肠道微生态与肝病专题论坛暨2021（第七届）肠道微生态与健康国际研讨会会前会
人体肠道内寄生着大量的微生物，并对人体的代谢、免疫、发育等多种生理过程发挥重要的调节作用。在多种慢性肝病的发展过程中都伴随着肠道菌群的改变。一方面，肝脏疾病的发生可以影响肠道菌群的组成。比如，乙肝病毒的感染可以延缓肠道菌群的定植和成熟。另一方面，肠道菌群也能反过来影响肝脏疾病的发展。比如，当肠道菌群失衡时，肠道的通透性发生改变，肠道菌群能向肝脏内移位，抑制肝脏免疫，不利于乙肝病毒的清除。此外，肠道菌群在自身免疫性肝病、代谢性肝病、酒精性肝病的发生发展过程中都发挥这重要的作用。粪菌移植可以促进慢性乙型肝炎患者HBeAg抗原的下降，还可用于治疗肝性脑病。
因此，本论坛特邀华中科技大学附属协和医院王俊忠博士，围绕”肠道微生态与肝病“的最新前沿研究进行精彩分享！
Abstract
Approximately a trillion microbial cells colonize the mammalian intestine; these are collectively termed gut microbiota. Gut microbiota play a critical role in many physiological and pathological processes, influencing host immunity and metabolism. Gut dysbiosis is related to not only intestinal but also extra-intestinal diseases, including nervous system, respiratory, cardiovascular system, and liver diseases.
The liver is the largest internal organ and gland in the human body, which receives blood both from the portal vein and hepatic artery. Therefore, the liver is exposed to gut microbes as well as their metabolites and products. Previous studies showed that live commensal bacteria can be sampled by intestinal dendritic cells (DC) and transferred to the liver through the lymphatic route or portal vein. In healthy mice, the liver can act as a second firewall in which Kupffer cells can capture and clean commensal bacteria from the systemic vasculature. The healthy liver can maintain sterility by removing not only live commensal bacteria but also microbial metabolites and products.
Gut microbiota dysbiosis is related to chronic liver diseases, including alcoholic liver disease, non-alcoholic fatty liver disease, autoimmune liver disease, chronic hepatitis B and C, liver cirrhosis, and hepatocellular carcinoma (HCC). In mice, gut microbiota depletion was found to impair the HBV-specific T cell response and prolong HBV infection. In patients with hepatitis B-related cirrhosis, the gut microbiota community and metabolism mediated by the gut microbiota was significantly changed when compared with healthy controls. Reconstitution of the gut microbiota using fecal microbiota transplantation (FMT) facilitated hepatitis B virus e-antigen (HBeAg) clearance in patients with HBeAg-positive chronic hepatitis B after long-term antiviral therapy. FMT is also a potent therapy strategy for hepatic encephalopathy.
中山大学左涛教授在线讲解“肠道病毒群与真菌群在疾病中作用”暨2021（第七届）肠道微生态与健康国际研讨会会前会
肠道微生态与人体健康密切相关，针对肠道菌群影响疾病发生发展的机制研究一直热度不减。肠道菌群作用机制的研究，被寄希望于通过直接用于治疗、配合其他药物治疗、诊断等手段最终转化成临床价值，学界医疗界及产业界积极合作展开了多种肠道微生态治疗、微生物或其代谢产物作为标志物的研究；另一方面，通过饮食干预调节肠道微环境从而达到健康管理目的也是菌群研究的一个重要方向，这其中以益生菌的开发和临床应用最具应用前景。 肠道健康产业目前处于起步阶段，不管是基于微生物的诊断治疗产品、相关技术服务、菌株开发及产业化都还有很大的发展空间，与产业休戚相关的标准建立、市场规范、菌株专利等问题也不容忽视。