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艰难梭菌感染和炎症性肠病的微生物组学见解。

MICROBIOTA INSIGHTS IN CLOSTRIDIUM DIFFICILE INFECTION AND INFLAMMATORY BOWEL DISEASE.

机构信息

Instituto de Investigación Biomédica de Málaga-IBIMA , Málaga, Spain.

Unidad de Gestión Clínica de Aparato Digestivo, Hospital Universitario Virgen de la Victoria , Málaga, Spain.

出版信息

Gut Microbes. 2020 Nov 9;12(1):1725220. doi: 10.1080/19490976.2020.1725220. Epub 2020 Mar 4.

Abstract

Inflammatory bowel disease (IBD) is characterized by chronic intestinal inflammation that includes Crohn´s disease (CD) and ulcerative colitis (UC). Although the etiology is still unknown, some specific factors have been directly related to IBD, including genetic factors, abnormal intestinal immunity, and/or gut microbiota modifications. Recent findings highlight the primary role of the gut microbiota closely associated with a persistent inappropriate inflammatory response. This gut environment of dysbiosis in a susceptible IBD host can increasingly worsen and lead to colonization and infection with some opportunistic pathogens, especially is an intestinal pathogen considered the main cause of antibiotic-associated diarrhea and colitis and an important complication of IBD, which can trigger or worsen an IBD flare. Recent findings have highlighted the loss of bacterial cooperation in the gut ecosystem, as well as the pronounced intestinal dysbiosis, in patients suffering from IBD and concomitant infection (CDI). The results of intestinal microbiota studies are still limited and often difficult to compare because of the variety of disease conditions. However, these data provide important clues regarding the main modifications and interrelations in the complicated gut ecosystem to better understand both diseases and to take advantage of the development of new therapeutic strategies. In this review, we analyze in depth the gut microbiota changes associated with both forms of IBD and CDI and their similarity with the dysbiosis that occurs in CDI. We also discuss the metabolic pathways that favor the proliferation or decrease in several important taxa directly related to the disease.

摘要

炎症性肠病(IBD)的特征是慢性肠道炎症,包括克罗恩病(CD)和溃疡性结肠炎(UC)。尽管病因尚不清楚,但一些特定因素已被直接与 IBD 相关联,包括遗传因素、肠道免疫异常和/或肠道微生物群的改变。最近的研究结果强调了与持续的不适当炎症反应密切相关的肠道微生物群的主要作用。在易患 IBD 的宿主中,这种肠道微生态失调环境可以逐渐恶化,并导致某些机会性病原体的定植和感染,特别是艰难梭菌,它被认为是抗生素相关性腹泻和结肠炎的主要原因,也是 IBD 的一个重要并发症,可引发或加重 IBD 发作。最近的研究结果强调了在患有 IBD 和同时艰难梭菌感染(CDI)的患者中,肠道生态系统中细菌合作的丧失以及明显的肠道失调。肠道微生物群研究的结果仍然有限,并且由于疾病状况的多样性,通常难以比较。然而,这些数据为复杂肠道生态系统中的主要变化和相互关系提供了重要线索,有助于更好地了解这两种疾病,并利用新的治疗策略的发展。在这篇综述中,我们深入分析了与 IBD 和 CDI 两种形式相关的肠道微生物群变化及其与 CDI 中发生的失调的相似性。我们还讨论了有利于与疾病直接相关的几个重要分类群增殖或减少的代谢途径。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5e9/7524151/f52887bad1c8/KGMI_A_1725220_F0001_OC.jpg

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