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Z Gastroenterol 2021; 59(01): 63-68
DOI: 10.1055/a-1330-9644
Übersicht

Bile Acids in Control of the Gut-Liver-Axis

Gallensäuren steuern die Darm-Leber-Achse
Benedikt Hild 
  Medizinische Klinik B (Gastroenterologie, Hepatologie, Endokrinologie, Klinische Infektiologie), Universitätsklinikum Münster, Munster, Germany
,
Hauke S. Heinzow
  Medizinische Klinik B (Gastroenterologie, Hepatologie, Endokrinologie, Klinische Infektiologie), Universitätsklinikum Münster, Munster, Germany
,
Hartmut H. Schmidt
  Medizinische Klinik B (Gastroenterologie, Hepatologie, Endokrinologie, Klinische Infektiologie), Universitätsklinikum Münster, Munster, Germany
,
Miriam Maschmeier
  Medizinische Klinik B (Gastroenterologie, Hepatologie, Endokrinologie, Klinische Infektiologie), Universitätsklinikum Münster, Munster, Germany
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Abstract

The liver and gut share an intimate relationship whose communication relies heavily on metabolites, among which bile acids play a major role. Beyond their function as emulsifiers, bile acids have been recognized for their influence on metabolism of glucose and lipids as well as for their impact on immune responses. Therefore, changes to the composition of the bile acid pool can be consequential to liver and to gut physiology. By metabolizing primary bile acids to secondary bile acids, the bacterial gut microbiome modifies how bile acids exert influence. An altered ratio of secondary to primary bile acids is found to be substantial in many studies. Thus, disease pathogenesis and progression could be changed by gut microbiome modification which influences the bile acid pool.

Zusammenfassung

Leber und Darm sind sehr eng miteinander verbunden. Ihre Interaktion erfolgt dabei u. a. über Metaboliten, die maßgeblich über die Pfortader und den Gallengang ausgetauscht werden. Eine besondere Bedeutung kommt dabei Gallensäuren zu. Neben ihrer Funktion als Emulgatoren spielen Gallensäuren nicht nur im Glucose- und Lipidstoffwechsel eine wichtige Rolle, sondern nehmen auch Einfluss auf die Immunantwort. Veränderungen der Gallezusammensetzung können sich daher sowohl auf die Physiologie der Leber als auch des Darms auswirken. Darmbakterien wandeln primäre in sekundäre Gallensäuren um und können auf diese Art den Einfluss der Gallensäuren modifizieren. Zahlreiche Studien belegen die Bedeutung eines veränderten Verhältnisses von primären zu sekundären Gallensäuren. Durch eine Modifikation des Darm-Mikrobioms, die wiederum Einfluss auf den Gallensäuren-Pool ausübt, könnte so die Pathogenese und der Verlauf zahlreicher Krankheiten verändert werden.

Key words

FXR - secondary bile acids - bacterial microbiome - NASH - metabolism - liver cancer - IBD

Schlüsselwörter

FXR - sekundäre Gallensäuren - bakterielles Mikrobiom - NASH - Stoffwechsel - Leberkarzinom - IBD


Publication History

Received: 01 November 2020

Accepted: 04 December 2020

Article published online:
11 January 2021

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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