Liu Lu, Yin Minyue, Gao Jingwen, Yu Chenyan, Lin Jiaxi, Wu Airong, Zhu Jinzhou, Xu Chunfang, Liu Xiaolin
Department of Gastroenterology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.
J Clin Transl Hepatol. 2023 Apr 28;11(2):452-458. doi: 10.14218/JCTH.2022.00089. Epub 2022 Aug 22.
Nonalcoholic fatty liver disease (NAFLD) is the most common chronic liver disease worldwide. The mechanisms involved in NAFLD onset are complicated and multifactorial. Recent literature has indicated that altered intestinal barrier function is related to the occurrence and progression of liver disease. The intestinal barrier is important for absorbing nutrients and electrolytes and for defending against toxins and antigens in the enteric environment. Major mechanisms by which the intestinal barrier influences the development of NAFLD involve the altered epithelial layer, decreased intracellular junction integrity, and increased intestinal barrier permeability. Increased intestinal permeability leads to luminal dysbiosis and allows the translocation of pathogenic bacteria and metabolites into the liver, inducing inflammation, immune response, and hepatocyte injury in NAFLD. Although research has been directed to NAFLD in recent decades, the pathophysiological changes in NAFLD initiation and progression are still not completely understood, and the therapeutic targets remain limited. A deeper understanding on the correlation between NAFLD pathogenesis and intestinal barrier regulation must be attained. Therefore, in this review, the components of the intestinal barrier and their respective functions and disruptions during the progression of NAFLD are discussed.
非酒精性脂肪性肝病(NAFLD)是全球最常见的慢性肝病。NAFLD发病机制复杂且具有多因素性。最近的文献表明,肠道屏障功能改变与肝病的发生和进展有关。肠道屏障对于吸收营养物质和电解质以及抵御肠道环境中的毒素和抗原至关重要。肠道屏障影响NAFLD发展的主要机制包括上皮层改变、细胞内连接完整性降低以及肠道屏障通透性增加。肠道通透性增加会导致肠腔微生物群失调,并使病原菌和代谢产物易位至肝脏,从而在NAFLD中引发炎症、免疫反应和肝细胞损伤。尽管近几十年来一直针对NAFLD进行研究,但NAFLD起始和进展过程中的病理生理变化仍未完全明确,治疗靶点也仍然有限。必须更深入地了解NAFLD发病机制与肠道屏障调节之间的相关性。因此,在本综述中,我们将讨论肠道屏障的组成部分及其各自的功能,以及在NAFLD进展过程中的破坏情况。