从肠道菌群角度认识阿尔茨海默病的潜在发病机制

过去10年中,人们逐渐认识到肠道微生物群的多样性及菌群平衡在维护宿主健康中发挥的作用。肠道微生物及其代谢产物通过一系列的生化、免疫和生理功能环节与宿主进行交流,从而影响宿主的稳态和健康。阿尔茨海默病(Alzheimer’s disease,AD)是一种复杂的神经退行性疾病,其易感性和发展过程受年龄、遗传和表观遗传等因素的影响。研究发现,肠道微生物群的紊乱(组成改变和易位)与神经系统疾病(AD)有关,胃肠道通过肠脑轴与中枢神经系统进行沟通,包括对神经的直接作用、内分泌途径和免疫调控方式。动物模型、粪便菌群移植及益生菌干预为肠道菌群与AD的相关性提供了证据。外漏的细菌代谢产物可能直接损害神经元功能,也可能诱发神经炎症,促进AD的发病。本文主要综述了肠道微生物群与AD的关联和作用机制,以期为通过改善肠道菌群结构预防AD的可能干预措施提供依据。     

基于无菌动物研究肠道微生物与类风湿关节炎发病相关性

肠道微生物与宿主的生长发育、免疫、代谢等方面均密切相关,但肠道菌群与宿主之间复杂的相互作用在很大程度上仍然是未知的。目前无菌动物已成为探索肠道微生物与宿主相互作用的重要工具,多项研究使用无菌动物模型探讨肠道菌群在宿主代谢、机体免疫系统的发育和成熟等方面的作用,其中包括肠道菌群在自身免疫性疾病发病及预后中的作用。研究发现,肠道菌群作为环境因素之一可能参与类风湿关节炎(rheumatoid arthritis,RA)发病,然而其因果关系未明。本文将对使用无菌动物探讨肠道微生物参与类风湿关节炎发病的相关性研究作一综述,为进一步深入研究肠道菌群在RA发病中的作用及机制研究提供理论依据。     

肠道菌群-肠-脑-肌轴信号交流的研究进展

肠道菌群及其代谢产物在老年神经退行性疾病、胃肠道疾病以及肌肉骨骼系统性疾病的发病与康复中的作用越来越受到关注。肠道菌群及其代谢产物可通过免疫、内分泌和神经系统等多种途径调节大脑神经或肌肉骨骼系统功能;反之,肠道、大脑或肌肉骨骼系统也可通过炎症、代谢或线粒体通路作用于肠道系统,调节肠道菌群微生态,形成肠道菌群与肠-脑、肠-肌、 肠-脑-肌之间的双向信号交流机制,从而影响机体健康。因此,本综述总结了肠道菌群如何通过代谢产物、肠道通透性和免疫-神经通路建立起肠-脑-肌之间的相互联系,为促进大脑神经的可塑性和改善肌肉健康提供新思路。     

单胃动物肠道微生物菌群与肠道免疫功能的相互作用

动物胃肠道栖息着大量的微生物,这些微生物及其代谢产物在营养、免疫等方面对宿主的健康有重要的意义。近年来研究发现肠道微生物与免疫系统间存在密切的交流和互作机制,尽管肠道共生菌具有定植抑制效应,但肠道微生物也可通过其特定组分刺激免疫细胞如Tregs细胞、Th17细胞的分化,肠道菌群的紊乱可能导致细菌移位、肠道屏障功能损伤,影响机体健康。宿主免疫系统可通过分泌多种免疫效应因子如MUC、sIgA、ITF、RegIIIγ、α-防御素等调节肠道微生物的分布和组成,调节肠道菌群的稳态。本文综述了单胃动物肠道微生物菌群的组成,深入探讨了肠道微生物菌群与动物肠道免疫功能之间的相互作用。     

