基于肠心轴学说探讨肠道菌群在心血管疾病中的作用

肠道内庞大的菌群之间相互依存、相互制约,协同参与机体生理代谢和营养物质的消化。肠道菌群与心血管健康相关研究已成为十分重要的研究领域,肠道菌群组成的改变、肠道菌群产生的代谢产物和毒素都能引发心血管系统的病变。心血管疾病(cardiovascular disease,CVD)因高发病率和死亡率已成为一个主要的健康问题,CVD的发生、发展中肠道特定菌群的改变已被确定为疾病发生的关键因素。然而,肠道菌群及其代谢产物如何产生及影响CVD的潜在机制仍不清楚。本文就肠道菌群通过肠心轴调节CVD的最新研究进展进行综述,重点总结肠道微生物及其代谢产物与CVD发生发展之间复杂的相互作用,以及肠道菌群失调的改变对心血管事件发生的影响,探讨肠道菌群与CVD发病机制之间的因果联系。     

肠道菌群失调与糖尿病相关性的研究进展

糖尿病为常见的慢性代谢性疾病之一,具有明显的遗传易感性。患者长期处于高血糖的状态易并发多系统损伤,有着较高的致残率和病死率,严重威胁到患者的健康。近年来,大量研究表明糖尿病的发生发展与遗传、环境等因素有关之外,还与肠道菌群失调有关。糖尿病患者的肠道菌群有着不同程度的失调,其中厚壁菌门与拟杆菌门的丰度变化尤为显著。肠道菌群失调可通过改变宿主肠黏膜屏障、影响短链脂肪酸合成、胆汁酸代谢异常等机制使患者胰岛素敏感性降低、能量代谢异常最终导致糖尿病。基于肠道菌群治疗糖尿病也是目前内分泌领域研究热点,用益生菌、粪便菌群移植、减肥手术等方式均能调节肠道菌群,对糖尿病起到治疗效果,为糖尿病患者带来了新的希望。     

肠道菌群失调与结肠癌发生发展之间关系的研究进展

肠道菌群是机体重要的组成部分,正常状况下肠道菌群保持稳态,在促进营养物质消化吸收、维持肠道正常生理功能、调节机体免疫等众多生命活动中发挥重要的作用。但当体内外环境发生改变,如年龄、饮食习惯、肥胖等代谢性疾病以及抗生素等药物均会造成菌群失调。近年来,很多研究发现肠道菌群失调可以引发多种疾病,其中结肠癌的发生、发展与肠道菌群失调关系密切。同时,有研究资料表明,通过改善肠道菌群的失调状态可降低结肠癌的发生率和抑制结肠癌的生长恶化,但是具体的作用机制尚无清晰的认识。该文就近年来国内外关于肠道菌群失调与结肠癌发生、发展研究的有关热点问题及治疗进行概述,为肠道菌群研究和结肠癌的治疗提供理论参考。     

肠道菌群调控骨代谢及中药应用研究进展

肠道菌群是定植在人体内复杂而庞大的微生物群落,肠道菌群及其代谢物短链脂肪酸在参与人体代谢、抵御外来致病菌以及调节免疫机制等方面发挥重要作用。近年来,不少研究发现肠道菌群与骨骼代谢密切相关。肠道菌群可通过营养吸收、短链脂肪酸生成、调节机体免疫、影响机体代谢等多种途径调控骨代谢,影响骨量变化。本文综述了肠道菌群影响骨代谢中骨量变化的潜在途径及作用机制,以及中药干预肠道菌群调控骨代谢的相关进展,以期为骨代谢相关疾病骨质疏松症的防治提供新思路。     

基于肠-肝轴发病机制的肝硬化治疗研究进展

肝硬化是一种慢性进展的弥漫性肝病。在参与肝硬化进展的因素中,肠道菌群可能是代谢和免疫等全身因素以及肠道和肝脏等器官的枢纽。肠道菌群失调参与肝硬化发展的机制可能包括肠道屏障功能的破坏、内毒素增多、肠壁通透性增加、宿主代谢紊乱等。肠道菌群可与其他器官通过不同的轴工作,其中肠-肝轴是最相关和研究最多的轴。肠-肝轴主要包括肠道菌群、细菌产物、肠道屏障以及肝脏。发生肠道菌群紊乱时,不仅肠道感染会加重,还会进一步增加肝脏代谢负担,并使肝组织破坏增多,促进肝脏炎症,激活免疫系统,导致肝硬化,二者相互作用、相互影响。目前,基于肠-肝轴机制调治肝硬化的干预措施主要包括水凝胶、碳纳米颗粒、噬菌体、粪便微生物移植、后生元、FXR激动剂、中医药等。现主要就肠-肝轴在肝硬化进展中的作用机制及治疗进行综述。     

