Prevention and treatment of hepatic encephalopathy: Focusing on gut microbiota

被引：49

作者：

Garcovich, Matteo ^{[1
]}

Zocco, Maria Assunta ^{[1
]}

Roccarina, Davide ^{[1
]}

Ponziani, Francesca Romana ^{[1
]}

Gasbarrini, Antonio ^{[1
]}

机构：

[1] Univ Cattolica Sacro Cuore, Dept Internal Med, I-00197 Rome, Italy

来源：

WORLD JOURNAL OF GASTROENTEROLOGY | 2012年 / 18卷 / 46期

关键词：

Hepatic encephalopathy; Gut microbiota; Cirrhosis; Non-absorbable disaccharides; Rifaximin; INTESTINAL BACTERIAL OVERGROWTH; RANDOMIZED CONTROLLED-TRIAL; CHRONIC LIVER-DISEASES; TOLL-LIKE RECEPTORS; DOUBLE-BLIND; CIRRHOTIC-PATIENTS; GASTROINTESTINAL TRANSIT; FRUCTO-OLIGOSACCHARIDE; AUTONOMIC NEUROPATHY; CLINICAL-TRIAL;

D O I：

10.3748/wjg.v18.i46.6693

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

The gut flora plays an important role in the pathogenesis of the complications of cirrhosis. Hepatic encephalopathy (HE) represents a broad continuum of neuropsychological dysfunction in patients with acute or chronic liver disease and/or porto-systemic shunting of blood flow and it manifests with progressive deterioration of the superior neurological functions. The pathophysiology of this disease is complex, as it involves overproduction and reduced metabolism of various neurotoxins, particularly ammonia. Management of HE is diversified and requires several steps: elimination of precipitating factors, removal of toxins, proper nutritional support, modulation of resident fecal flora and downregulation of systemic and gut-derived inflammation. This review will provide an overview of gut barrier function and the influence of gut-derived factors on HE, focusing on the role of gut microbiota in the pathogenesis of HE and the recent literature findings on its therapeutic manipulation. (C) 2012 Baishideng. All rights reserved.

引用

页码：6693 / 6700

页数：8

共 68 条

[1]

Alcorn Joe, 2008, ACP J Club, V149, P11

[2]

Als-Nielsen B, 2004, Cochrane Database Syst Rev, DOI 10.1002/14651858.CD003044.pub2

[3] Kupffer cells in non-alcoholic fatty liver disease: The emerging view [J].

Baffy, Gyoergy .

JOURNAL OF HEPATOLOGY, 2009, 51 (01) :212-223

[4] Review article: the modern management of hepatic encephalopathy [J].

Bajaj, J. S. .

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2010, 31 (05) :537-547

[5] Inhibitory Control Test for the Diagnosis of Minimal Hepatic Encephalopathy [J].

Bajaj, Jasmohan S. ;

Hafeezullah, Muhammad ;

Franco, Jose ;

Varma, Rajiv R. ;

Hoffmann, Raymond G. ;

Knox, Joshua F. ;

Hischke, Darrell ;

Hammeke, Thomas A. ;

Pinkerton, Steven D. ;

Saeian, Kia .

GASTROENTEROLOGY, 2008, 135 (05) :1591-1600

[6] Probiotic yogurt for the treatment of minimal hepatic encephalopathy [J].

Bajaj, Jasmohan S. ;

Saeian, Kia ;

Christensen, Kenneth M. ;

Hafeezullah, Muhammad ;

Varma, Rajiv R. ;

Franco, Jose ;

Pleuss, Joan A. ;

Krakower, Glenn ;

Hoffmann, Raymond G. ;

Binion, David G. .

AMERICAN JOURNAL OF GASTROENTEROLOGY, 2008, 103 (07) :1707-1715

[7] Diagnosis and treatment of minimal hepatic encephalopathy to prevent motor vehicle accidents: A cost-effectiveness analysis [J].

Bajaj, Jasmohan S. ;

Pinkerton, Steven D. ;

Sanyal, Arun J. ;

Heuman, Douglas M. .

HEPATOLOGY, 2012, 55 (04) :1164-1171

[8] Linkage of gut microbiome with cognition in hepatic encephalopathy [J].

Bajaj, Jasmohan S. ;

Ridlon, Jason M. ;

Hylemon, Phillip B. ;

Thacker, Leroy R. ;

Heuman, Douglas M. ;

Smith, Sean ;

Sikaroodi, Masoumeh ;

Gillevet, Patrick M. .

AMERICAN JOURNAL OF PHYSIOLOGY-GASTROINTESTINAL AND LIVER PHYSIOLOGY, 2012, 302 (01) :G168-G175

[9] Rifaximin Improves Driving Simulator Performance in a Randomized Trial of Patients With Minimal Hepatic Encephalopathy [J].

Bajaj, Jasmohan S. ;

Heuman, Douglas M. ;

Wade, James B. ;

Gibson, Douglas P. ;

Saeian, Kia ;

Wegelin, Jacob A. ;

Hafeezullah, Muhammad ;

Bell, Debulon E. ;

Sterling, Richard K. ;

Stravitz, R. Todd ;

Fuchs, Michael ;

Luketic, Velimir ;

Sanyal, Arun J. .

GASTROENTEROLOGY, 2011, 140 (02) :478-U179

[10] Minimal Hepatic Encephalopathy Is Associated with Motor Vehicle Crashes: The Reality Beyond the Driving Test [J].

Bajaj, Jasmohan S. ;

Saeian, Fia ;

Schubert, Christine M. ;

Hafeezullah, Muhammad ;

Franco, Jose ;

Varma, Rajiv R. ;

Gibson, Douglas P. ;

Hoffmann, Raymond G. ;

Stravitz, R. Todd ;

Heuman, Douglas M. ;

Sterling, Richard K. ;

Shiffman, Mitchell ;

Topaz, Allyne ;

Boyett, Sherry ;

Bell, Debulon ;

Sanyall, Arun J. .

HEPATOLOGY, 2009, 50 (04) :1175-1183

← 1 2 3 4 5 6 7 →