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微生物群-肠道-脑轴理论:肠道微生物群调节剂(GMMs)在胃肠道、神经和精神疾病中的作用。

The microbiota-gut-brain-axis theory: role of gut microbiota modulators (GMMs) in gastrointestinal, neurological, and mental health disorders.

作者信息

Wadan Al-Hassan Soliman, El-Aziz Mostafa K Abd, Ellakwa Doha El-Sayed

机构信息

Oral Biology Department, Faculty of Dentistry, Galala University (15888), Galala Plateau, Attaka, Suez Governorate, Egypt.

Faculty of Pharmacy, King Salman International University, Ras-Sudr, South Sinai, Egypt.

出版信息

Naunyn Schmiedebergs Arch Pharmacol. 2025 May 5. doi: 10.1007/s00210-025-04155-2.

Abstract

The modulation of gut microbiota presents promising therapeutic possibilities for various health conditions, ranging from gastrointestinal infections to neurodegenerative and mental health disorders. Among the available interventions, gut microbiota modulators (GMMs) such as probiotics and prebiotics have demonstrated significant potential in infection prevention and neuroprotection. Despite these encouraging findings, the clinical application of GMMs remains challenging due to safety concerns and inconsistent effectiveness across diverse patient populations. These factors create substantial barriers to the widespread adoption of microbiota-based therapies in clinical practice. To overcome these challenges and fully leverage the therapeutic potential of microbiota modulation, this review explores the feasibility of repurposing GMMs for managing multiple health disorders. A broad spectrum of microbiota-targeted strategies is examined, including dietary modifications, fecal microbiota transplantation, bacteriophage therapy, microbiome engineering, and immune system modulation. A particularly innovative approach involves integrating GMMs with pharmaceutical delivery systems to enhance therapeutic efficacy while mitigating potential adverse effects. This integrative strategy underscores the pivotal role of the gut microbiome in health and disease, supporting the development of precision medicine tailored to individual patient needs. By combining GMMs with targeted delivery mechanisms, this approach not only improves treatment effectiveness but also addresses critical concerns regarding safety and patient variability. Furthermore, this review outlines future research directions within the rapidly evolving field of microbiota modulation, emphasizing the necessity of comprehensive clinical trials and long-term safety evaluations. By critically assessing both the challenges and opportunities associated with microbiota-based interventions, this study provides a strategic framework for translating experimental research into viable clinical applications. A holistic approach to gut microbiota modulation has the potential to redefine treatment paradigms, offering personalized therapeutic strategies for a wide range of disorders and advancing the broader field of precision medicine.

摘要

肠道微生物群的调节为各种健康状况带来了有前景的治疗可能性,从胃肠道感染到神经退行性和精神健康障碍。在现有的干预措施中,益生菌和益生元等肠道微生物群调节剂(GMM)已在预防感染和神经保护方面显示出巨大潜力。尽管有这些令人鼓舞的发现,但由于安全问题以及不同患者群体中疗效不一致,GMM的临床应用仍然具有挑战性。这些因素为基于微生物群的疗法在临床实践中的广泛应用造成了重大障碍。为了克服这些挑战并充分利用微生物群调节的治疗潜力,本综述探讨了重新利用GMM来管理多种健康障碍的可行性。研究了广泛的针对微生物群的策略,包括饮食调整、粪便微生物群移植、噬菌体疗法、微生物组工程和免疫系统调节。一种特别创新的方法是将GMM与药物递送系统相结合,以提高治疗效果,同时减轻潜在的不良反应。这种综合策略强调了肠道微生物群在健康和疾病中的关键作用,支持开发针对个体患者需求的精准医学。通过将GMM与靶向递送机制相结合,这种方法不仅提高了治疗效果,还解决了有关安全性和患者变异性的关键问题。此外,本综述概述了微生物群调节快速发展领域的未来研究方向,强调了全面临床试验和长期安全性评估的必要性。通过批判性地评估基于微生物群的干预措施相关的挑战和机遇,本研究提供了一个将实验研究转化为可行临床应用的战略框架。一种整体的肠道微生物群调节方法有可能重新定义治疗模式,为广泛的疾病提供个性化治疗策略,并推动精准医学这一更广泛领域的发展。

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