腸道微生物群（GM）是一個由細菌、原生動物、古細菌、真菌和病毒組成的多樣性生態系統，在人類健康的生理病理條件中發揮著重要作用，不可避免地會影響胃腸道、肝臟、呼吸系統、心血管、內分泌和許多其他疾病的發病機制。近年來，腸肝軸受到了越來越多的關注。GM通訊是雙向的，涉及內分泌和免疫學機制，因而腸道營養不良和「古代」微生物群的組成可能與許多慢性肝病的發病機理有關。International Journal of Molecular Sciences雜誌近期發表了腸肝軸、腸道菌群及其在肝病治療中調控作用的相關綜述：Milosevic I, Vujovic A, Barac A, et al. Gut-liver axis, gut microbiota, and its modulation in the management of liver diseases: A review of the literature. Int J Mol Sci. 2019 Jan 17;20(2). doi: 10.3390/ijms20020395。
該綜述介紹了腸肝軸、菌群失調參與慢性B型肝炎（CHB）、慢性C型肝炎（CHC）、酒精性肝病（ALD）、非酒精性脂肪肝疾病（NAFLD）和非酒精性脂肪肝炎（NASH）、肝性腦病（HE）和自發性細菌性腹膜炎（SBP）、肝細胞癌（HCC）發生的潛在機制，並介紹了針對GM的潛在治療靶點，包括糞便移植、抗生素、益生菌、益生元和共生等。
該綜述提出，GM在人群水平的變化能在腸肝軸中起調節作用，因而在慢性肝病的發病機制中也起著調節作用。
Abstract
The rapid scientific interest in gut microbiota (GM) has coincided with a global increase in the prevalence of infectious and non-infectivous liver diseases. GM, which is also called "the new virtual metabolic organ", makes axis with a number of extraintestinal organs, such as kidneys, brain, cardiovascular, and the bone system. The gut-liver axis has attracted greater attention in recent years. GM communication is bi-directional and involves endocrine and immunological mechanisms. In this way, gut-dysbiosis and composition of "ancient" microbiota could be linked to pathogenesis of numerous chronic liver diseases such as chronic hepatitis B (CHB), chronic hepatitis C (CHC), alcoholic liver disease (ALD), non-alcoholic fatty liver disease (NAFLD), non-alcoholic steatohepatitis (NASH), development of liver cirrhosis, and hepatocellular carcinoma (HCC). In this paper, we discuss the current evidence supporting a GM role in the management of different chronic liver diseases and potential new therapeutic GM targets, like fecal transplantation, antibiotics, probiotics, prebiotics, and symbiotics. We conclude that population-level shifts in GM could play a regulatory role in the gut-liver axis and, consequently, etiopathogenesis of chronic liver diseases. This could have a positive impact on future therapeutic strategies.