Del Fabbro Stefania, Calder Philip C, Childs Caroline E
School of Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK.
NIHR Southampton Biomedical Research Centre, University Hospital Southampton NHS Foundation Trust and University of Southampton, Southampton, UK.
Proc Nutr Soc. 2020 Apr 29:1-11. doi: 10.1017/S0029665120006953.
The aim of the present paper is to review the effects of non-digestible oligosaccharides (NDO) on immunity, focusing on their microbiota-independent mechanisms of action, as well as to explore their potential beneficial role in inflammatory bowel diseases (IBD). IBD are chronic, inflammatory conditions of the gastrointestinal tract. Individuals with IBD have an aberrant immune response to commensal microbiota, resulting in extensive mucosal inflammation and increased intestinal permeability. NDO are prebiotic fibres well known for their role in supporting intestinal health through modulation of the gut microbiota. NDO reach the colon intact and are fermented by commensal bacteria, resulting in the production of SCFA with immunomodulatory properties. In disease states characterised by increased gut permeability, prebiotics may also bypass the gut barrier and directly interact with intestinal and systemic immune cells, as demonstrated in patients with IBD and in infants with an immature gut. In vitro models show that fructooligosaccharides, inulin and galactooligosaccharides exert microbiota-independent effects on immunity by binding to toll-like receptors on monocytes, macrophages and intestinal epithelial cells and by modulating cytokine production and immune cell maturation. Moreover, animal models and human supplementation studies demonstrate that some prebiotics, including inulin and lactulose, might reduce intestinal inflammation and IBD symptoms. Although there are convincing preliminary data to support NDO as immunomodulators in the management of IBD, their mechanisms of action are still unclear and larger standardised studies need to be performed using a wider range of prebiotics.
本文旨在综述不可消化寡糖（NDO）对免疫的影响，重点关注其不依赖微生物群的作用机制，并探讨它们在炎症性肠病（IBD）中的潜在有益作用。IBD是胃肠道的慢性炎症性疾病。IBD患者对共生微生物群有异常的免疫反应，导致广泛的黏膜炎症和肠道通透性增加。NDO是益生元纤维，因其通过调节肠道微生物群来支持肠道健康的作用而闻名。NDO完整地到达结肠并被共生细菌发酵，产生具有免疫调节特性的短链脂肪酸。在以肠道通透性增加为特征的疾病状态下，益生元也可能绕过肠道屏障，直接与肠道和全身免疫细胞相互作用，IBD患者和肠道未成熟的婴儿就是如此。体外模型表明，低聚果糖、菊粉和低聚半乳糖通过与单核细胞、巨噬细胞和肠道上皮细胞上的Toll样受体结合，并调节细胞因子产生和免疫细胞成熟，对免疫发挥不依赖微生物群的作用。此外，动物模型和人体补充研究表明，一些益生元，包括菊粉和乳果糖，可能会减轻肠道炎症和IBD症状。尽管有令人信服的初步数据支持NDO作为IBD管理中的免疫调节剂，但其作用机制仍不清楚，需要使用更广泛的益生元进行更大规模的标准化研究。
