Patients with chronic liver disease and cirrhosis demonstrate a global mucosal immune impairment, which is associated with altered gut microbiota composition and functionality. These changes progress along with the advancing degree of cirrhosis and can be linked with hepatic encephalopathy, infections and even prognostication independent of clinical biomarkers. Along with compositional changes, microbial functional alterations focused on short-chain fatty acids, bioenergetics and bile acid metabolism are also associated with cirrhosis progression and outcomes. Altering the microbial functional and structural profile is partly achieved by medications used in patients with cirrhosis such as rifaximin, lactulose, proton pump inhibitors and other antibiotics. However, the role of fecal or intestinal microbiota transplantation is being increasingly recognized. The challenges, opportunities and the road ahead for the appropriate and safe use of intestinal microbiota transplantation in liver disease are reviewed, which opens up an exciting field of investigation and therapy in cirrhosis.

中文翻译：

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肝病和肝硬化的微生物群变化和肠道微生物群移植

慢性肝病和肝硬化患者表现出整体黏膜免疫损伤，这与肠道微生物群组成和功能的改变有关。这些变化随着肝硬化程度的进展而进展，并且可能与肝性脑病、感染甚至预后相关，而与临床生物标志物无关。随着成分的变化，以短链脂肪酸、生物能量学和胆汁酸代谢为重点的微生物功能改变也与肝硬化的进展和结果有关。改变微生物功能和结构特征的部分原因是肝硬化患者使用的药物，如利福昔明、乳果糖、质子泵抑制剂和其他抗生素。然而，粪便或肠道微生物群移植的作用越来越得到认可。回顾了在肝病中适当和安全地使用肠道微生物群移植的挑战、机遇和前进的道路，这为肝硬化的研究和治疗开辟了一个令人兴奋的领域。