Prevention and treatment of hepatic encephalopathy: Focusing on gut microbiota

被引：48
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.
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收藏
页码：6693 / 6700
页数：8
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