Department of Gastroenterology and Hepatology, Jinling Hospital, Medical School of Nanjing University, Zhongshan East Road 305, Nanjing, 210002, China.
Department of Stomatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.
Dig Dis Sci. 2022 Jan;67(1):42-55. doi: 10.1007/s10620-021-06837-2. Epub 2021 Feb 1.
Inflammatory bowel disease (IBD) is a group of chronic intestinal inflammatory disorders with a prolonged duration characterized by recurrent relapse and remission. The exact etiology of IBD remains poorly understood despite the identification of relevant risk factors, including individual genetic susceptibility, environmental triggers, and disruption of immune homeostasis. Dysbiosis of the gut microbiota is believed to exacerbate the progression of IBD. Recently, increasing evidence has also linked oral microbiota dysbiosis with the development of IBD. On the one hand, IBD patients show significantly unbalanced composition and function of the oral microbiota known as dysbiosis. On the other, overabundances of oral commensal bacteria with opportunistic pathogenicity have been found in the gut microbiota of IBD patients. Herein, we review the current information on the causative factors of IBD, especially recent evidence of IBD-associated oral microbiota dysbiosis, which has seldom been covered in the previous literature review, highlighting the pathogenic mechanisms of specific oral bacteria in the development of IBD. Ectopic colonization of several oral bacteria, including a subset of Porphyromonas gingivalis, Streptococcus mutans, Fusobacterium nucleatum, Campylobacter concisus, and Klebsiella pneumoniae, may lead to destruction of the intestinal epithelial barrier, excessive secretion of inflammatory cytokines, disruption of the host immune system, and dysbiosis of gut microbiota, consequently aggravating chronic intestinal inflammation. Studying oral microbiota dysbiosis may open future horizons for understanding IBD pathogenesis and provide novel biomarkers for IBD. This review also presents the current treatment and new perspectives for IBD treatment.
炎症性肠病（IBD）是一组慢性肠道炎症性疾病，具有持续时间长、反复发作和缓解的特点。尽管已经确定了相关的危险因素，包括个体遗传易感性、环境触发因素和免疫平衡的破坏，但 IBD 的确切病因仍知之甚少。肠道微生物群落的失调被认为会加剧 IBD 的进展。最近，越来越多的证据也将口腔微生物群落失调与 IBD 的发展联系起来。一方面，IBD 患者表现出明显的口腔微生物群落失调，即组成和功能失衡。另一方面，IBD 患者的肠道微生物群落中发现了大量具有机会致病性的口腔共生菌。在此，我们综述了 IBD 的致病因素的最新信息，特别是最近关于与 IBD 相关的口腔微生物群落失调的证据，这在以前的文献综述中很少涉及，强调了特定口腔细菌在 IBD 发展中的致病机制。几种口腔细菌的异位定植，包括一部分牙龈卟啉单胞菌、变形链球菌、具核梭杆菌、弯曲菌和肺炎克雷伯菌，可能导致肠道上皮屏障的破坏、炎症细胞因子的过度分泌、宿主免疫系统的破坏和肠道微生物群落的失调，从而加重慢性肠道炎症。研究口腔微生物群落失调可能为了解 IBD 发病机制开辟新的前景，并为 IBD 提供新的生物标志物。本文还介绍了 IBD 的当前治疗方法和新的治疗视角。
