臨牀消化器内科 Vol.32 No.10(1-7)

特集名	腸内細菌と臨床
題名	腸内細菌と消化器疾患（7）腸内細菌と肝疾患
発刊年月	2017年 09月
著者	冨田謙吾	防衛医科大学校内科学（消化器内科）
著者	穂苅量太	防衛医科大学校内科学（消化器内科）
【要旨】	肝臓は，門脈を介して腸管から直接の血流の供給を受ける臓器であり，肝臓病・肝臓癌の病態は，腸内細菌叢，細菌菌体成分，腸内細菌産生代謝物などの強い影響を受けることが近年明らかとなってきた．腸内細菌叢の乱れ（dysbiosis）は，腸管内のPAMPs（病原体関連分子パターン：pathogen‒associated molecular patterns），VOCs（揮発性有機化合物：volatileorganic compouns）をはじめとする種々の因子に大きな影響を与え，さらに腸管透過性亢進（leaky gut）をも促進し，門脈血流を介して肝臓病態を変化させる．腸内細菌叢をターゲットとした，プレバイオティクス，プロバイオティクス，抗生剤，糞便移植などの新たな治療法の確立が今後期待されるものである．

Theme	Roles and Importance of Microbiota in Clinical Medicine
Title	Gut Microbiota and Liver Disease
Author	Kengo Tomita	Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Defense Medical College
Author	Ryota Hokari	Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Defense Medical College
[ Summary ]	The liver is an organ that is supplied with blood flow directly from the intestinal tract via the portal vein. Recent studies have shown that the pathophysiology of liver diseases/liver cancer is strongly influenced by the composition of the gut microbiota, bacterial components, products, and metabolites. Dysbiosis, an ecological disorder of the bacterial community, has a great impact on several factors, including content of pathogen‒associated molecular patterns (PAMPs) and volatile organic compounds (VOCs) in the intestine, and promotes intestinal permeability (leaky gut) which modulates the development of liver pathology through portal blood flow. The establishment of new therapeutic modalities such as prebiotics, probiotics, antibiotics, and FMT targeting gut microbiota is expected in the future.