Ning Shiyang, Zhang Zhe, Zhou Chuan, Wang Binbin, Liu Zhanju, Feng Baisui
Department of Gastroenterology, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Department of Gastroenterology, The Shanghai Tenth People's Hospital, Shanghai, China.
Front Med (Lausanne). 2024 Sep 16;11:1457218. doi: 10.3389/fmed.2024.1457218. eCollection 2024.
Inflammatory bowel disease (IBD), which includes ulcerative colitis (UC) and Crohn's disease (CD), is a group of chronic immune-mediated gastrointestinal disorders. The etiology of IBD is multifactorial, involving genetic susceptibility, environmental factors, and a complex interplay between the gut microbiota and the host's immune system. Intestinal resident macrophages play an important role in the pathogenesis and progress of IBD, as well as in maintaining intestinal homeostasis and facilitating tissue repair. This review delves into the intricate relationship between intestinal macrophages and gut microbiota, highlighting their pivotal roles in IBD pathogenesis. We discuss the impact of macrophage dysregulation and the consequent polarization of different phenotypes on intestinal inflammation. Furthermore, we explore the compositional and functional alterations in gut microbiota associated with IBD, including the emerging significance of fungal and viral components. This review also examines the effects of current therapeutic strategies, such as 5-aminosalicylic acid (5-ASA), antibiotics, steroids, immunomodulators, and biologics, on gut microbiota and macrophage function. We underscore the potential of fecal microbiota transplantation (FMT) and probiotics as innovative approaches to modulate the gut microbiome in IBD. The aim is to provide insights into the development of novel therapies targeting the gut microbiota and macrophages to improve IBD management.
炎症性肠病（IBD）包括溃疡性结肠炎（UC）和克罗恩病（CD），是一组慢性免疫介导的胃肠道疾病。IBD的病因是多因素的，涉及遗传易感性、环境因素以及肠道微生物群与宿主免疫系统之间的复杂相互作用。肠道常驻巨噬细胞在IBD的发病机制和进展中以及在维持肠道稳态和促进组织修复方面发挥着重要作用。本综述深入探讨了肠道巨噬细胞与肠道微生物群之间的复杂关系，强调了它们在IBD发病机制中的关键作用。我们讨论了巨噬细胞失调以及不同表型的随之极化对肠道炎症的影响。此外，我们探讨了与IBD相关的肠道微生物群的组成和功能改变，包括真菌和病毒成分的新出现的重要性。本综述还研究了当前治疗策略，如5-氨基水杨酸（5-ASA）、抗生素、类固醇、免疫调节剂和生物制剂，对肠道微生物群和巨噬细胞功能的影响。我们强调粪便微生物群移植（FMT）和益生菌作为调节IBD肠道微生物组的创新方法的潜力。目的是为开发针对肠道微生物群和巨噬细胞的新型疗法以改善IBD管理提供见解。
