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抗生素、肠道微生物群与肠易激综合征:它们之间有什么关系?

Antibiotics, gut microbiota, and irritable bowel syndrome: What are the relations?

作者信息

Mamieva Zarina, Poluektova Elena, Svistushkin Valery, Sobolev Vasily, Shifrin Oleg, Guarner Francisco, Ivashkin Vladimir

机构信息

Department of Internal Disease Propaedeutics, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 119991, Russia.

Department of Ear, Throat and Nose Diseases, N.V. Sklifosovsky Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow 119991, Russia.

出版信息

World J Gastroenterol. 2022 Mar 28;28(12):1204-1219. doi: 10.3748/wjg.v28.i12.1204.

Abstract

Irritable bowel syndrome (IBS) is a functional gastrointestinal disorder in which recurrent abdominal pain is associated with defecation or a change in bowel habits (constipation, diarrhea, or both), and it is often accompanied by symptoms of abdominal bloating and distension. IBS is an important health care issue because it negatively affects the quality of life of patients and places a considerable financial burden on health care systems. Despite extensive research, the etiology and underlying pathophysiology of IBS remain incompletely understood. Proposed mechanisms involved in its pathogenesis include increased intestinal permeability, changes in the immune system, visceral hypersensitivity, impaired gut motility, and emotional disorders. Recently, accumulating evidence has highlighted the important role of the gut microbiota in the development of IBS. Microbial dysbiosis within the gut is thought to contribute to all aspects of its multifactorial pathogenesis. The last few decades have also seen an increasing interest in the impact of antibiotics on the gut microbiota. Moreover, antibiotics have been suggested to play a role in the development of IBS. Extensive research has established that antibacterial therapy induces remarkable shifts in the bacterial community composition that are quite similar to those observed in IBS. This suggestion is further supported by data from cohort and case-control studies, indicating that antibiotic treatment is associated with an increased risk of IBS. This paper summarizes the main findings on this issue and contributes to a deeper understanding of the link between antibiotic use and the development of IBS.

摘要

肠易激综合征(IBS)是一种功能性胃肠疾病,其特征为反复出现的腹痛与排便或排便习惯改变(便秘、腹泻或两者兼有)相关,且常伴有腹胀和腹部膨胀症状。IBS是一个重要的医疗保健问题,因为它会对患者的生活质量产生负面影响,并给医疗保健系统带来相当大的经济负担。尽管进行了广泛研究,但IBS的病因和潜在病理生理学仍未完全明确。其发病机制中涉及的拟议机制包括肠道通透性增加、免疫系统变化、内脏超敏反应、肠道动力受损和情绪障碍。最近,越来越多的证据凸显了肠道微生物群在IBS发病中的重要作用。肠道内的微生物失调被认为在其多因素发病机制的各个方面都起作用。过去几十年里,人们对抗生素对肠道微生物群的影响也越来越感兴趣。此外,有研究表明抗生素在IBS的发病中起作用。广泛的研究证实,抗菌治疗会引起细菌群落组成的显著变化,这与在IBS中观察到的变化非常相似。队列研究和病例对照研究的数据进一步支持了这一观点,表明抗生素治疗与IBS风险增加有关。本文总结了关于这一问题的主要研究结果,有助于更深入地理解抗生素使用与IBS发病之间的联系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7578/8968486/3a530639f816/WJG-28-1204-g001.jpg

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