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Global hepatobiliary disease burden is increasing, prompting gut-liver axis research. Gut microbiota-secreted bacterial extracellular vesicles (BEVs) carry bioactive molecules affecting host immunity, inflammation, and metabolism. Whether BEVs actively or passively cause liver damage is unclear. This review suggests gut-derived BEVs trigger hepatic innate immunity and sterile inflammation. By combining current findings on how gut microbes, their BEVs, and hepatobiliary diseases interact, we improve the "gut-liver/bile axis" idea. Acknowledging BEVs' active part in disease offers new ways to use them as diagnostic markers and treatment targets, likely better managing hepatobiliary disorders.
Hu et al. (Wed,) studied this question.