酒精相关性肝病（ALD）由于过度饮酒产生特殊的肠道菌群组成。ALD患者的疾病进展无关生存期与肠道菌群失调程度相关。ALD中肠道菌群失调与疾病进展之间存在恶性循环，包括：乙醛生成及胆汁酸分泌增加，肠道屏障受损，血液循环菌群富集，菌群代谢产物毒性，一系列炎症介质的级联反应以及活性氧产生增加等。上述病理生理过程在ALD的不同疾病阶段中发挥重要作用，包括酒精性肝炎、ALD肝硬化、神经功能障碍和肝细胞癌等病变。本综述旨在阐述ALD中肠道菌群的病理生理，并明确肠脑相互作用机制，通过这些机制可以为ALD的未来治疗干预提供靶点选择的机会。版权所有 © 2023 Zhu、Wang、Pan和Xing。

Alcohol-related liver disease (ALD) from excessive alcohol intake has a unique gut microbiota profile. The disease progression-free survival in ALD patients has been associated with the degree of gut dysbiosis. The vicious cycles between gut dysbiosis and the disease progression in ALD including: an increase of acetaldehyde production and bile acid secretion, impaired gut barrier, enrichment of circulating microbiota, toxicities of microbiota metabolites, a cascade of pro-inflammatory chemokines or cytokines, and augmentation in the generation of reactive oxygen species. The aforementioned pathophysiology process plays an important role in different disease stages with a spectrum of alcohol hepatitis, ALD cirrhosis, neurological dysfunction, and hepatocellular carcinoma. This review aims to illustrate the pathophysiology of gut microbiota and clarify the gut-brain crosstalk in ALD, which may provide the opportunity of identifying target points for future therapeutic intervention in ALD.Copyright © 2023 Zhu, Wang, Pan and Xing.