McCarville Justin L, Caminero Alberto, Verdu Elena F
Farncombe Family Digestive Health Research Institute, McMaster University, Hamilton, ON, Canada.
Farncombe Family Digestive Health Research Institute, McMaster University, 1280 Main Street West, Hamilton, ON, Canada L8S 4L8.
Therap Adv Gastroenterol. 2016 Jul;9(4):580-93. doi: 10.1177/1756283X16637819. Epub 2016 Apr 4.
The gut microbiota contributes to the maintenance of health and, when disrupted, may drive gastrointestinal and extragastrointestinal disease. This can occur through direct pathways such as interaction with the epithelial barrier and mucosal immune system or indirectly via production of metabolites. There is no current curative therapy for chronic inflammatory conditions such as inflammatory bowel disease, which are complex multifactorial disorders involving genetic predisposition, and environmental triggers. Therapies are directed to suppress inflammation rather than the driver, and these approaches are not devoid of adverse effects. Therefore, there is great interest in modulation of the gut microbiota to provide protection from disease. Interventions that modulate the microbiota include diet, probiotics and more recently the emergence of experimental therapies such as fecal microbiota transplant or phage therapy. Emerging data indicate that certain bacteria can induce protective immune responses and enhance intestinal barrier function, which could be potential therapeutic targets. However, mechanistic links and specific therapeutic recommendations are still lacking. Here we provide a pathophysiological overview of potential therapeutic applications of the gut microbiota.
肠道微生物群有助于维持健康，若其受到破坏，则可能引发胃肠道和胃肠道外疾病。这可通过直接途径发生，如与上皮屏障和黏膜免疫系统相互作用，或通过代谢产物的产生间接发生。目前对于诸如炎症性肠病等慢性炎症性疾病尚无治愈性疗法，这些疾病是涉及遗传易感性和环境触发因素的复杂多因素疾病。治疗方法旨在抑制炎症而非病因，且这些方法并非没有副作用。因此，人们对调节肠道微生物群以预防疾病产生了浓厚兴趣。调节微生物群的干预措施包括饮食、益生菌，以及最近出现的粪便微生物群移植或噬菌体疗法等实验性疗法。新出现的数据表明，某些细菌可诱导保护性免疫反应并增强肠道屏障功能，这可能是潜在的治疗靶点。然而，仍缺乏机制联系和具体的治疗建议。在此，我们提供了肠道微生物群潜在治疗应用的病理生理学概述。
