Gut-liver axis in liver cirrhosis： How to manage leaky gutand endotoxemia
摘要
A ＂leaky gut＂ may be the cutting edge for the passageof toxins, antigens or bacteria into the body, andmay play a pathogenic role in advanced liver cirrhosisand its complications. Plasma endotoxin levels havebeen admitted as a surrogate marker of bacterialtranslocation and close relations of endotoxemia tohyperdynamic circulation, portal hypertension, renal,cardiac, pulmonary and coagulation disturbanceshave been reported. Bacterial overgrowth, increasedintestinal permeability, failure to inactivate endotoxin,activated innate immunity are all likely to play a rolein the pathological states of bacterial translocation.Therapeutic approach by management of the gut-liveraxis by antibiotics, probiotics, synbiotics, prebiotics andtheir combinations may improve the clinical course ofcirrhotic patients. Special concern should be paid onanti-endotoxin treatment. Adequate management ofthe gut-liver axis may be effective for prevention of livercirrhosis itself by inhibiting the progression of fibrosis.