gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2018-28-4-84-90gastro-j-255Research ArticleНАЦИОНАЛЬНАЯ ШКОЛА ГАСТРОЭНТЕРОЛОГОВ, ГЕПАТОЛОГОВNATIONAL COLLEGE OF GASTROENTEROLOGISTS, HEPATOLOGISTSНеалкогольная жировая болезнь печени, желчные кислоты и кишечная микробиотаNon-Alcoholic Fatty Liver Disease, Bile Acids and Intestinal MicrobiotaМасленниковР. В.MaslennikovR. V.

аспирант кафедры пропедевтики внутренних болезней лечебного факультета, 

1199991, г. Москва, ул. Погодинская, д. 1, стр. 1

Ph.D. researcher of the Department of Propaedeutics of Internal Diseases, Faculty of Physiology

mmmm00@yandex.ruЕвсютинаЮ. В.EvsyutinaYu. V.

кандидат медицинских наук, научный сотрудник отдела фундаментальных и прикладных аспектов ожирения,

101990, г. Москва, Петроверигский пер., д. 10, стр. 3

Cand. Sci. (Med.), Researcher, Department of Fundamental and Applied Aspects of Obesity

uselina@mail.ruФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» (Сеченовский университет) Министерства здравоохранения Российской ФедерацииРоссияI.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Healthcare of the Russian FederationRussian FederationФГБУ «Национальный медицинский исследовательский центр профилактической медицины» Министерства здравоохранения Российской ФедерацииРоссияNational Research Center for Preventive MedicineRussian Federation2018310820182848490Copyright © Масленников Р.В., Евсютина Ю.В., 20182018Масленников Р.В., Евсютина Ю.В.Maslennikov R.V., Evsyutina Y.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/255Цель обзора

Цель обзора:  представить современные данные о связи неалкогольной жировой болезни печени (НАЖБП) с нарушением метаболизма желчных кислот (ЖК) и изменением состава кишечной микробиоты.

Основные положения

Основные положения.  НАЖБП сопровождается изменением состава кишечной микробиоты: увеличивается доля таксонов, деконъюгирующих ЖК, и снижается процент таксонов, превращающих первичные ЖК во вторичные. Также увеличивается количество бактерий, образующих липополисахарид (ЛПС), который, поступая с кровью воротной вены в печень, способствует развитию в ней воспаления и инсулинорезистентности. Нарушение метаболизма желчных кислот через влияние на рецепторы FXR и TGR5 также приводит к инсулинорезистентности и стеатозу печени. Пробиотики и агонисты FXR — перспективные препараты для лечения НАЖБП.

Заключение

Заключение. При НАЖБП наблюдается изменение состава кишечной микробиоты, которое способствует развитию воспаления в печени и нарушает метаболизм желчных кислот, приводя к инсулинорезистентности. 

Aim

Aim.  The aim of the review is to present current data on the relationship between non-alcoholic fatty liver disease (NAFLD) with the metabolic disorders of bile acids (BA) and changes in the composition of the intestinal microbiota.

Background

Background.  NAFLD is accompanied by a change in the intestinal microbiotic composition: the proportion of taxa deconjugating BAs increases, while the proportion of taxa converting primary BAs to secondary ones decreases. The number of bacteria forming lipopolysaccharide (LPS) also increases. LPS, entering the liver with the portal vein blood, promotes the development of its inflammation and insulin resistance. The disturbance of bile acid metabolism through the effect on the FXR and TGR5 receptors also leads to insulin resistance and liver steatosis. FXR probiotics and agonists are promising drugs for the NAFLD treatment.

Conclusion

Conclusion.  In the course of NAFLD, a change in the composition of the intestinal microbiota is observed, which contributes to the development of inflammation in the liver and disrupts the metabolism of bile acids, leading to insulin resistance. 

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The authors declare that there are no conflicts of interest present.