Department of Veterinary Medicine, University of Cambridge, Madingley Road, Cambridge CB3 0ES, UK.
Nat Rev Gastroenterol Hepatol. 2011 Mar;8(3):152-68. doi: 10.1038/nrgastro.2011.3. Epub 2011 Feb 8.
Crohn's disease is widely regarded as a multifactorial disease, and evidence from human and animal studies suggests that bacteria have an instrumental role in its pathogenesis. Comparison of the intestinal microbiota of patients with Crohn's disease to that of healthy controls has revealed compositional changes. In most studies these changes are characterized by an increase in the abundance of Bacteroidetes and Proteobacteria and a decrease in that of Firmicutes. In addition, a number of specific mucosa-associated bacteria have been postulated to have a role in Crohn's disease, including Mycobacterium avium subspecies paratuberculosis, adherent and invasive Escherichia coli, Campylobacter and Helicobacter species. The association between mutations in pattern-recognition receptors (Toll-like receptors and Nod-like receptors) and autophagy proteins and Crohn's disease provides further evidence to suggest that defective sensing and killing of bacteria may drive the onset of disease. In this Review, we present recent advances in understanding the role of bacteria and the contribution of pattern-recognition receptors and autophagy in the pathogenesis of Crohn's disease.
克罗恩病被广泛认为是一种多因素疾病，来自人体和动物研究的证据表明，细菌在其发病机制中起重要作用。将克罗恩病患者的肠道微生物组与健康对照组进行比较，发现了组成上的变化。在大多数研究中，这些变化的特征是厚壁菌门和变形菌门的丰度增加，而拟杆菌门和Firmicutes 的丰度减少。此外，一些特定的黏膜相关细菌被认为与克罗恩病有关，包括鸟分枝杆菌亚种副结核分枝杆菌、黏附侵袭性大肠杆菌、弯曲菌和幽门螺杆菌。模式识别受体（Toll 样受体和 Nod 样受体）和自噬蛋白突变与克罗恩病之间的关联提供了进一步的证据，表明细菌的检测和杀伤功能缺陷可能导致疾病的发生。在这篇综述中，我们介绍了对细菌作用以及模式识别受体和自噬在克罗恩病发病机制中的作用的最新研究进展。
