Hou Jun-Jie, Wang Xin, Wang Yu-Ming, Wang Bang-Mao
Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.
Tianjin Institute of Digestive Disease, Tianjin Medical University General Hospital, Tianjin, China.
Crit Rev Microbiol. 2022 Nov;48(6):696-713. doi: 10.1080/1040841X.2021.2018401. Epub 2021 Dec 22.
Irritable bowel syndrome (IBS) is a common functional gastrointestinal disease that disturbs the physiology and psychology of patients and increases the burden on families, the healthcare system, society, and economic development, affecting more and more people around the world. Despite the multiple factors that account for IBS remaining incompletely studied, emerging evidence demonstrated the abnormal changes in gut microbiota and bile acids (BAs) metabolism closely associated with IBS. Moreover, microbiota drives significant modifications for BAs, consisting of deconjugation, 7α-dehydroxylation, oxidation, epimerization, desulfation, esterification, and so on, while BAs, in turn, affect the microbiota directly or indirectly. In light of the complex connection among gut microbiota, BAs, and IBS, it is urgent to review the latest research progress in this field. In this review, we described the disorders of intestinal microecology and BAs profiles in IBS-D and also highlighted the cross-talk between gut microbiota and BAs in the context of IBS-D. Integrating these, we suggest that new therapeutic strategies targeting the microbiota-BAs axis for IBS-D, even for other related diseases caused by bacteria-bile acid dysbiosis should be expected.
肠易激综合征（IBS）是一种常见的功能性胃肠疾病，它扰乱患者的生理和心理，并增加家庭、医疗保健系统、社会和经济发展的负担，影响着全球越来越多的人。尽管导致IBS的多种因素仍未得到充分研究，但新出现的证据表明，肠道微生物群和胆汁酸（BAs）代谢的异常变化与IBS密切相关。此外，微生物群驱动了胆汁酸的显著修饰，包括去共轭、7α-脱羟基化、氧化、差向异构化、脱硫、酯化等，而胆汁酸反过来又直接或间接地影响微生物群。鉴于肠道微生物群、胆汁酸和IBS之间的复杂联系，迫切需要回顾该领域的最新研究进展。在本综述中，我们描述了腹泻型肠易激综合征（IBS-D）中肠道微生态和胆汁酸谱的紊乱，并强调了IBS-D背景下肠道微生物群与胆汁酸之间的相互作用。综合这些内容，我们建议针对IBS-D的微生物群-胆汁酸轴，甚至针对由细菌-胆汁酸失调引起的其他相关疾病，有望开发出新的治疗策略。
