Pathogenesis and Therapeutic Advances in Cholelithiasis: From Gut Microbiota Regulation to the Frontiers of Precision Medicine
Keywords:
Cholelithiasis, Gut Microbiota, FXR agonists, Metabolic dysbiosis, Bile acid metabolism, Precision medicineAbstract
Cholelithiasis, or gallstone disease, has long been associated with cholesterol oversaturation and biliary stasis. The gut microbiota and metabolic dysbiosis play an important role in the disease's development. This study explores the role of gut microbial community structure and metabolic derangements in gallstone formation and clinical consequences. This review integrates current literature on microbiome studies, multi-omics characterization, and precision medicine techniques in cholelithiasis. Gut dysbiosis disrupts bile acid balance, promotes inflammation, and facilitates cholesterol crystallization. Disease-associated microbial signatures include reduced diversity, increased Proteobacteria, and impaired bile salt hydrolase activity. New diagnostic technologies, such as Artificial Intelligence (AI)-based imaging and exosome biomarkers, aid in early detection. New molecular pathway medicines, such as Farnesoid X Receptor (FXR) agonists, customized probiotics, and phage therapy, have the potential to go beyond standard surgical treatments. Shortcomings include a lack of longitudinal data, limited efficacy of targeted drug delivery, and complexities in multi-omics integration. Combining gut microbiota information with metabolic and precision diagnostic approaches opens up new possibilities for individualized cholelithiasis prevention and therapy. Multidisciplinary and computational improvements are required to properly incorporate these findings into clinical practice.
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