Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Curr Opin Infect Dis. 2010 Oct;23(5):470-4. doi: 10.1097/QCO.0b013e32833da1eb.
The purpose of this review is to describe recent progress in the understanding of the role of Bacteroides spp. in human diarrheal diseases and newer murine studies implicating certain Bacteroides spp. in colorectal cancer.
Bacteroides fragilis is the only strain of Bacteroides spp. associated with diarrheal disease. Toxin-producing strains of B. fragilis, termed enterotoxigenic Bacteroides fragilis (ETBF), are an established cause of diarrheal disease in people. The clinical syndrome associated with ETBF diarrheal disease encompasses abdominal pain, tenesmus and inflammatory diarrhea. Two new studies conducted in mice have further defined the chronic inflammatory response associated with ETBF infection and observed that in the multiple intestinal neoplasia mouse strain, heterozygotes for the adenomatous polyposis coli gene, ETBF infection enhances development of colonic tumors. Separate murine studies have begun to define the role of nontoxin-producing B. fragilis as a symbiont, serving possibly to protect the host from colonic inflammation.
B. fragilis remains the leading anaerobe in human disease. ETBF is emerging as an important cause of human diarrheal disease but additional epidemiologic studies are needed to better understand the role of ETBF human disease.
目的综述：本综述旨在描述对拟杆菌属在人类腹泻疾病中作用的最新研究进展，以及涉及某些拟杆菌属与结直肠癌关系的新的小鼠研究。
最近发现：脆弱拟杆菌是唯一与腹泻疾病相关的拟杆菌属菌株。产毒脆弱拟杆菌，称为肠毒素产生脆弱拟杆菌（ETBF），是引起人类腹泻疾病的公认原因。与 ETBF 腹泻疾病相关的临床综合征包括腹痛、里急后重和炎症性腹泻。两项在小鼠中进行的新研究进一步定义了与 ETBF 感染相关的慢性炎症反应，并观察到在多发性肠息肉小鼠模型中，APC 基因杂合子，ETBF 感染增强结肠肿瘤的发展。单独的小鼠研究已经开始定义非产毒脆弱拟杆菌作为共生体的作用，可能有助于宿主免受结肠炎症的影响。
总结：脆弱拟杆菌仍然是人类疾病中的主要厌氧菌。ETBF 作为人类腹泻疾病的一个重要病因正在显现，但需要更多的流行病学研究来更好地理解 ETBF 与人类疾病的关系。
