Department of Molecular and Cellular Biology, University of Guelph, Guelph, Ontario, Canada.
Ann N Y Acad Sci. 2024 Nov;1541(1):63-82. doi: 10.1111/nyas.15237. Epub 2024 Oct 11.
Over the last two decades, advancements in sequencing technologies have significantly deepened our understanding of the human microbiome's complexity, leading to increased concerns about the detrimental effects of antibiotics on these intricate microbial ecosystems. Concurrently, the rise in antimicrobial resistance has intensified the focus on how beneficial microbes can be harnessed to treat diseases and improve health and offer potentially promising alternatives to traditional antibiotic treatments. Here, we provide a comprehensive overview of both established and emerging microbe-centric therapies, from probiotics to advanced microbial ecosystem therapeutics, examine the sophisticated ways in which microbes are used medicinally, and consider their impacts on microbiome homeostasis and health outcomes through a microbial ecology lens. In addition, we explore the concept of rewilding the human microbiome by reintroducing "missing microbes" from nonindustrialized societies and personalizing microbiome modulation to fit individual microbial profiles-highlighting several promising directions for future research. Ultimately, the advancements in sequencing technologies combined with innovative microbial therapies and personalized approaches herald a new era in medicine poised to address antibiotic resistance and improve health outcomes through targeted microbiome management.
在过去的二十年中，测序技术的进步极大地加深了我们对人类微生物组复杂性的理解，这引发了人们对抗生素对这些复杂微生物生态系统的有害影响的更多关注。与此同时，抗生素耐药性的上升加剧了人们对有益微生物如何被利用来治疗疾病、改善健康以及为传统抗生素治疗提供潜在有前途的替代方法的关注。在这里，我们全面概述了已建立和新兴的以微生物为中心的治疗方法，从益生菌到先进的微生物生态系统治疗，探讨了微生物在医学上的复杂应用方式，并从微生物生态学的角度考虑它们对微生物组动态平衡和健康结果的影响。此外，我们还探讨了通过重新引入非工业化社会中的“缺失微生物”和个性化的微生物调节来“重新野化”人类微生物组的概念，以适应个体微生物特征——强调了未来研究的几个有前途的方向。最终，测序技术的进步与创新的微生物治疗方法和个性化方法相结合，预示着医学的新时代即将到来，有望通过靶向微生物组管理来应对抗生素耐药性并改善健康结果。
