Xie Hongjun, Yu Siyan, Tang Mingyu, Xun Yating, Shen Qin, Wu Gaojue
Department of Gastroenterology, Wuxi No. 2 People's Hospital, Affiliated Wuxi Clinical College of Nantong University, Wuxi, Jiangsu, China.
School of Medicine, Nantong University, Nantong, Jiangsu, China.
Front Cell Infect Microbiol. 2025 Jun 27;15:1608025. doi: 10.3389/fcimb.2025.1608025. eCollection 2025.
Recent studies have deepened our understanding on gut microbiota alterations and the interaction with intestinal barrier impairments, which play a crucial role in the etiology and pathophysiology of Inflammatory bowel disease (IBD). The intestinal microbiota dysbiosis in IBD including the altered microbiota composition, decreased beneficial species and increased harmful species. The disturbed gut microbiota results in the aggravation of intestinal barrier dysfunction through regulation of antimicrobial substances in mucus layer, tight junction protein in mechanical layer and inflammatory response in immune layer. The therapeutic options targeted on the microbiota including antibiotics, probiotics and fecal microbiota transplantation (FMT) exhibit efficacies and limitations in the treatment of IBD. Reasonable single or combined use of these treatments can restore intestinal microecological homeostasis, which further contributes to the treatment of IBD. This review analyzes the underlying mechanisms for the interaction between microbiota alterations and gut barrier dysfunction in IBD; meanwhile, it provides new insights into the microbiota-targeted therapeutic options IBD, including the benefits, risks and limitations of antibiotic and probiotic therapies, unresolved clinical application strategies for FMT, and combination administrations of antibiotics and FMT.
最近的研究加深了我们对肠道微生物群改变以及与肠屏障损伤相互作用的理解，这在炎症性肠病（IBD）的病因学和病理生理学中起着至关重要的作用。IBD中的肠道微生物群失调包括微生物群组成改变、有益菌减少和有害菌增加。紊乱的肠道微生物群通过调节黏液层中的抗菌物质、机械层中的紧密连接蛋白和免疫层中的炎症反应，导致肠屏障功能障碍加重。针对微生物群的治疗选择，包括抗生素、益生菌和粪便微生物群移植（FMT），在IBD治疗中显示出疗效和局限性。合理地单独或联合使用这些治疗方法可以恢复肠道微生态平衡，这进一步有助于IBD的治疗。本综述分析了IBD中微生物群改变与肠屏障功能障碍之间相互作用的潜在机制；同时，它为IBD的微生物群靶向治疗选择提供了新的见解，包括抗生素和益生菌治疗的益处、风险和局限性、FMT未解决的临床应用策略以及抗生素与FMT的联合给药。
