Research Progress on the Role of Gut Microbiota in the Pathogenesis and Treatment of Sepsis-associated Liver Injury

doi:10.12114/j.issn.1007-9572.2023.0069

Abstract

Abstract:

Sepsis is characterized by a dysregulation of immune response to infection, leading to life-threatening organ dysfunction. Sepsis-associated liver injury (SALI) is considered an independent risk factor for predicting death in the intensive care unit (ICU). With the increasing number of studies on the gut-liver axis in recent years, the close linkage of gut microbiota and liver diseases has been gradually revealed. Dysbiosis of gut microbiota has been shown to induce SALI through the mitogen-activated protein kinase/nuclear transcription factorκB (MAPK/NF-κB) signaling pathway and damage to the intestinal barrier. Meanwhile, fecal microbiota transplantation (FMT) and the application of probiotics have great potential in the treatment of SALI. This paper reviews the relevant research progress in recent years both at home and abroad, in order to provide new insights into the pathogenesis and treatment of SALI.

Key words: Gastrointestinal microbiome, Gut microbiota, Sepsis, Liver injury, FMT, Probiotics, Review

摘要：

脓毒症的特点是对感染的免疫反应失调，导致威胁生命的器官功能障碍。脓毒症相关性肝损伤（SALI）被认为是重症监护室（ICU）中预测患者死亡的独立危险因素。随着近年来对肠-肝轴的研究越来越多，肠道菌群与肝脏疾病的密切联系逐步被揭开。肠道菌群失调被证明可以通过丝裂原活化蛋白激酶/核转录因子κB（MAPK/NF-κB）信号通路和损害肠道屏障诱发SALI。同时，粪便微生物移植（FMT）和益生菌的使用在SALI的治疗中具有很大的潜力。本文综述了近年来国内外相关研究进展，以期为SALI的发病和治疗提供新的见解。

关键词: 胃肠道微生物组, 肠道菌群, 脓毒症, 肝损伤, 粪便微生物移植, 益生菌, 综述

CHEN Wensheng,LIU Wenming. Research Progress on the Role of Gut Microbiota in the Pathogenesis and Treatment of Sepsis-associated Liver Injury[J]. Chinese General Practice, 2024, 27(21): 2665-2671. DOI: 10.12114/j.issn.1007-9572.2023.0069.
陈文胜,刘文明. 肠道菌群在脓毒症相关性肝损伤发病与治疗中的作用研究进展[J]. 中国全科医学, 2024, 27(21): 2665-2671. DOI: 10.12114/j.issn.1007-9572.2023.0069.

Figures/Tables 1

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供体	受体	结果	参考文献
Sen小鼠与Res小鼠	无菌小鼠	Res小鼠粪便的受体小鼠在CLP后表现的肝损伤更轻（P<0.05）	GONG等^[27]
脓毒症患者与健康人	无菌小鼠	健康人粪便的受体小鼠在CLP后表现的肝损伤更轻（P<0.05），而其他器官损伤在两组之间无显著差异	LIU等^[22]
SALI小鼠与MET+SALI小鼠	无菌小鼠	MET+SALI小鼠粪便的受体小鼠在CLP后表现的肝损伤更轻（P<0.05）	LIANG等^[20]
CLP小鼠与MET+CLP小鼠	无菌小鼠	MET+CLP小鼠粪便的受体小鼠在CLP后表现出更轻的神经炎症（P>0.05）和神经元损伤（P<0.05）	ZHAO等^[43]
SSAE小鼠与LSAE小鼠	无菌小鼠	LSAE小鼠粪便的受体小鼠在CLP后表现出更轻的神经元损伤（P<0.05）	ZHANG等^[44]

供体	受体	结果	参考文献
Sen小鼠与Res小鼠	无菌小鼠	Res小鼠粪便的受体小鼠在CLP后表现的肝损伤更轻（P<0.05）	GONG等^[27]
脓毒症患者与健康人	无菌小鼠	健康人粪便的受体小鼠在CLP后表现的肝损伤更轻（P<0.05），而其他器官损伤在两组之间无显著差异	LIU等^[22]
SALI小鼠与MET+SALI小鼠	无菌小鼠	MET+SALI小鼠粪便的受体小鼠在CLP后表现的肝损伤更轻（P<0.05）	LIANG等^[20]
CLP小鼠与MET+CLP小鼠	无菌小鼠	MET+CLP小鼠粪便的受体小鼠在CLP后表现出更轻的神经炎症（P>0.05）和神经元损伤（P<0.05）	ZHAO等^[43]
SSAE小鼠与LSAE小鼠	无菌小鼠	LSAE小鼠粪便的受体小鼠在CLP后表现出更轻的神经元损伤（P<0.05）	ZHANG等^[44]