Systematic review: microbial dysbiosis and nonalcoholic fatty liver disease

作者：Wieland A; Frank D N; Harnke B; Bambha K

来源：Alimentary Pharmacology and Therapeutics, 2015, 42(9): 1051-1063.

DOI：10.1111/apt.13376

<jats:title>Summary</jats:title><jats:sec><jats:title>Background</jats:title><jats:p>The human intestinal microbiota is a key regulator of host metabolic and immune functions and alterations in the microbiome (‘dysbiosis’) have been implicated in several human diseases. Because of the anatomical links between the intestines and the liver, dysbiosis may also disrupt hepatic function and thereby contribute to the pathogenesis of nonalcoholic fatty liver disease (<jats:styled-content style="fixed-case">NAFLD</jats:styled-content>).</jats:p></jats:sec><jats:sec><jats:title>Aim</jats:title><jats:p>To perform a comprehensive review of the medical literature investigating associations between intestinal dysbiosis and <jats:styled-content style="fixed-case">NAFLD</jats:styled-content>, with a particular emphasis on studies that characterise the microbiome in <jats:styled-content style="fixed-case">NAFLD</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We conducted a search of PubMed, Embase, and Web of Science using multiple search terms including: ‘<jats:styled-content style="fixed-case">NAFLD</jats:styled-content>,<jats:styled-content style="fixed-case"> NASH</jats:styled-content>, fatty liver, steatohepatitis’ combined with ‘metagenome, microbiom*, microbiota*, fecal flora, intestinal flora, gut bacteria’. Results were manually reviewed and studies selected based on relevance to intestinal microbiota and <jats:styled-content style="fixed-case">NAFLD</jats:styled-content>. We also included studies that addressed potential mechanistic models of pathways linking the dysbiosis to <jats:styled-content style="fixed-case">NAFLD</jats:styled-content>.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Nine studies (five human and four animal models) were identified in our search that assessed associations between specific intestinal microbiota composition and <jats:styled-content style="fixed-case">NAFLD</jats:styled-content>. We reviewed and summarised the results of additional investigations that more broadly addressed the mechanisms by which the microbiome may impact <jats:styled-content style="fixed-case">NAFLD</jats:styled-content> pathogenesis.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Investigations in humans and animals demonstrate associations between intestinal dysbiosis and <jats:styled-content style="fixed-case">NAFLD</jats:styled-content>; however, causality has not been proven and mechanistic links require further delineation. As the field of microbiome research matures in techniques and study design, more detailed insights into <jats:styled-content style="fixed-case">NAFLD</jats:styled-content> pathogenesis and its associations with the intestinal microbiota will be elucidated.</jats:p></jats:sec>

• 出版日期2015-11