Shanahan Fergus
Alimentary Pharmabiotic Centre, Department of Medicine, Clinical Science Building, Cork University Hospital, University College Cork, National University of Ireland, Wilton, Cork, Ireland.
Adv Drug Deliv Rev. 2004 Apr 19;56(6):809-18. doi: 10.1016/j.addr.2003.11.003.
The intestinal flora has a conditioning effect on intestinal homeostasis, delivering regulatory signals to the epithelium, the mucosal immune system and to the neuromuscular activity of the gut. Beneficial metabolic activities of the enteric flora include nutrient production, metabolism of dietary carcinogens, conversion of prodrugs to active drugs. However, increasing evidence suggests that some components of the enteric flora are essential ingredients in the pathogenesis of inflammatory bowel disease (IBD); this has prompted interest in therapeutic manipulation of the flora with probiotics. Probiotics are biologic control agents-described as live microbial food supplements which confer a health benefit beyond inherent basic nutrition. Multiple potential beneficial effects have been attributed to the probiotic use of lactic acid bacteria, bifidobacteria and other non-pathogenic commensals. At present, much of the promise of probiotics remains outside the realm of evidence-based medicine and awaits the results of prospective trials, now underway. No reliable in vitro predictors of in vivo efficacy of putative probiotics have been identified. Rigorous comparisons of probiotic performance have not been performed and the suitability of a given probiotic for different individuals is largely unexplored. Notwithstanding, an improved understanding of the normal commensal flora and host-flora interactions has the potential to open up new therapeutic strategies for inflammatory disorders of the gut.
肠道菌群对肠道内环境稳定具有调节作用，可向肠上皮、黏膜免疫系统及肠道神经肌肉活动传递调节信号。肠道菌群的有益代谢活动包括营养物质产生、膳食致癌物代谢、前体药物转化为活性药物。然而，越来越多的证据表明，肠道菌群的某些成分是炎症性肠病（IBD）发病机制中的关键因素；这引发了人们对用益生菌进行菌群治疗性调控的兴趣。益生菌是生物控制剂，被描述为活的微生物食品补充剂，除了提供基本营养外还能带来健康益处。乳酸菌、双歧杆菌及其他非致病性共生菌的益生菌应用已被赋予多种潜在益处。目前，益生菌的诸多前景仍处于循证医学范畴之外，有待正在进行的前瞻性试验的结果。尚未确定推测的益生菌体内功效的可靠体外预测指标。尚未对益生菌性能进行严格比较，且特定益生菌对不同个体的适用性在很大程度上尚未得到探索。尽管如此，对正常共生菌群及宿主 - 菌群相互作用的深入理解有可能为肠道炎症性疾病开辟新的治疗策略。
