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Viszeralmedizin. 2015 Jun;31(3):156-61. doi: 10.1159/000431071. Epub 2015 Jun 5.

Biliary Mucosal Barrier and Microbiome.

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1
Department of Internal Medicine III, University Hospital RWTH Aachen, Aachen, Germany.

Abstract

BACKGROUND:

The biliary system is in continuous contact with the complex microbiota of the intestine. Microbial products have recently been proposed as potential triggers for biliary diseases.

METHODS:

The aim of this review is to provide a summary of the current knowledge regarding the role of the biliary and intestinal microbiome in biliary inflammatory diseases.

RESULTS:

Previously, it was suggested that the healthy biliary system is a sterile organ, while acute cholangitis and cholecystitis may occur from ascending infections. Although non-inflammatory biliary colonization by certain bacteria such as Salmonella spp. has been already recognized since several decades, human and animal studies indicated only very recently that the gallbladder harbors a complex microbiota also under non-pathologic conditions. Novel findings suggested that - similar to the situation in the intestine - the biliary mucosa features a chemical, mechanical, and immunological barrier, ensuring immunological tolerance against commensals. However, microbial triggers might influence acute and chronic inflammatory disease of the biliary system and the whole liver.

CONCLUSION:

Although yet undefined, dysbiosis of the biliary or intestinal microbiota rather than a single microorganism may influence disease progression.

KEYWORDS:

Bile acids; Cholecystolithiasis; Gallstones; Microbiome; Microbiota; PBC; PSC; Primary biliary cirrhosis; Primary sclerosing cholangitis

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