Division of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Kaohsiung J Med Sci. 2019 Feb;35(2):73-82. doi: 10.1002/kjm2.12011.
Germ theory of disease and Koch's postulates has been governing our understanding of the role of microbes in human health since 19th century. The discovery of Helicobacter pylori (H. pylori) and H. pylori associated diseases has typically represented the concept and framework of Koch's postulates. Eradication of H. pylori to prevent peptic ulcers recurrence and gastric cancer is the triumph of this microbiology paradigm. Advances of next generation sequencing provide great insight into the unculturable microbes and show trillions of microbes have evolved with human beings. Research into the microbiome-the microbial communities (microbiota) and the host environment that they inhabit-has changed our understanding about microbes in human health and disease. The gut microbiota, the largest reservoir of the microbiome in human, plays a critical role in our catabolic-metabolism and immunity. This review will show the changes of the view of microbes on human health. We will briefly discuss dysbiosis, the disruption of symbiotic relationship between the host and microbiota, and the associated diseases. This leads to an idea to manipulate the microbiota, either by restoring missing functions or by eliminating harmful functions, to prevent or treat a variety of diseases. Current evidences of two common germ therapies, fecal microbiota transplantation and probiotics, in treating diseases will be reviewed.
自 19 世纪以来，疾病的细菌理论和科赫假设一直主导着我们对微生物在人类健康中作用的理解。幽门螺杆菌（H. pylori）的发现及其相关疾病典型地代表了科赫假设的概念和框架。根除 H. pylori 以预防消化性溃疡复发和胃癌是这一微生物学范例的胜利。下一代测序技术的进步为研究无法培养的微生物提供了深刻的见解，并表明数以万亿计的微生物与人类一起进化。对微生物组（微生物群落和它们所栖息的宿主环境）的研究改变了我们对微生物在人类健康和疾病中的认识。肠道微生物组是人类微生物组中最大的储存库，在我们的分解代谢-代谢和免疫中起着关键作用。这篇综述将展示人们对微生物与人类健康关系的看法的变化。我们将简要讨论微生态失调，即宿主和微生物群之间共生关系的破坏，以及相关疾病。这导致了一种通过恢复缺失的功能或消除有害的功能来操纵微生物群，以预防或治疗各种疾病的想法。将回顾两种常见的细菌疗法，粪便微生物移植和益生菌，在治疗疾病方面的现有证据。