胆汁酸和肠道菌群相互作用对非酒精性脂肪性肝病的影响

近年来,大量研究发现胆汁酸与肠道菌群相互作用对非酒精性脂肪性肝病的发生和发展有重要影响。胆汁酸主要在肝脏中合成,分泌进入肠道后不仅可以促进脂类物质的消化和吸收,还具有重要的生理信号和代谢调节作用,其能通过参与能量代谢和炎症反应影响非酒精性脂肪性肝病的进程。肠道菌群的代谢产物(如胆汁酸、短链脂肪酸、内生性乙醇和三甲胺等)对宿主的代谢表型、免疫稳态、炎症反应和病程进展等都有重要调节作用。本文主要综述了胆汁酸的合成、转运代谢与肠道菌群结构变化之间的互相作用和对话交流机制,揭示了肠道菌群结构紊乱和胆汁酸代谢异常对非酒精性脂肪性肝病的推动作用,以期为临床上治疗非酒精性脂肪性肝病提供全新的策略和方法。     

益生菌与宿主疾病关系的研究进展

人类肠道中含有的多种微生物,称为肠道菌群,它们对宿主的健康起着至关重要的作用。肠道菌群的组成包括细菌、病毒和真核生物,已经被证明与宿主健康有密切的联系,尤其是其中的益生菌。益生菌通过多种途径发挥作用,包括与宿主微生物的相互作用、抵御病原菌的定殖、改善肠道屏障功能、调节免疫功能、产生相关代谢产物,在宿主的代谢、免疫和神经系统中发挥有益作用。综述益生菌的作用机制,讨论了近年来益生菌应用临床研究实例以更好地理解其对疾病风险和健康可持续性的贡献,将为新的治疗干预和疾病预防策略提供参考。     

肠道菌群代谢产物短链脂肪酸在慢性肾脏病中的研究进展

近年来研究发现肾脏与肠道微生态间存在密切的联系,称为"肠-肾轴"。慢性肾脏病患者(CKD)由于各种因素往往导致肠道生态失调,表现为肠道菌群种类的相对丰度、组成及其代谢产物发生改变。肠道菌群代谢产物短链脂肪酸(SCFAs)是联系宿主和肠道菌群的重要中介物质,具有生物学效应。研究发现SCFAs主要通过与G蛋白偶联受体结合,抑制组蛋白去乙酰化酶调节RAS系统、炎症反应和细胞自噬等,起到延缓肾脏炎症和纤维化的作用。基于SCFAs与肾脏之间的紧密联系,SCFAs可能成为慢性肾脏病治疗的新靶点。外源性补充SCFAs能延缓CKD发生和发展的作用逐渐受到认可。因此,进一步研究SCFAs在肾脏方面的具体作用机制尤为重要。     

肠道菌群与病毒性肺炎关系的研究进展

在21世纪头20年里,呼吸道病毒造成的地区性乃至世界性的流行已经发生多次,而疫情的暴发严重威胁人类健康与生存,但临床上,仍缺乏针对病毒的特异性治疗手段。随着肠道微生态相关研究的广泛开展,肠道菌群在哮喘,纤维化及细菌性感染等多种肺部疾病的发病及防治中发挥着重要作用,成为"肠-肺轴"的关键枢纽。病毒性肺炎与肠道微生态间也存在着紧密的相互联系,通过改善肠道菌群,对呼吸病毒感染具有较好的防治作用。其内在机制主要涉及到:通过增强肠道黏膜屏障功能、减少继发性细菌的感染;通过菌体成分或者代谢产物如短链脂肪酸,色氨酸代谢产物等提高固有样淋巴细胞(Innate lymphoid cells,ILC)、单核-巨噬细胞、树突状细胞、自然杀伤细胞(Natural killer,NK)、粒细胞等固有免疫细胞的抗病毒免疫功能及调节Th17/Treg平衡抑制过度的炎症反应等。本文将系统回顾已发表的文章,对肠道菌群在病毒性肺炎方面的研究作系统的阐述,以求为研究者在病毒性肺炎的机制探究和防治方面提供帮助。     

肠道菌群在代谢手术改善肥胖代谢性疾病中的研究进展

肥胖不仅是体内脂肪细胞的增加,而且是机体代谢状态的异常改变,导致肥胖患者出现2型糖尿病、非酒精性脂肪性肝病、心血管疾病和多囊卵巢综合征等代谢紊乱性疾病。代谢手术在减重的同时,能够治疗和缓解由肥胖导致的相关疾病。对代谢手术改善肥胖及其合并症的机制研究发现,肠道微生物在术后显著改变,这促使肠道菌群及其代谢产物（短链脂肪酸和胆汁酸）等成为代谢手术改善代谢效应机制研究的热点。随着粪菌移植和口服益生菌治疗肥胖及其合并症的报道,进一步验证了肠道菌群在改善肥胖及其相关并发症中发挥有益作用。本综述将总结肠道菌群在代谢手术领域中的最新研究进展。     

