,2019,10(6):560-570.
[11] Li J, Lian X, Li B, et al. Pharmacodynamic material basis of licorice and mechanisms of modulating bile acid metabolism and gut microbiota in cisplatin-induced liver injury based on LC-MS and network pharmacology analysis[J]. J Ethnopharmacol,2025,340:119293.
[12] Yuan M, Hu X, Yao L, et al. Causal relationship between gut microbiota and liver cirrhosis: 16S rRNA sequencing and mendelian randomization analyses[J]. J Clin Transl Hepatol,2024,12(2):123-133.
[13] He X, Hu M, Xu Y, et al. The gut-brain axis underlying hepatic encephalopathy in liver cirrhosis[J]. Nat Med,2025,31(2):627-638.
[14] Wang X, Fang Y, Liang W, et al. Gut-liver translocation of pathogen Klebsiella pneumoniae promotes hepatocellular carcinoma in mice[J]. Nat Microbiol,2025,10(1):169-184.
[15] Wei H, Suo C, Gu X, et al. AKR1D1 suppresses liver cancer progression by promoting bile acid metabolism-mediated NK cell cytotoxicity[J]. Cell Metab,2025,37(5):1103-1118.e7.
[16] Qiu X X, Cheng L S, Liu H Y , et al. Fecal microbiota transplantation for treatment of non-alcoholic fatty liver disease: mechanism, clinical evidence, and prospect[J]. World J Gastroenterol,2024,30(8):833-842.
[17] Zhang Y, Li P, Chen B, et al. Therapeutic effects of fecal microbial transplantation on alcoholic liver injury in rat models[J]. Clin Res Hepatol Gastroenterol,2024,48(9):102478.
[18] Wang P, Wang R, Zhao W, et al. Gut microbiota-derived 4-hydroxyphenylacetic acid from resveratrol supplementation prevents obesity through SIRT1 signaling activation[J]. Gut Microbes,2025,17(1):2446391.
[19] Deng Z, Mei S, Ouyang Z, et al. Dysregulation of gut microbiota stimulates NETs-driven HCC intrahepatic metastasis: therapeutic implications of healthy faecal microbiota transplantation[J]. Gut Microbes,2025,17(1):2476561.
[20] Bajaj J S, Fagan A, Gavis E A, et al. Microbiota transplant for hepatic encephalopathy in cirrhosis: the THEMATIC trial[J]. J Hepatol,2025,83(1):81-91.
[21] Wang T, Fan Y, Tan S, et al. Probiotics and their metabolite spermidine enhance IFN-γ+CD4⁺ T cell immunity to inhibit hepatitis B virus[J]. Cell Rep Med,2024,5(11):101822.
[22] Kim H J, Jeon H J, Kim D G, et al. Lacticaseibacillus paracsei HY7207 alleviates hepatic steatosis, inflammation, and liver fibrosis in mice with non-alcoholic fatty liver disease[J]. Int J Mol Sci,2024,25(18):9870.
[23] Maslennikov R, Benuni N, Levshina A, et al. Effect of saccharomyces boulardii on liver diseases: a systematic review[J]. Microorganisms,2024,12(8):1678.
[24] Chen D, Wang Y, Yang J, et al. Shenling Baizhu San ameliorates non-alcoholic fatty liver disease in mice by modulating gut microbiota and metabolites[J]. Front Pharmacol,2024,15:1343755.
[25] Zhao Y, Zhao M, Zhang Y, et al. Bile acids metabolism involved in the beneficial effects of Danggui Shaoyao San via gut microbiota in the treatment of CCl₄ induced hepatic fibrosis[J]. J Ethnopharmacol,2023,319(P3):117383.
[26] Wang Y, Lv S, Shen T, et al. Qinghua Fang inhibits high-fat diet-induced non-alcoholic fatty liver disease by modulating gut microbiota[J]. Annals of palliative medicine,2021,10(3):3219-3234.
[27] 施晶莹.基于小鼠非酒精性脂肪肝模型的泽泻汤生物标志物发现研究[D].中国科学院大学(中国科学院上海药物研究所),2022.
[28] Jiang F Y, Yue S R, Tan Y Y, et al. Gynostemma pentaphyllum extract alleviates nash in mice: exploration of inflammation and gut microbiota[J]. Nutrients,2024,16(11):1782.
[29] Zhao W, Duan C, Liu Y, et al. Modulating effects of Astragalus polysaccharide on immune disorders via gut microbiota and the TLR4/NF-κB pathway in rats with syndrome of dampness stagnancy due to spleen deficiency[J]. J Zhejiang Univ Sci B,2023,24(7):650-662.
[30] Wang C, Yang Y, Chen J, et al. Berberine protects against high-energy and low-protein diet-induced hepatic steatosis: modulation of gut microbiota and bile acid metabolism in laying hens[J]. Int J Mol Sci,2023;24(24):17304.
[31] 刘礼剑,杨成宁,沈飞霞,等.基于“肠-肝轴”肠道菌群调节观察当归芍药散加味治疗肝硬化的临床疗效[J].世界中医药,2017,12(8):1789-1792.
[32] 刘悦.茵陈蒿汤加减对非酒精性脂肪肝湿热证患者肠道微生态的影响[J].辽宁中医杂志,2021,48(3):115-118.
[33] 谢维宁,彭红兵,李烨,等.柴胡疏肝散对肝郁脾虚型非酒精性脂肪肝患者的临床疗效及肠道菌群的影响[J].中国实验方剂学杂志,2021,27(3):129-137.