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Microbiome-immune interactions in autoimmune liver diseases
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DOI：10.3748/wjg.v32.i12.115853.png)
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Abstract
En 中文
The impact of gut microbiota on immune regulation has received increasing attention in recent years, particularly its role in immune-mediated liver diseases such as autoimmune hepatitis (AIH), primary biliary cholangitis (PBC), primary sclerosing cholangitis (PSC), and immunoglobulin G4 (IgG4)-related sclerosing cholangitis (IgG4-SC). Disturbances in gut microbiota composition (gut dysbiosis) compromise the intestinal barrier and trigger abnormal immune activity, which foster persistent inflammation, autoimmunity and subsequent liver damage. An increase in Veillonella, Streptococcus, and Lactobacillus were found in most studies for all four diseases. A decrease in Clostridium was detected in AIH and PBC, but an increase in these bacteria is observed in PSC and IgG4-SC. Other common changes in AIH and PBC were an increase in Klebsiella and a decrease in Ruminococcus. In contrast, Ruminococcus is often found to be elevated in PSC. Common features of PBC and PSC are an increase in Enterococcus and a decrease in Faecalibacterium, Enterobacterium, and Coprococcus. Gut microbiome changes in IgG4-SC are most similar to PSC. Probiotics have positive effects in AIH and cholestatic liver diseases in small randomized controlled trial (RCTs). Positive effects of butyrate were in mice models of AIH and PBC. A small study found a positive effect of butyrate on patients with PBC. Indole-3-carboxaldehyde reduced the inflammatory activity of T-cells in patients with AIH in vitro and reduced inflammation in a PSC mouse model. Fecal microbiota transplantation showed beneficial effects in mouse models of AIH and in patients with PSC. Many studies demonstrated the effectiveness of microbiota-targeted therapy on mouse models of autoimmune liver diseases. However, these results remain to be verified in RCTs involving humans.
Keywords:
Microbiota
Microbiome
Bacterial translocation
Dysbiosis
Gut-liver axis
Gut-immunity axis
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