从肠道菌群及色氨酸代谢角度探讨中药在三阴性乳腺癌中作用的研究进展

三阴性乳腺癌属于免疫原性较强的乳腺癌亚型,由于缺乏有效的治疗靶点,仍属于难以治疗的乳腺癌类型。越来越多的研究表明,肠道菌群可通过干预宿主或微生物的色氨酸代谢,重塑肿瘤免疫微环境,从而影响三阴性乳腺癌的发生、发展及免疫治疗疗效。中药在以往的研究中已被证实可以有效调节肠道稳态,抑制炎症反应,促进肿瘤细胞的凋亡等。然而,肠道菌群及其代谢物与三阴性乳腺癌之间的中医机制尚不明确。因此,本文在中医辨证乳腺癌基础理论的基础上,回顾以往的文献,从肠道菌群和色氨酸代谢的角度出发,梳理中药对肠道菌群及其代谢物质的干预作用,探索其抗肿瘤的机制,以期能为中西医结合治疗三阴性乳腺癌提供新的思路和方法。     

肠道微生物对肥胖影响

肠道微生物是哺乳动物最密集的微生物群落,也是最多样化的微生物群落之一。随着宏基因组学的不断发展,肠道微生物成为热门的研究领域。肠道微生物具有保护和代谢等功能,在胰岛素抵抗和肥胖等疾病中发挥重要作用。本文介绍了肠道微生物及其代谢物通过调节食欲、神经递质合成分泌、炎性反应进而调节肥胖,探讨了肠道微生物的影响因素,展望了肠道微生物对治疗人类肥胖的应用前景。     

肠道微生物群落与炎症性肠病关系研究进展

目的炎症性肠病（IBD）包括克罗恩病（CD）和溃疡性结肠炎（UC）,以持续性肠道非特异性炎症为特征,通常反复发作、迁延不愈,临床上仍无特效性的治疗手段。IBD确切的发病机制尚不清楚,涉及免疫、环境及遗传等因素,这些因素共同诱导肠道炎症、黏膜损伤和修复。肠道微生物群落及其代谢产物、宿主基因易感性及肠道黏膜免疫三方面共同参与了IBD的发病机制。本文从消化道微生态角度出发,对目前IBD相关的肠道微生物群落研究现状、宿主-微生物间免疫应答及益生菌治疗等内容进行探讨。     

The gut microbiota and its interactions with cardiovascular disease

The intestine is colonized by a considerable community of microorganisms that cohabits within the host and plays a critical role in maintaining host homeostasis. Recently, accumulating evidence has revealed that the gut microbial ecology plays a pivotal role in the occurrence and development of cardiovascular disease (CVD). Moreover, the effects of imbalances in microbe–host interactions on homeostasis can lead to the progression of CVD. Alterations in the composition of gut flora and disruptions in gut microbial metabolism are implicated in the pathogenesis of CVD. Furthermore, the gut microbiota functions like an endocrine organ that produces bioactive metabolites, including trimethylamine/trimethylamine N-oxide, short-chain fatty acids and bile acids, which are also involved in host health and disease via numerous pathways. Thus, the gut microbiota and its metabolic pathways have attracted growing attention as a therapeutic target for CVD treatment. The fundamental purpose of this review was to summarize recent studies that have illustrated the complex interactions between the gut microbiota, their metabolites and the development of common CVD, as well as the effects of gut dysbiosis on CVD risk factors. Moreover, we systematically discuss the normal physiology of gut microbiota and potential therapeutic strategies targeting gut microbiota to prevent and treat CVD.     

