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肠道微生物群、免疫发育和功能。

Gut microbiota, immune development and function.

机构信息

Division of Surgery & Interventional Science, University College London, 4th floor, 74 Huntley Street, London WC1E 6AU, United Kingdom.

出版信息

Pharmacol Res. 2013 Mar;69(1):87-113. doi: 10.1016/j.phrs.2012.09.002. Epub 2012 Sep 16.

Abstract

The microbiota of Westerners is significantly reduced in comparison to rural individuals living a similar lifestyle to our Paleolithic forefathers but also to that of other free-living primates such as the chimpanzee. The great majority of ingredients in the industrially produced foods consumed in the West are absorbed in the upper part of small intestine and thus of limited benefit to the microbiota. Lack of proper nutrition for microbiota is a major factor under-pinning dysfunctional microbiota, dysbiosis, chronically elevated inflammation, and the production and leakage of endotoxins through the various tissue barriers. Furthermore, the over-comsumption of insulinogenic foods and proteotoxins, such as advanced glycation and lipoxidation molecules, gluten and zein, and a reduced intake of fruit and vegetables, are key factors behind the commonly observed elevated inflammation and the endemic of obesity and chronic diseases, factors which are also likely to be detrimental to microbiota. As a consequence of this lifestyle and the associated eating habits, most barriers, including the gut, the airways, the skin, the oral cavity, the vagina, the placenta, the blood-brain barrier, etc., are increasingly permeable. Attempts to recondition these barriers through the use of so called 'probiotics', normally applied to the gut, are rarely successful, and sometimes fail, as they are usually applied as adjunctive treatments, e.g. in parallel with heavy pharmaceutical treatment, not rarely consisting in antibiotics and chemotherapy. It is increasingly observed that the majority of pharmaceutical drugs, even those believed to have minimal adverse effects, such as proton pump inhibitors and anti-hypertensives, in fact adversely affect immune development and functions and are most likely also deleterious to microbiota. Equally, it appears that probiotic treatment is not compatible with pharmacological treatments. Eco-biological treatments, with plant-derived substances, or phytochemicals, e.g. curcumin and resveratrol, and pre-, pro- and syn-biotics offers similar effects as use of biologicals, although milder but also free from adverse effects. Such treatments should be tried as alternative therapies; mainly, to begin with, for disease prevention but also in early cases of chronic diseases. Pharmaceutical treatment has, thus far, failed to inhibit the tsunami of endemic diseases spreading around the world, and no new tools are in sight. Dramatic alterations, in direction of a paleolithic-like lifestyle and food habits, seem to be the only alternatives with the potential to control the present escalating crisis. The present review focuses on human studies, especially those of clinical relevance.

摘要

与生活方式与我们的穴居祖先相似的农村个体,以及与其他自由生活的灵长类动物(如黑猩猩)相比,西方人的微生物组显著减少。在西方工业化生产的食品中,绝大多数成分都被小肠上部吸收,因此对微生物组的益处有限。缺乏适当的营养物质是导致功能失调的微生物组、肠道菌群失调、慢性炎症升高以及内毒素通过各种组织屏障泄漏的主要因素。此外,过度摄入胰岛素生成食物和蛋白毒素,如糖基化和脂质氧化终产物、面筋和玉米醇溶蛋白,以及水果和蔬菜摄入量减少,是常见炎症升高和肥胖症和慢性病流行的关键因素,这些因素也可能对微生物组有害。由于这种生活方式和相关的饮食习惯,包括肠道、气道、皮肤、口腔、阴道、胎盘、血脑屏障等在内的大多数屏障的通透性越来越大。通过使用所谓的“益生菌”来调节这些屏障的尝试很少成功,有时甚至失败,因为它们通常作为辅助治疗方法应用,例如与重度药物治疗同时应用,药物治疗通常包括抗生素和化疗。越来越多的人观察到,大多数药物,即使是那些被认为副作用极小的药物,如质子泵抑制剂和抗高血压药,实际上也会对免疫发育和功能产生不利影响,而且很可能对微生物组也有害。同样,益生菌治疗似乎与药物治疗不兼容。生态生物学治疗,使用植物来源的物质或植物化学物质,如姜黄素和白藜芦醇,以及预、生和合生菌,具有与生物制剂相似的效果,尽管效果较温和,但也没有副作用。这些治疗方法应该作为替代疗法进行尝试;主要是,首先用于疾病预防,也用于慢性疾病的早期病例。迄今为止,药物治疗未能抑制在世界各地蔓延的地方性疾病的海啸,也没有新的工具出现。朝穴居人式生活方式和饮食习惯的急剧转变,似乎是控制目前不断升级的危机的唯一选择。本综述侧重于人体研究,特别是具有临床相关性的研究。

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