Quigley Eamonn M M, Craig Orla F
University College Cork, Alimentary Pharmabiotic Centre, Cork, Ireland.
Turk J Gastroenterol. 2012 Aug;23(4):313-22. doi: 10.4318/tjg.2012.0551.
The description of the de novo development of irritable bowel syndrome following an episode of bacterial gastroenteritis (pos-infectious irritable bowel syndrome) illustrated the potential for a luminal factor (a bacterial pathogen) to cause this common gastrointestinal ailment. As a consequence of these and other observations, as well as results of experiments involving animal models, the enteric flora and the immune response that it generates in the host have, somewhat surprisingly, come centre-stage in irritable bowel syndrome research, given their potential to induce the pathophysiological changes that are associated with irritable bowel syndrome. While evidence for immune dysfunction both in the mucosa and systemically continues to accumulate, methodological limitations have hampered a full delineation of the nature of the microbiota in irritable bowel syndrome. The latter is eagerly awaited and may yet provide a firm rationale for the use of certain probiotics and antibiotics in irritable bowel syndrome, whose benefits have now been described with some consistency. Despite its prevalence, there is a striking lack of effective therapeutic options for irritable bowel syndrome. While there is reason for optimism in the management of irritable bowel syndrome with several promising new agents currently undergoing clinical trials, confirmation of the efficacy and safety of these agents in wider patient populations is awaited. A clearer understanding of the physiopathologic mechanisms underlying irritable bowel syndrome, as well as of interrelationships between irritable bowel syndrome and other gastrointestinal and non-gastrointestinal disorders, will likely be required before effective drug therapies can be found.
细菌性肠胃炎发作后新发肠易激综合征（感染后肠易激综合征）的描述表明，管腔内因素（一种细菌病原体）有可能引发这种常见的胃肠道疾病。基于这些及其他观察结果，以及涉及动物模型的实验结果，肠内菌群及其在宿主体内引发的免疫反应在肠易激综合征研究中出人意料地成为了核心关注点，因为它们有可能诱发与肠易激综合征相关的病理生理变化。尽管黏膜和全身免疫功能障碍的证据不断积累，但方法学上的局限性阻碍了对肠易激综合征中微生物群本质的全面描述。人们急切期待这方面的进展，它可能为在肠易激综合征中使用某些益生菌和抗生素提供坚实的理论依据，目前已对其益处进行了一些较为一致的描述。尽管肠易激综合征很常见，但明显缺乏有效的治疗选择。虽然目前有几种有前景的新药正在进行临床试验，这让人们对肠易激综合征的治疗感到乐观，但仍有待在更广泛的患者群体中证实这些药物的疗效和安全性。在找到有效的药物治疗方法之前，可能需要更清楚地了解肠易激综合征的病理生理机制，以及肠易激综合征与其他胃肠道和非胃肠道疾病之间的相互关系。
