Xu Yao, Xie Runxiang, Weng Yuqing, Fang Yewei, Tao Shuan, Zhang He, Chen Huimin, Han Axiang, Jiang Qi, Liang Wei
Department of Clinical Laboratory, The First Affiliated Hospital of Ningbo University, Ningbo, China.
Health Science Center, Ningbo University, Ningbo, China.
Int J Colorectal Dis. 2025 May 28;40(1):130. doi: 10.1007/s00384-025-04917-7.
Crohn's disease (CD) is a chronic, nonspecific inflammatory bowel disease with a poor prognosis. Despite its increasing incidence, curing CD remains challenging due to its complex etiology and unclear pathogenesis.
A comprehensive PubMed and Web of Science search was conducted using the keywords Crohn's disease, gut microbiota, dysbiosis, pathogenesis and treatment, focusing on studies published between 2014 and 2024.
Recent studies have demonstrated a close relationship between gut microbiota dysbiosis and the development of CD. Although many dysbioses associated with CD have not yet been proven to be causal or consequential, it has been observed that the gut microbiota in CD patients exhibits reduced diversity, a decrease in beneficial bacteria, and an increase in pathogenic bacteria. These changes may lead to decreased intestinal barrier function, abnormal immune responses, and enhanced inflammatory reactions, which are related to the disease's activity, phenotype, drug treatment efficacy, and postoperative therapeutic outcomes. Therefore, further exploration of the microbiota-host interactions and the pathogenesis of CD, the identification of biomarkers, and the development of targeted strategies for modulating the gut microbiota could offer new avenues for the prevention and treatment of CD.
This review highlights the pivotal role of gut microbiota dysbiosis in driving CD pathogenesis and its progression, while underscoring its potential as a therapeutic target through dietary modulation, microbial interventions, and integrative strategies to improve clinical management and prognostic outcomes.
克罗恩病(CD)是一种慢性非特异性炎症性肠病,预后较差。尽管其发病率不断上升,但由于病因复杂、发病机制不明,治愈CD仍然具有挑战性。
使用关键词“克罗恩病”“肠道微生物群”“生态失调”“发病机制”和“治疗”,在PubMed和Web of Science上进行全面检索,重点关注2014年至2024年发表的研究。
最近的研究表明肠道微生物群生态失调与CD的发生密切相关。尽管许多与CD相关的生态失调尚未被证明具有因果关系,但已观察到CD患者的肠道微生物群多样性降低、有益菌减少、致病菌增加。这些变化可能导致肠道屏障功能下降、免疫反应异常和炎症反应增强,这与疾病的活动、表型、药物治疗效果和术后治疗结果有关。因此,进一步探索微生物群与宿主的相互作用以及CD的发病机制、鉴定生物标志物以及开发调节肠道微生物群的靶向策略,可能为CD的预防和治疗提供新途径。
本综述强调了肠道微生物群生态失调在驱动CD发病机制及其进展中的关键作用,同时强调了通过饮食调节、微生物干预和综合策略将其作为治疗靶点以改善临床管理和预后结果的潜力。