Gu Yu, Li Lingfeng, Yang Min, Liu Tianyu, Song Xueli, Qin Xiali, Xu Xin, Liu Jinghua, Wang Bangmao, Cao Hailong
Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin, China.
Department of Gastroenterology, Tianjin TEDA hospital, Tianjin, China.
Crit Rev Microbiol. 2023 May;49(3):350-369. doi: 10.1080/1040841X.2022.2058353. Epub 2022 Apr 7.
Irritable bowel syndrome (IBS) is a common disorder of gut-brain interaction with an increasing prevalence, and its precise aetiology remains unclear. Gut microbiota dysbiosis has been found to be associated with IBS pathogenesis. In addition, a high incidence of bile acid diarrhoea and disturbed bile acid metabolism has been observed in IBS patients. The abundant microorganisms inhabited in human gut have essential functions in bile acid biotransformation, and can immensely affect the size and constitution of bile acid pool. Meanwhile, the alterations of bile acid profile can inversely interfere with the gut microbiota. This review discussed the role of intricate correlations between bile acids and gut microbiota in IBS pathogenesis and delineated the possible molecular mechanisms, mainly the signalling induced by farnesoid X receptor and transmembrane G protein-coupled receptor 5. Besides, some biomarkers for identifying bile acid diarrhoea in IBS population were listed, assisting the diagnosis and classification of IBS. Moreover, it also assessed some therapeutic strategies for IBS that regulate the bile acid-gut microbiota axis, such as dietary modulation, probiotics/prebiotics, faecal microbiota transplantation, and antibiotics. Collectively, this article illustrated the relationship between bile acids and gut microbiota in IBS pathophysiology and might offer some novel therapeutic options for IBS.
肠易激综合征（IBS）是一种常见的肠-脑互动障碍性疾病，患病率呈上升趋势，其确切病因尚不清楚。肠道微生物群失调已被发现与IBS的发病机制有关。此外，在IBS患者中观察到胆汁酸腹泻的高发病率和胆汁酸代谢紊乱。栖息在人体肠道中的丰富微生物在胆汁酸生物转化中具有重要作用，并可极大地影响胆汁酸池的大小和组成。同时，胆汁酸谱的改变可反过来干扰肠道微生物群。本综述讨论了胆汁酸与肠道微生物群之间复杂的相关性在IBS发病机制中的作用，并阐述了可能的分子机制，主要是法尼醇X受体和跨膜G蛋白偶联受体5诱导的信号传导。此外，还列出了一些用于识别IBS人群中胆汁酸腹泻的生物标志物，有助于IBS的诊断和分类。此外，还评估了一些调节胆汁酸-肠道微生物群轴的IBS治疗策略，如饮食调节、益生菌/益生元、粪便微生物群移植和抗生素。总的来说，本文阐述了胆汁酸与肠道微生物群在IBS病理生理学中的关系，并可能为IBS提供一些新的治疗选择。