肠道菌群在炎症相关肠癌中的研究进展

炎症相关肠癌 （CAC） 是世界医学难题, 肿瘤微环境是目前研究的热点, 肠道菌群失调与CAC的发病密切 相关, 肠道菌群失调加重结肠炎诱导CAC的发生。随着微生态学的发展, 肠道菌群在CAC研究中备受关注。本文概 述了CAC发生过程中肠道菌群与饮食、 炎症机制、 肠黏膜的关系以及在诊断、 治疗中相关研究, 重点讨论了肠道菌群 可能成为CAC作用机制的新靶点和相关应用前景。     

中药治疗溃疡性结肠炎的代谢组学研究进展

溃疡性结肠炎（UC）作为临床消化系统的常见病、难治病，一直是医学研究的热点和难点。中医药在治疗UC方面具有疗效显著、安全性高、停药后不易反复等优势，但作用机制尚未完全阐明。代谢组学从整个机体内源性动态代谢角度出发，寻找潜在的生物标志物及代谢途径，有助于评价药物治疗效果和探索相关作用机制。中药治疗UC的代谢组学研究显示，中药复方、单味中药以及中药单体可通过调控机体内源性代谢物，作用于氨基酸代谢、脂质代谢、能量代谢等诸多相关通路，从而抑制免疫炎症反应、改善氧化应激、降低肠道敏感性、调节肠道菌群、修复肠道黏膜损伤，使机体恢复正常的代谢活动。但相关代谢标志物还需进一步筛选与验证。     

中医药在治疗多系统疾病中对肠道菌群影响的研究进展

肠道菌群在人体健康状态下始终保持动态平衡,并与人体相互依存、相互抑制、相互竞争。随着日益精进的医学及生物技术水平提高,越来越多的研究发现中医药在治疗多系统疾病中的功效与其可调节肠道菌群失调有关。本文对近几年关于中医药对肠道菌群影响的研究进行归纳及总结,发现中医药可改善肠道菌群丰度和均匀度、影响代谢途径及代谢产物、调控肠道黏膜屏障,从而在多系统疾病中发挥功效。     

肠道微生态与消化系统疾病关系的研究进展

肠道微生态参与机体生理、代谢、营养、免疫等多种生理功能,影响多种疾病的发生及发展,其中消化系统受肠道微生态影响最大。肠道菌群失调(intestinal dysbacteriosis)是许多疾病发生的病因或疾病发生的相关因素,包括一些全身性疾病和消化系统疾病,其与消化系统疾病的关系是目前的研究热点。在其与炎症性肠病、结直肠肿瘤、一些肝胆疾病和功能性胃肠病关系的研究中已取得一些研究成果。本文重点阐述肠道菌群与消化系统疾病之间的关系,通过探讨肠道菌群与疾病发生发展之间的机制及影响,加强临床工作者对相关疾病的认知。     

短链脂肪酸:肠-器官轴调控疾病的信号使者

肠道菌群是一个复杂而动态的系统,对机体的健康至关重要。它作为机体的“第二基因组”,通过调节肠道神经、胃肠激素、肠屏障、肠道免疫和代谢与宿主重要脏器建立通讯轴,影响宿主的多种生理功能。短链脂肪酸作为肠道菌群的重要代谢产物,在机体的免疫、代谢、内分泌及信号传导等方面都有重要作用,是肠-器官轴上的重要通讯物质。本文总结了肠-肝/脑/肾/肺轴与疾病的互作关系,并重点探讨了短链脂肪酸在这种互作关系中的作用及机制,为相关疾病的治疗提供新思路。     

肠道微生物群在中药治疗非酒精性脂肪性肝病中的作用

非酒精性脂肪性肝病(NAFLD)是一种与遗传和环境因素密切相关的代谢性疾病,可发展为肝纤维化、肝硬化,以致肝细胞癌。近年来, NAFLD的患病率逐年上升,目前还缺乏明确的药物治疗方法。中药在NAFLD防治中具有很大潜力但相关机制研究较少。越来越多的证据表明,肠道菌群与NAFLD的发生发展密切相关,肠道菌研究为阐明中药的作用机制开辟了新的视野。本文旨在介绍肠道菌群与NAFLD发生、发展的关系,解析肠道菌群调节在以中药为基础的NAFLD治疗中的作用及机制,以期为相关研究提供参考。     

