"INSERM, Université Pierre et Marie Curie - Paris, Assistance Publique-Hôpitaux de Paris", France.
Nat Rev Gastroenterol Hepatol. 2012 Oct;9(10):590-8. doi: 10.1038/nrgastro.2012.161. Epub 2012 Aug 28.
The gut microbiota is recognized to have an important role in energy storage and the subsequent development of obesity. To date, bariatric surgery (indicated for severe obesity) represents the only treatment that enables substantial and sustained weight loss. Bariatric surgery is also a good model to study not only the pathophysiology of obesity and its related diseases but also the mechanisms involved in their improvement after weight reduction. Scarce data from humans and animal models have demonstrated that gut microbiota composition is modified after Roux-en-Y gastric bypass (RYGB), suggesting that weight reduction could affect gut microbiota composition. However, weight loss might not be the only factor responsible for those modifications. Indeed, bariatric surgery not only improves hormonal and inflammatory status, but also induces numerous changes in the digestive tract that might account for the observed modifications of microbiota ecology. In future bariatric surgery studies in humans or mice, these major surgery-induced modifications will need to be taken into account when analyzing the link between gut microbiota composition, obesity, its complications and their improvement after bariatric surgery. This Review outlines the potential mechanisms by which the major changes in the digestive tract after bariatric surgery can affect the gut microbiota.
肠道微生物群被认为在能量储存和随后的肥胖发展中起着重要作用。迄今为止，减肥手术（适用于严重肥胖）是唯一能够实现显著和持续减肥的治疗方法。减肥手术也是研究肥胖及其相关疾病的病理生理学以及减肥后其改善所涉及的机制的良好模型。来自人类和动物模型的稀缺数据表明，Roux-en-Y 胃旁路术（RYGB）后肠道微生物群组成发生了改变，这表明体重减轻可能会影响肠道微生物群组成。然而，体重减轻可能不是导致这些改变的唯一因素。事实上，减肥手术不仅改善了激素和炎症状态，还引起了消化道的许多变化，这些变化可能解释了观察到的微生物群落生态改变。在未来的人类或小鼠减肥手术研究中，在分析肠道微生物群落组成、肥胖及其并发症与减肥手术后改善之间的联系时，需要考虑到这些主要手术引起的改变。这篇综述概述了减肥手术后消化道的主要变化影响肠道微生物群的潜在机制。