The role of gut microbiota in pathogenesis of Alzheimer's disease

This paper describes the effects of the gut microbiota on the pathogenesis of Alzheimer's pathology by evaluating the current original key findings and identifying gaps in the knowledge required for validation. The diversity of the gut microbiota declines in the elderly and in patients with Alzheimer's disease (AD). Restoring the diversity with probiotic treatment alleviates the psychiatric and histopathological findings. This presents a problem: How does gut microbiota interact with the pathogenesis of AD? The starting point of this comprehensive review is addressing the role of bacterial metabolites and neurotransmitters in the brain under various conditions, ranging from a healthy state to ageing and disease. In the light of current literature, we describe three different linkages between the present gut microbiome hypothesis and the other major theories for the pathogenesis of AD as follows: bacterial metabolites and amyloids can trigger central nervous system inflammation and cerebrovascular degeneration; impaired gut microbiome flora inhibits the autophagy-mediated protein clearance process; and gut microbiomes can change the neurotransmitter levels in the brain through the vagal afferent fibres.     

The role of intestinal microbiota in cardiovascular disease

Accumulating evidence has indicated that intestinal microbiota is involved in the development of various human diseases, including cardiovascular diseases (CVDs). In the recent years, both human and animal experiments have revealed that alterations in the composition and function of intestinal flora, recognized as gut microflora dysbiosis, can accelerate the progression of CVDs. Moreover, intestinal flora metabolizes the diet ingested by the host into a series of metabolites, including trimethylamine N‐oxide, short chain fatty acids, secondary bile acid and indoxyl sulfate, which affects the host physiological processes by activation of numerous signalling pathways. The aim of this review was to summarize the role of gut microbiota in the pathogenesis of CVDs, including coronary artery disease, hypertension and heart failure, which may provide valuable insights into potential therapeutic strategies for CVD that involve interfering with the composition, function and metabolites of the intestinal flora.     

The development of gut immune responses and gut microbiota: effects of probiotics in prevention and treatment of allergic disease

The infant's immature intestinal immune system develops as it comes into contact with dietary and microbial antigens in the gut. The evolving indigenous intestinal microbiota have a significant impact on the developing immune system and there is accumulating evidence indicating that an intimate interaction between gut microbiota and host defence mechanisms is mandatory for the development and maintenance of a balance between tolerance to innocuous antigens and capability of mounting an inflammatory response towards potential pathogens. Disturbances in the mucosal immune system are reflected in the composition of the gut microbiota and vice versa. Distinctive alterations in the composition of the gut microbiota appear to precede the manifestation of atopic disease, which suggests a role for the interaction between the intestinal immune system and specific strains of the microbiota in the pathogenesis of allergic disorders. The administration of probiotics, strains of bacteria from the healthy human gut microbiota, have been shown to stimulate antiinflammatory, tolerogenic immune responses, the lack of which has been implied in the development of atopic disorders. Thus probiotics may prove beneficial in the prevention and alleviation of allergic disease.     

肠道菌群：肠道干细胞增殖分化的调节者

肠道干细胞(intestinal stem cells, ISCs)是肠道各类上皮细胞的来源,通过平衡增殖与分化维持肠道稳态。同时,肠道菌群及其代谢物在维持宿主肠道稳态中也发挥着重要作用。随着技术的发展,研究者认识到ISCs与肠道菌群之间存在相互作用。研究表明,ISCs对上皮细胞亚型的调控影响肠道菌群的组成,并且肠道菌群及其代谢物也影响ISCs介导的上皮发育。本文阐述了ISCs分化对肠道菌群的影响,重点总结了肠道菌群及其代谢物调控ISCs增殖分化的研究进展,从菌群调控ISCs的角度探讨肠道损伤的治疗思路,并对未来可能的研究方向进行讨论。     

Relationship between gut microbiota and development of T cell associated disease

The interplay between the immune response and the gut microbiota is complex. Although it is well-established that the gut microbiota is essential for the proper development of the immune system, recent evidence indicates that the cells of the immune system also influence the composition of the gut microbiota. This interaction can have important consequences for the development of inflammatory diseases, including autoimmune diseases and allergy, and the specific mechanisms by which the gut commensals drive the development of different types of immune responses are beginning to be understood. Furthermore, sex hormones are now thought to play a novel role in this complex relationship, and collaborate with both the gut microbiota and immune system to influence the development of autoimmune disease. In this review, we will focus on recent studies that have transformed our understanding of the importance of the gut microbiota in inflammatory responses.