Department of Internal Medicine/Infectious Diseases Division, University of Michigan Medical School, Ann Arbor, MI 48109-5666, USA
BMJ. 2017 Mar 15;356:j831. doi: 10.1136/bmj.j831.
Research into the microbiome-the indigenous microbial communities (microbiota) and the host environment that they inhabit-has changed clinicians' ideas about microbes in human health and disease. Perhaps the most radical change is the realization that most of the microbes that inhabit our body supply crucial ecosystem services that benefit the entire host-microbe system. These services include the production of important resources, bioconversion of nutrients, and protection against pathogenic microbes. Thus disease can result from a loss of beneficial functions or the introduction of maladaptive functions by invading microbes. This review will show how an understanding of the dynamics and function of the indigenous microbiota has altered our view of microbes in maintaining homeostasis and causing disease. It will discuss how disruption of the beneficial functions of the microbiota can lead to disease. Methods for studying the microbiota will be introduced as part of a conceptual framework for using these methods to delineate novel roles for microbes in health. Key associations between specific changes in the microbiome and disease will be discussed. This will lead to an explanation of how the intentional manipulation of the microbiota, either by restoring missing functions or eliminating harmful functions, may lead to novel methods to prevent or treat a variety of diseases. With the explosion of studies relating the microbiome to health and disease, this review aims to provide a foundation for clinicians to follow this developing area of biomedical research.
对微生物组（微生物群落及其栖息的宿主环境）的研究改变了临床医生对人类健康和疾病中微生物的看法。也许最激进的变化是认识到，栖息在我们体内的大多数微生物提供了对整个宿主-微生物系统有益的关键生态系统服务。这些服务包括重要资源的生产、营养物质的生物转化以及对致病微生物的保护。因此，疾病可能是由于有益功能的丧失或入侵微生物引入适应不良的功能而导致的。这篇综述将展示对土著微生物群落动态和功能的理解如何改变了我们对维持体内平衡和导致疾病的微生物的看法。它将讨论有益微生物功能的破坏如何导致疾病。将介绍研究微生物组的方法，作为利用这些方法描绘微生物在健康中发挥新作用的概念框架的一部分。将讨论特定微生物组变化与疾病之间的关键关联。这将解释为什么有意操纵微生物组，无论是通过恢复缺失的功能还是消除有害的功能，都可能导致预防或治疗各种疾病的新方法。随着将微生物组与健康和疾病相关联的研究的爆炸式增长，本综述旨在为临床医生提供一个基础，以跟踪这一不断发展的生物医学研究领域。
