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高脂饮食诱发溃疡性结肠炎肠道黏膜屏障功能障碍:新机制及饮食干预视角

High-fat diet induces intestinal mucosal barrier dysfunction in ulcerative colitis: emerging mechanisms and dietary intervention perspective.

作者信息

Jiang Shijing, Miao Zhiwei

机构信息

First Clinical Medical College, Nanjing University of Chinese Medicine Nanjing, Jiangsu, China.

Department of Gastroenterology, Zhangjiagang TCM Hospital Affiliated to Nanjing University of Chinese Medicine Zhangjiagang, Suzhou, Jiangsu, China.

出版信息

Am J Transl Res. 2023 Feb 15;15(2):653-677. eCollection 2023.

Abstract

The incidence of ulcerative colitis (UC) is increasing worldwide, but its pathogenesis remains largely unclear. The intestinal mucosa is a barrier that maintains the stability of the body's internal environment, and dysfunction of this barrier leads to the occurrence and aggravation of UC. A high-fat diet (HFD) contains more animal fat and low fiber, and accumulating evidence has shown that long-term intake of an HFD is associated with UC. The mechanism linking an HFD with intestinal mucosal barrier disruption is multifactorial, and it typically involves microbiota dysbiosis and altered metabolism of fatty acids, bile acids, and tryptophan. Dysbiosis-induced metabolic changes can enhance intestinal permeability through multiple pathways. These changes modulate the programmed death of intestinal epithelial cells, inhibit the secretion of goblet cells and Paneth cells, and impair intercellular interactions. Gut metabolites can also induce intestinal immune imbalance by stimulating multiple proinflammatory signaling pathways and decreasing the effect of anti-inflammatory immune cells. In this review, we critically analyze the molecular mechanisms by which an HFD disrupts the intestinal mucosal barrier (IMB) and contributes to the development of UC. We also discuss the application and future direction of dietary intervention in the treatment of the IMB and prevention of UC.

摘要

溃疡性结肠炎(UC)的发病率在全球范围内呈上升趋势,但其发病机制在很大程度上仍不清楚。肠道黏膜是维持机体内部环境稳定的一道屏障,该屏障功能障碍会导致UC的发生和加重。高脂饮食(HFD)含有较多的动物脂肪且纤维含量低,越来越多的证据表明,长期摄入HFD与UC有关。HFD与肠道黏膜屏障破坏之间的联系机制是多因素的,通常涉及微生物群失调以及脂肪酸、胆汁酸和色氨酸代谢的改变。微生物群失调引起的代谢变化可通过多种途径增强肠道通透性。这些变化调节肠道上皮细胞的程序性死亡,抑制杯状细胞和潘氏细胞的分泌,并损害细胞间相互作用。肠道代谢产物还可通过刺激多种促炎信号通路和降低抗炎免疫细胞的作用来诱导肠道免疫失衡。在这篇综述中,我们批判性地分析了HFD破坏肠道黏膜屏障(IMB)并促进UC发生发展的分子机制。我们还讨论了饮食干预在IMB治疗和UC预防中的应用及未来方向。

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