肠易激综合征:一种与肠道微生物群相关的疾病?

Irritable bowel syndrome: a gut microbiota-related disorder?

作者信息

Bhattarai Yogesh, Muniz Pedrogo David A, Kashyap Purna C

机构信息

Enteric Neuroscience Program, Mayo Clinic, Rochester, Minnesota; and.

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota.

出版信息

Am J Physiol Gastrointest Liver Physiol. 2017 Jan 1;312(1):G52-G62. doi: 10.1152/ajpgi.00338.2016. Epub 2016 Nov 23.

Abstract

Irritable bowel syndrome (IBS) is one of the most common gastrointestinal (GI) disorders. Despite its prevalence, the pathophysiology of IBS is not well understood although multiple peripheral and central factors are implicated. Recent studies suggest a role for alterations in gut microbiota in IBS. Significant advances in next-generation sequencing technology and bioinformatics and the declining cost have now allowed us to better investigate the role of gut microbiota in IBS. In the following review, we propose gut microbiota as a unifying factor in the pathophysiology of IBS. We first describe how gut microbiota can be influenced by factors predisposing individuals to IBS such as host genetics, stress, diet, antibiotics, and early life experiences. We then highlight the known effects of gut microbiota on mechanisms implicated in the pathophysiology of IBS including disrupted gut brain axis (GBA), visceral hypersensitivity (VH), altered GI motility, epithelial barrier dysfunction, and immune activation. While there are several gaps in the field that preclude us from connecting the dots to establish causation, we hope this overview will allow us to identify and fill in the voids.

摘要

肠易激综合征(IBS)是最常见的胃肠道(GI)疾病之一。尽管其发病率很高,但尽管涉及多种外周和中枢因素,IBS的病理生理学仍未得到很好的理解。最近的研究表明肠道微生物群的改变在IBS中起作用。下一代测序技术和生物信息学的重大进展以及成本的下降现在使我们能够更好地研究肠道微生物群在IBS中的作用。在以下综述中,我们提出肠道微生物群是IBS病理生理学中的一个统一因素。我们首先描述肠道微生物群如何受到使个体易患IBS的因素的影响,如宿主遗传学、压力、饮食、抗生素和早期生活经历。然后,我们强调肠道微生物群对IBS病理生理学所涉及机制的已知影响,包括肠道-脑轴(GBA)紊乱、内脏超敏反应(VH)、胃肠动力改变、上皮屏障功能障碍和免疫激活。虽然该领域存在一些差距,使我们无法将各个点联系起来以确定因果关系,但我们希望这一概述将使我们能够识别并填补空白。

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