肠道微生态与炎症性肠病

炎症性肠病(inflammatory bowel disease,IBD)是一组病因未明、发病机制亦不明确的慢性肠道炎症性疾病,主要包括克罗恩病(Crohn's disease,CD)和溃疡性结肠炎(ulcerative colitis,UC)。近几十年的研究结果认为,其发病是环境、易感基因和肠道微生态3个要素相互作用的结果,且这些要素使IBD成为一种适合研究宿主与肠道微生物相互作用的高优先平台。最近,肠道菌群的图谱分析将IBD的发病机制与菌群各组成部分特征的改变相联系,进一步支持"肠道微生物和宿主相互作用的改变能形成IBD"这一观点。该文回顾性分析有关IBD患者体内微生物的研究文献,综述肠道微生态失衡对IBD的多方面影响,以动物模型和临床验证资料阐述不同的治疗方法改善肠道微生态变化的最新进展。     

Interactions of gut microbiota with functional food components and nutraceuticals

The human gut is populated by an array of bacterial species, which develop important metabolic and immune functions, with a marked effect on the nutritional and health status of the host. Dietary component also play beneficial roles beyond basic nutrition, leading to the development of the functional food concept and nutraceuticals. Prebiotics, polyunsaturated fatty acids (PUFAs) and phytochemicals are the most well characterized dietary bioactive compounds. The beneficial effects of prebiotics mainly relay on their influence on the gut microbiota composition and their ability to generate fermentation products (short-chain fatty acids) with diverse biological roles. PUFAs include the ω-3 and ω-6 fatty acids, whose balance may influence diverse aspects of immunity and metabolism. Moreover, interactions between PUFAs and components of the gut microbiota may also influence their biological roles. Phytochemicals are bioactive non-nutrient plant compounds, which have raised interest because of their potential effects as antioxidants, antiestrogenics, anti-inflammatory, immunomodulatory, and anticarcinogenics. However, the bioavailability and effects of polyphenols greatly depend on their transformation by components of the gut microbiota. Phytochemicals and their metabolic products may also inhibit pathogenic bacteria while stimulate the growth of beneficial bacteria, exerting prebiotic-like effects. Therefore, the intestinal microbiota is both a target for nutritional intervention and a factor influencing the biological activity of other food compounds acquired orally. This review focuses on the reciprocal interactions between the gut microbiota and functional food components, and the consequences of these interactions on human health.     

口服难吸收中药重塑肠道微生态干预代谢相关脂肪性肝病的研究进展

代谢相关脂肪性肝病（MAFLD）是多系统代谢紊乱的肝脏疾病,其发病机制的复杂性和治疗目标的多元化导致临床缺乏效果理想的药物。中药对防治肝脏疾病有很好的疗效,口服给药是最普遍的给药方式,药物不仅可以通过肠道与肠道菌群建立联系,而且经肠道细菌作用后可改善吸收差、生物利用度低的问题。然而,肠道微生态紊乱会导致机体免疫功能障碍并促进MAFLD的发生发展。因此,口服难吸收中药对肠道菌群的调节作用可能是治疗MAFLD的潜在靶点。从口服难吸收中药的药理作用、相关代谢、肠道菌群作用等不同角度总结了中药对MAFLD的治疗作用以及肠道菌群与MAFLD的联系,为研究中药、MAFLD和肠道菌群间的关系提供理论依据,为进一步研究中药治疗MAFLD奠定药效物质基础,为从肠道菌群角度研究中药治疗MAFLD的作用机制与靶点奠定基础。     

Modulation of Gut-Brain Axis by Probiotics: A Promising Anti-depressant Approach

The human digestive system is embedded with trillions of microbes of various species and genera. These organisms serve several purposes in the human body and exist in symbiosis with the host. Their major role is involved in the digestion and conversion of food materials into many useful substrates for the human body. Apart from this, the gut microbiota also maintains healthy communication with other body parts, including the brain. The connection between gut microbiota and the brain is termed as gut-brain axis (GBA), and these connections are established by neuronal, endocrine and immunological pathways. Thus, they are involved in neurophysiology and neuropathology of several diseases like Parkinson’s disease (PD), Alzheimer’s disease (AD), depression, and autism. There are several food supplements such as prebiotics and probiotics that modulate the composition of gut microbiota. This article provides a review about the role of gut microbiota in depression and supplements such as probiotics that are useful in the treatment of depression.     

