Department of Translational Medicine Platform, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, Zhejiang 310015, China.
Department of School of Life Sciences, Zhejiang University of Traditional Chinese Medicine, Hangzhou, Zhejiang 310053, China.
Chin Med J (Engl). 2023 Jun 20;136(12):1390-1400. doi: 10.1097/CM9.0000000000002711. Epub 2023 May 18.
The intestinal mucus layer is a barrier that separates intestinal contents and epithelial cells, as well as acts as the "mucus layer-soil" for intestinal flora adhesion and colonization. Its structural and functional integrity is crucial to human health. Intestinal mucus is regulated by factors such as diet, living habits, hormones, neurotransmitters, cytokines, and intestinal flora. The mucus layer's thickness, viscosity, porosity, growth rate, and glycosylation status affect the structure of the gut flora colonized on it. The interaction between "mucus layer-soil" and "gut bacteria-seed" is an important factor leading to the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Probiotics, prebiotics, fecal microbiota transplantation (FMT), and wash microbial transplantation are efficient methods for managing NAFLD, but their long-term efficacy is poor. FMT is focused on achieving the goal of treating diseases by enhancing the "gut bacteria-seed". However, a lack of effective repair and management of the "mucus layer-soil" may be a reason why "seeds" cannot be well colonized and grow in the host gut, as the thinning and destruction of the "mucus layer-soil" is an early symptom of NAFLD. This review summarizes the existing correlation between intestinal mucus and gut microbiota, as well as the pathogenesis of NAFLD, and proposes a new perspective that "mucus layer-soil" restoration combined with "gut bacteria-seed" FMT may be one of the most effective future strategies for enhancing the long-term efficacy of NAFLD treatment.
肠黏液层是分隔肠内容物和上皮细胞的屏障，也是肠道菌群黏附定植的“黏液层-土壤”。其结构和功能完整性对人体健康至关重要。肠黏液受饮食、生活习惯、激素、神经递质、细胞因子和肠道菌群等因素的调节。黏液层的厚度、黏度、孔隙率、增长率和糖基化状态影响着定植其上的肠道菌群结构。“黏液层-土壤”与“肠道细菌-种子”的相互作用是导致非酒精性脂肪性肝病（NAFLD）发病的重要因素。益生菌、益生元、粪便微生物移植（FMT）和灌洗微生物移植是治疗 NAFLD 的有效方法，但长期疗效不佳。FMT 专注于通过增强“肠道细菌-种子”来实现治疗疾病的目标。然而，缺乏对“黏液层-土壤”的有效修复和管理可能是“种子”不能在宿主肠道中良好定植和生长的原因，因为“黏液层-土壤”的变薄和破坏是非酒精性脂肪性肝病的早期症状。本综述总结了肠道黏液与肠道菌群之间的现有相关性，以及非酒精性脂肪性肝病的发病机制，并提出了一个新的观点，即“黏液层-土壤”的修复与“肠道细菌-种子”的 FMT 相结合可能是增强非酒精性脂肪性肝病治疗长期疗效的最有效策略之一。
