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已发表论文
肠肝轴：肝脏疾病中的分子机制与治疗靶点
Authors Ma L, Wang H, Jin Q, Sun Z, Yu S, Zhang Y
Received 4 July 2025
Accepted for publication 6 December 2025
Published 15 December 2025 Volume 2025:18 Pages 7531—7546
DOI https://doi.org/10.2147/IJGM.S551494
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Professor Kenneth Adler
Liang Ma,1 He Wang,2 Qiuyu Jin,3 Zhiwen Sun,3 Shuang Yu,4 Yang Zhang3
1First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, 150040, People’s Republic of China; 2Department of Cardiology, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, 150040, People’s Republic of China; 3Department of Gastroenterology, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, 150040, People’s Republic of China; 4College of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin, 150040, People’s Republic of China
Correspondence: Yang Zhang, Department of Gastroenterology, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 26 Heping Street, Xiangfang District, Harbin, Heilongjiang, 150006, People’s Republic of China, Email zhangyanghljucm@126.com
Abstract: The gut microbiota, often termed the “second genome”, demonstrates profound therapeutic potential through its intricate biological network connecting multiple distal organs. Although microbial diversity is strongly correlated with intestinal health, its systemic implications on overall physiological homeostasis remain incompletely understood. This review synthesizes the latest evidence from clinical trials, randomized controlled trials (RCTs), systematic reviews, and meta-analyses to elucidate the biological pathways and therapeutic applications of the gut–liver axis. Through comprehensive schematic illustrations, we delineate the molecular mechanisms underlying bidirectional gut–liver communication, including microbial metabolite signaling, immune modulation networks, and enterohepatic circulation dynamics. Although interventional studies have confirmed the beneficial physiological effects of microbial modulation, current mechanistic insights are predominantly derived from animal models with limited clinical translation. While large-scale cohort studies with long-term follow-up data remain imperative, the existing evidence strongly supports the clinical value of microbiome-targeted strategies for treating hepatic diseases and related complications. These findings establish a critical theoretical framework for the development of next-generation microbial therapeutics targeting the gut–liver axis. The novelty of this review lies in its systematic classification of gut microbiota and their metabolites in the pathogenesis and treatment of various liver diseases, its detailed elaboration on signaling pathways, and its dedicated focus on the role of Traditional Chinese Medicine (TCM) in modulating the gut–liver axis.
Keywords: gut microbiome, gut-liver axis, biological pathways, immune response, liver diseases, non-alcoholic fatty liver disease
1First Clinical Medical College, Heilongjiang University of Chinese Medicine, Harbin, 150040, People’s Republic of China; 2Department of Cardiology, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, 150040, People’s Republic of China; 3Department of Gastroenterology, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang, 150040, People’s Republic of China; 4College of Pharmacy, Heilongjiang University of Chinese Medicine, Harbin, 150040, People’s Republic of China
Correspondence: Yang Zhang, Department of Gastroenterology, First Affiliated Hospital of Heilongjiang University of Chinese Medicine, No. 26 Heping Street, Xiangfang District, Harbin, Heilongjiang, 150006, People’s Republic of China, Email zhangyanghljucm@126.com
Abstract: The gut microbiota, often termed the “second genome”, demonstrates profound therapeutic potential through its intricate biological network connecting multiple distal organs. Although microbial diversity is strongly correlated with intestinal health, its systemic implications on overall physiological homeostasis remain incompletely understood. This review synthesizes the latest evidence from clinical trials, randomized controlled trials (RCTs), systematic reviews, and meta-analyses to elucidate the biological pathways and therapeutic applications of the gut–liver axis. Through comprehensive schematic illustrations, we delineate the molecular mechanisms underlying bidirectional gut–liver communication, including microbial metabolite signaling, immune modulation networks, and enterohepatic circulation dynamics. Although interventional studies have confirmed the beneficial physiological effects of microbial modulation, current mechanistic insights are predominantly derived from animal models with limited clinical translation. While large-scale cohort studies with long-term follow-up data remain imperative, the existing evidence strongly supports the clinical value of microbiome-targeted strategies for treating hepatic diseases and related complications. These findings establish a critical theoretical framework for the development of next-generation microbial therapeutics targeting the gut–liver axis. The novelty of this review lies in its systematic classification of gut microbiota and their metabolites in the pathogenesis and treatment of various liver diseases, its detailed elaboration on signaling pathways, and its dedicated focus on the role of Traditional Chinese Medicine (TCM) in modulating the gut–liver axis.
Keywords: gut microbiome, gut-liver axis, biological pathways, immune response, liver diseases, non-alcoholic fatty liver disease