Department of Metabolism Digestion and Reproduction, Imperial College London, UK.
Institute of Health Futures, Murdoch University, Perth, WA, Australia.
J Crohns Colitis. 2021 May 4;15(5):813-826. doi: 10.1093/ecco-jcc/jjaa227.
The inflammatory bowel diseases [IBD], Crohn's disease and ulcerative colitis, are chronic, idiopathic gastrointestinal diseases. Although their precise aetiology is unknown, it is thought to involve a complex interaction between genetic predisposition and an abnormal host immune response to environmental exposures, probably microbial. Microbial dysbiosis has frequently been documented in IBD. Metabolomics [the study of small molecular intermediates and end products of metabolism in biological samples] provides a unique opportunity to characterize disease-associated metabolic changes and may be of particular use in quantifying gut microbial metabolism. Numerous metabolomic studies have been undertaken in IBD populations, identifying consistent alterations in a range of molecules across several biological matrices. This systematic review aims to summarize these findings.
A comprehensive, systematic search was carried out using Medline and Embase. All studies were reviewed by two authors independently using predefined exclusion criteria. Sixty-four relevant papers were assessed for quality and included in the review.
Consistent metabolic perturbations were identified, including increases in levels of branched chain amino acids and lipid classes across stool, serum, plasma and tissue biopsy samples, and reduced levels of microbially modified metabolites in both urine [such as hippurate] and stool [such as secondary bile acids] samples.
This review provides a summary of metabolomic research in IBD to date, highlighting underlying themes of perturbed gut microbial metabolism and mammalian-microbial co-metabolism associated with disease status.
炎症性肠病（IBD）包括克罗恩病和溃疡性结肠炎，是慢性、特发性胃肠道疾病。尽管其确切病因尚不清楚，但人们认为它涉及遗传易感性与宿主对环境暴露（可能是微生物）的异常免疫反应之间的复杂相互作用。IBD 中经常出现微生物失调。代谢组学（研究生物样本中代谢的小分子中间产物和终产物）提供了一个独特的机会来描述与疾病相关的代谢变化，并且可能特别有助于量化肠道微生物代谢。在 IBD 人群中进行了许多代谢组学研究，在几种生物基质中确定了一系列分子的一致改变。本系统评价旨在总结这些发现。
使用 Medline 和 Embase 进行全面、系统的搜索。两名作者独立使用预定义的排除标准对所有研究进行了审查。对 64 篇相关论文进行了质量评估，并纳入了综述。
一致的代谢紊乱被确定，包括粪便、血清、血浆和组织活检样本中支链氨基酸和脂质类水平的升高，以及尿液[如马尿酸]和粪便[如次级胆汁酸]样本中微生物修饰代谢物水平的降低。
本综述总结了迄今为止 IBD 的代谢组学研究，强调了与疾病状态相关的肠道微生物代谢紊乱和哺乳动物-微生物共代谢的潜在主题。
