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肠道微生物群:2型糖尿病领域的一场革命。

Gut microbiome: A revolution in type II diabetes mellitus.

作者信息

Jeyaraman Madhan, Mariappan Tejaswin, Jeyaraman Naveen, Muthu Sathish, Ramasubramanian Swaminathan, Santos Gabriel Silva, da Fonseca Lucas Furtado, Lana José Fábio

机构信息

Department of Orthopaedics, ACS Medical College and Hospital, Dr MGR Educational and Research Institute, Chennai 600077, Tamil Nadu, India.

Department of Orthopaedics, Brazilian Institute of Regenerative Medicine, Indaiatuba 13334-170, São Paulo, Brazil.

出版信息

World J Diabetes. 2024 Sep 15;15(9):1874-1888. doi: 10.4239/wjd.v15.i9.1874.

Abstract

Type II diabetes mellitus (T2DM) has experienced a dramatic increase globally across countries of various income levels over the past three decades. The persistent prevalence of T2DM is attributed to a complex interplay of genetic and environmental factors. While numerous pharmaceutical therapies have been developed, there remains an urgent need for innovative treatment approaches that offer effectiveness without significant adverse effects. In this context, the exploration of the gut microbiome presents a promising avenue. Research has increasingly shown that the gut microbiome of individuals with T2DM exhibits distinct differences compared to healthy individuals, suggesting its potential role in the disease's pathogenesis and progression. This emerging field offers diverse applications, particularly in modifying the gut environment through the administration of prebiotics, probiotics, and fecal microbiome transfer. These inter-ventions aim to restore a healthy microbiome balance, which could potentially alleviate or even reverse the metabolic dysfunctions associated with T2DM. Although current results from clinical trials have not yet shown dramatic effects on diabetes management, the groundwork has been laid for deeper investigation. Ongoing and future clinical trials are critical to advancing our understanding of the microbiome's impact on diabetes. By further elucidating the mechanisms through which microbiome alterations influence insulin resistance and glucose metabolism, researchers can develop more targeted interventions. The potential to harness the gut microbiome in developing new therapeutic strategies offers a compelling prospect to transform the treatment landscape of T2DM, potentially reducing the disease's burden significantly with approaches that are less reliant on traditional pharmaceuticals and more focused on holistic, systemic health improvements.

摘要

在过去三十年中,全球各个收入水平国家的2型糖尿病(T2DM)患病率都急剧上升。T2DM的持续流行归因于遗传和环境因素的复杂相互作用。尽管已经开发出了众多药物疗法,但仍迫切需要创新的治疗方法,这些方法既要有效又不能有明显的副作用。在这种背景下,对肠道微生物群的探索提供了一条有前景的途径。越来越多的研究表明,与健康个体相比,T2DM患者的肠道微生物群存在明显差异,这表明其在疾病发病机制和进展中可能发挥的作用。这个新兴领域有多种应用,特别是通过施用益生元、益生菌和粪便微生物群移植来改变肠道环境。这些干预措施旨在恢复健康的微生物群平衡,这有可能减轻甚至逆转与T2DM相关的代谢功能障碍。尽管目前临床试验的结果尚未显示对糖尿病管理有显著效果,但已经为更深入的研究奠定了基础。正在进行的和未来的临床试验对于推进我们对微生物群对糖尿病影响的理解至关重要。通过进一步阐明微生物群改变影响胰岛素抵抗和葡萄糖代谢的机制,研究人员可以开发更有针对性的干预措施。利用肠道微生物群开发新治疗策略的潜力为改变T2DM的治疗格局提供了一个引人注目的前景,有可能通过减少对传统药物的依赖、更注重整体和全身健康改善的方法来显著减轻疾病负担。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/773c/11372632/1fdd8ad416c3/WJD-15-1874-g001.jpg

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