靶向肠道菌群调控肠源尿毒素代谢通路干预慢性肾病进展的治疗策略分析

慢性肾病(chronic kidney disease,CKD)是一种发病率高、预后差、并发症复杂的重大慢性疾病,对人类健康造成极大危害。硫酸吲哚酚(indoxyl-sulfate,IS)和硫酸对甲酚(p-cresol sulfate,PCS)是两种典型的肠源尿毒素,由肠道菌群与宿主共代谢生成。随着慢性肾病的进展,慢性肾病患者体内的IS和PCS等肠源尿毒素不断蓄积,并进一步促进CKD进展。肠道菌群与CKD密切相关,靶向肠道菌群调控肠源尿毒素合成及代谢通路很可能是延缓CKD进展的新思路及新策略。本文通过对肠道菌群及肠源尿毒素与慢性肾病进展之间的关系进行分析,提出基于肠源尿毒素代谢调控干预慢性肾病进展的治疗策略。     

中医药调节肠道菌群防治冠心病的研究概述

冠状动脉粥样硬化性心脏病(CHD)病程较长,发病机制是多种因素相互作用引发,肠道菌群(GM)的结构紊乱及功能障碍与CHD的进展密切相关。此外,GM的代谢物也可影响CHD的发展和预后。现基于中医学基础理论,探讨GM及代谢物质与CHD之间的关系,进一步论述中医药防治CHD的现代研究进展。     

肠道菌群与川崎病

川崎病(KD)是一种儿童急性发热性全身性中、小动脉炎,是儿童获得性心脏病最常见的原因,其主要特征为免疫紊乱和全身性血管炎.以婴幼儿多见,其病因及发病机制不明,与感染、遗传及环境因素相关.近年来研究表明,KD病人存在肠道菌群紊乱,导致了肠道屏障功能破坏和自身免疫激活.作者对KD的肠道菌群研究做一综述,探讨菌群干预作为KD...     

Modulating Gut Microbiota: An Emerging Approach in the Prevention and Treatment of Multiple Sclerosis

Multiple sclerosis (MS) is a progressive neuromuscular disorder characterized by demyelination of neurons of the central nervous system (CNS). The pathogenesis of the disorder is described as an autoimmune attack targeting the myelin sheath of nerve cell axons in the CNS. Available treatments only reduce the risk of relapse, prolonging the remissions of neurological symptoms and halt the progression of the disorder. Among the new ways of targeting neurological disorders, including MS, there is modulation of gut microbiota since the link between gut microbiota has been rethought within the term gut-brain axis. Gut microbiota is known to help the body with essential functions such as vitamin production and positive regulation of immune, inflammatory, and metabolic pathways. High consumption of saturated fatty acids, gluten, salt, alcohol, artificial sweeteners, or antibiotics is the responsible factor for causing gut dysbiosis. The latter can lead to dysregulation of immune and inflammatory pathways, which eventually results in leaky gut syndrome, systemic inflammation, autoimmune reactions, and increased susceptibility to infections. In modern medicine, scientists have mostly focused on the modulation of gut microbiota in the development of novel and effective therapeutic strategies for numerous disorders, with probiotics and prebiotics being the most widely studied in this regard. Several pieces of evidence from preclinical and clinical studies have supported the positive impact of probiotic and/or prebiotic intake on gut microbiota and MS. This review aims to link gut dysbiosis with the development/progression of MS, and the potential of modulation of gut microbiota in the therapeutics of the disease.     

Intestinal microbiota and obesity

The human gut harbors a highly diverse microbial ecosystem of approximately 400 different species, which is characterized by a high interindividual variability. The intestinal microbiota has recently been suggested to contribute to the development of obesity and the metabolic syndrome. Transplantation of gut microbiota from obese mice to nonobese, germ-free mice resulted in transfer of metabolic syndrome-associated features from the donor to the recipient. Proposed mechanisms for the role of gut microbiota include the provision of additional energy by the conversion of dietary fiber to short-chain fatty acids, effects on gut-hormone production, and increased intestinal permeability causing elevated systemic levels of lipopolysaccharides (LPS). This metabolic endotoxemia is suggested to contribute to low-grade inflammation, a characteristic trait of obesity and the metabolic syndrome. Finally, activation of the endocannabinoid system by LPS and/or high-fat diets is discussed as another causal factor. In conclusion, there is ample evidence for a role of gut microbiota in the development of obesity in rodents. However, the magnitude of its contribution to human obesity is still unknown.