Biomedical Sciences Graduate Program, University of California San Diego, La Jolla, California.
Department of Pediatrics, University of California San Diego, La Jolla, California.
Clin Gastroenterol Hepatol. 2019 Jan;17(2):218-230. doi: 10.1016/j.cgh.2018.09.017. Epub 2018 Sep 18.
Advances in technical capabilities for reading complex human microbiomes are leading to an explosion of microbiome research, leading in turn to intense interest among clinicians in applying these techniques to their patients. In this review, we discuss the content of the human microbiome, including intersubject and intrasubject variability, considerations of study design including important confounding factors, and different methods in the laboratory and on the computer to read the microbiome and its resulting gene products and metabolites. We highlight several common pitfalls for clinicians, including the expectation that an individual's microbiome will be stable, that diet can induce rapid changes that are large compared with the differences among subjects, that everyone has essentially the same core stool microbiome, and that different laboratory and computational methods will yield essentially the same results. We also highlight the current limitations and future promise of these techniques, with the expectation that an understanding of these considerations will help accelerate the path toward routine clinical application of these techniques developed in research settings.
技术能力的进步使得对复杂的人类微生物组进行解读成为可能,这导致微生物组研究呈爆炸式增长,进而促使临床医生对将这些技术应用于患者产生了浓厚的兴趣。在这篇综述中,我们讨论了人类微生物组的内容,包括个体间和个体内的可变性、研究设计的考虑因素,包括重要的混杂因素,以及在实验室和计算机上读取微生物组及其产生的基因产物和代谢物的不同方法。我们强调了临床医生常见的几个误区,包括期望个体的微生物组是稳定的、饮食可以诱导与个体间差异相比变化较大的快速变化、每个人的核心粪便微生物组基本相同,以及不同的实验室和计算方法将产生基本相同的结果。我们还强调了这些技术的当前局限性和未来前景,期望对这些考虑因素的理解将有助于加速这些在研究环境中开发的技术向常规临床应用的发展。