From Harvard Medical School, Boston, Massachusetts.
Ann Intern Med. 2017 Jan 17;166(2):133-138. doi: 10.7326/M16-1855.
In recent medical and popular literature, audiences have been asked to consider whether antibiotics have contributed to the rising obesity epidemic. Prominent magazines have stated that weight may be adversely affected by antibiotics that destroy existing microbiomes and replace them with less helpful ones. However, there is a long history of efforts to investigate the relationship between antibiotics and human weight gain. In the early 1950s, amid initial findings that low doses of antibiotics served as growth promoters in animal livestock, investigators explored the role of antibiotics as magic bullets for human malnutrition. Nevertheless, early enthusiasm was tempered by controlled studies showing that antibiotics did not serve as useful, nonspecific growth promoters for humans. In subsequent decades, against the backdrop of rising concern over antibiotic resistance, investigators studying the role of antibiotics in acute malnutrition have had to navigate a more complicated public health calculus. In a related historical stream, scientists since the 1910s have explored the role of the intestinal microflora in human health. By the 2000s, as increasing resources and more sophisticated tools were devoted to understanding the microbiome (a term coined in 2001), attention would turn to the role of antibiotics and the intestinal microflora in the rising obesity epidemic. Despite scientific and commercial enthusiasm, easy answers (whether about antibiotics or probiotics) have again given way to an appreciation for the complexity of human growth. History encourages caution about our hopes for simplistic answers for presumed "fat drugs" and slimming probiotics alike.
在最近的医学和大众文学作品中,人们被要求考虑抗生素是否促成了肥胖症的流行。一些著名杂志指出,抗生素可能会破坏现有的微生物群落,并取而代之的是效果较差的微生物群落,从而对体重产生不利影响。然而,人们一直努力研究抗生素与人类体重增加之间的关系。早在 20 世纪 50 年代,人们最初发现低剂量的抗生素可以促进动物牲畜生长,随后调查人员就探索了抗生素作为人类营养不良的“神奇子弹”的作用。然而,早期的研究结果被控制研究削弱了,这些研究表明抗生素对人类没有作为有用的、非特异性的生长促进剂。在随后的几十年里,随着人们对抗生素耐药性的日益关注,研究抗生素在急性营养不良中作用的研究人员不得不面对更复杂的公共卫生计算。在一个相关的历史脉络中,自 20 世纪 10 年代以来,科学家们一直在探索肠道微生物群在人类健康中的作用。到 21 世纪 00 年代,随着越来越多的资源和更复杂的工具被用于理解微生物组(该术语于 2001 年提出),人们开始关注抗生素和肠道微生物群在不断上升的肥胖症流行中的作用。尽管科学界和商业界热情高涨,但简单的答案(无论是关于抗生素还是益生菌)再次让位于对人类生长复杂性的认识。历史告诫我们要谨慎对待我们对假定的“肥胖药物”和减肥益生菌的简单答案的期望。