Gut-liver axis in cirrhosis:Are hemodynamic changes a missing link?  

作　　者：Roman Maslennikov Vladimir Ivashkin Irina Efremova Elena Poluektova Elena Shirokova 

机构地区：[1]Department of Internal Medicine,Gastroenterology and Hepatology,Sechenov University,Moscow 119435,Russia [2]The Interregional Public Organization"Scientific Community for the Promotion of the Clinical Study of the Human Microbiome",Moscow 119435,Russia [3]Department of Internal Medicine,Consultative and Diagnostic Center of the Moscow City Health Department,Moscow 107564,Russia

出　　处：《World Journal of Clinical Cases》2021年第31期9320-9332,共13页世界临床病例杂志

摘　　要：Recent evidence suggests that the condition of the gut and its microbiota greatly influence the course of liver disease,especially cirrhosis.This introduces the concept of the gut-liver axis,which can be imagined as a chain connected by several links.Gut dysbiosis,small intestinal bacterial overgrowth,and intestinal barrier alteration lead to bacterial translocation,resulting in systemic inflammation.Systemic inflammation further causes vasodilation,arterial hypotension,and hyperdynamic circulation,leading to the aggravation of portal hypertension,which contributes to the development of complications of cirrhosis,resulting in a poorer prognosis.The majority of the data underlying this model were obtained initially from animal experiments,and most of these correlations were further reproduced in studies including patients with cirrhosis.However,despite the published data on the relationship of the disorders of the gut microbiota with the complications of cirrhosis and the proposed pathogenetic role of hemodynamic disorders in their development,the direct relations between gut dysbiosis and hemodynamic changes in this disease are poorly studied.They remain a missing link in the gut-liver axis and a challenge for future research.

关 键 词：Gut microbiota Gut dysbiosis Small intestinal bacterial overgrowth Intestinal barrier Bacterial translocation VASODILATION Hyperdynamic circulation Gut microbiome Cardiac output Systemic vascular resistance 

分 类 号：R575.2[医药卫生—消化系统]