Chiriac Mircea T, Mahapatro Mousumi, Neurath Markus F, Becker Christoph
Department of Medicine 1, University Hospital Erlangen, University of Erlangen-Nuremberg, Erlangen, Germany.
Visc Med. 2017 May;33(2):153-162. doi: 10.1159/000470892. Epub 2017 Apr 7.
It has become increasingly evident over the past two decades that the microbiota plays a nurturing role in the development of the immune system. This appears to be important since the amplitude of immune responses has a crucial regulatory function in homeostasis and the prevention of unwanted inflammation. Hence, a malfunctioning gut flora has been shown to play a key role in visceral medicine. Strong evidence demonstrates for example that intestinal inflammation can develop as a result of a dysregulated microbiota, deficient antimicrobial responses, and aberrant bacterial translocation into the bowel wall. In healthy individuals, the bacterial translocation is blocked by a single layer of highly specialized intestinal epithelial cells which forms a strong barrier that lines the gut wall. This structure is responsible for an efficient absorption of nutrients while keeping the luminal flora at bay. In susceptible individuals, for yet incompletely understood reasons, either defective epithelial barrier function or dysregulated microbial composition or microbial pathogens drive intestinal inflammation. Many therapeutic strategies focusing on the modulation of the microbiota have been proposed recently but future research including prospective human studies and gnotobiotic mouse models are still needed to evaluate the contribution and potential therapeutic value of individual bacteria to human health.
在过去二十年中，越来越明显的是，微生物群在免疫系统的发育中发挥着滋养作用。这似乎很重要，因为免疫反应的幅度在体内平衡和预防不必要的炎症方面具有关键的调节功能。因此，肠道菌群失调已被证明在内科医学中起着关键作用。例如，有力的证据表明，肠道炎症可能是由于微生物群失调、抗菌反应不足以及细菌异常转移到肠壁而引起的。在健康个体中，细菌转移被单层高度特化的肠道上皮细胞所阻断，这些细胞形成了一道强大的屏障，排列在肠壁上。这种结构负责有效地吸收营养，同时阻止腔内菌群。在易感个体中，由于尚未完全理解的原因，上皮屏障功能缺陷、微生物组成失调或微生物病原体都会引发肠道炎症。最近已经提出了许多针对微生物群调节的治疗策略，但仍需要未来的研究，包括前瞻性人体研究和无菌小鼠模型，来评估单个细菌对人类健康的贡献和潜在治疗价值。
