|
|
肠道菌群在肠易激综合征治疗中的研究进展
|
Abstract:
肠易激综合征(IBS)是临床常见的功能性胃肠病(FGIDs)之一，由于目前没有完全理解其发病机制，治疗方向以缓解症状为主，而肠道菌群在肠易激综合征的治疗中日益受到关注。近期研究揭示了肠道菌群与肠易激综合征之间的紧密联系，菌群失调可能引发免疫和神经系统的异常，进而导致肠易激综合征症状的发生。治疗方面，针对菌群的调整成为一项重要策略，以恢复肠道微生态平衡。本文阐述了肠道菌群在肠易激综合征治疗中的研究进展。
Irritable Bowel Syndrome (IBS) is a common functional gastrointestinal disorder (FGID) in clinical practice. Due to the incomplete understanding of its pathogenesis, the treatment approach mainly focuses on symptom relief. Recently, there has been increasing attention on the role of gut microbi-ota in the treatment of Irritable Bowel Syndrome. Recent research has revealed a close connection between gut microbiota and Irritable Bowel Syndrome, suggesting that dysbiosis may trigger ab-normalities in the immune and nervous systems, leading to the occurrence of IBS symptoms. In terms of treatment, adjusting the microbiota has become a crucial strategy to restore the balance of the gut microbiota. This article elaborates on the research progress of gut microbiota in the treat-ment of Irritable Bowel Syndrome.
| [1] | Buono, J.L., Carson, R.T. and Flores, N.M. (2017) Health-Related Quality of Life, Work Productivity, and Indirect Costs among Patients with Irritable Bowel Syndrome with Diarrhea. Health and Quality of Life Outcomes, 15, Article No. 35. https://doi.org/10.1186/s12955-017-0611-2 |
| [2] | Lacy, B.E. and Patel, N.K. (2017) Rome Criteria and a Diagnostic Approach to Irritable Bowel Syndrome. Journal of Clinical Medicine, 6, Article 99. https://doi.org/10.3390/jcm6110099 |
| [3] | Sperber, A.D., Bangdiwala, S.I., Drossman, D.A., et al. (2021) World-wide Prevalence and Burden of Functional Gastrointestinal Disorders, Results of Rome Foundation Global Study. Gas-troenterology, 160, 99-114.E3. |
| [4] | Vasant, D.H., Paine, P.A., Black, C.J., et al. (2021) British Society of Gastroenter-ology Guidelines on the Management of Irritable Bowel Syndrome. Gut, 70, 1214-1240. https://doi.org/10.1136/gutjnl-2021-324598 |
| [5] | 杨芳, 严晶, 刘丽娜, 等. 肠易激综合征病因及发病机制研究的新进展[J]. 河北医科大学学报, 2020, 41(8): 987-992. |
| [6] | Tian, S., Zhang, H., Chen, S., et al. (2023) Global Re-search Progress of Visceral Hypersensitivity and Irritable Bowel Syndrome: Bibliometrics and Visualized Analysis. Frontiers in Pharmacology, 14, Article 1175057.
https://doi.org/10.3389/fphar.2023.1175057 |
| [7] | Mayer, E.A. (2011) Gut Feelings: The Emerging Biology of Gut-Brain Communication. Nature Reviews Neuroscience, 12, 453-466. https://doi.org/10.1038/nrn3071 |
| [8] | Mawdsley, J.E. and Rampton, D.S. (2005) Psychological Stress in IBD: New Insights into Pathogenic and Therapeutic Implications. Gut, 54, 1481-1491. https://doi.org/10.1136/gut.2005.064261 |
| [9] | Koloski, N.A., Jones, M., Kalantar, J., et al. (2012) The Brain—Gut Pathway in Functional Gastrointestinal Disorders Is Bidirectional: A 12-Year Prospective Population-Based Study. Gut, 61, 1284-1290.
https://doi.org/10.1136/gutjnl-2011-300474 |
| [10] | Koloski, N.A., Jones, M. and Talley, N.J. (2016) Evidence That Independent Gut-to-Brain and Brain-to-Gut Pathways Operate in the Irritable Bowel Syndrome and Functional Dyspep-sia: A 1-Year Population-Based Prospective Study. Alimentary Pharmacology & Therapeutics, 44, 592-600. https://doi.org/10.1111/apt.13738 |
| [11] | Sender, R., Fuchs, S. and Milo, R. (2016) Are We Really Vastly Outnum-bered? Revisiting the Ratio of Bacterial to Host Cells in Humans. Cell, 164, 337-340. https://doi.org/10.1016/j.cell.2016.01.013 |
| [12] | De Vos, W.M., Tilg, H., Van Hul, M. and Cani, P.D. (2022) Gut Microbiome and Health: Mechanistic Insights. Gut, 71, 1020-1032. https://doi.org/10.1136/gutjnl-2021-326789 |
| [13] | Leonardi, I., Gao, I.H., Lin, W.Y., et al. (2022) Mucosal Fungi Promote Gut Barrier Function and Social Behavior via Type 17 Immunity. Cell, 185, 831-846.E14. https://doi.org/10.1016/j.cell.2022.01.017 |
| [14] | Hookway, C., Buckner, S., Crosland, P., et al. (2015) Irritable Bowel Syndrome in Adults in Primary Care: Summary of Updated NICE Guidance. BMJ, 350, h701. https://doi.org/10.1136/bmj.h701 |
| [15] | Li, C.Y. and Li, S.C. (2015) Treatment of Irritable Bowel Syndrome in Chi-na: A Review. World Journal of Gastroenterology, 21, 2315-2322. https://doi.org/10.3748/wjg.v21.i8.2315 |
| [16] | Chang, L., Lembo, A. and Sultan, S. (2014) American Gastroentero-logical Association Institute Technical Review on the Pharmacological Management of Irritable Bowel Syndrome. Gas-troenterology, 147, 1149-1172.E2.
https://doi.org/10.1053/j.gastro.2014.09.002 |
| [17] | Nam, Y., Min, Y.S. and Sohn, U.D. (2018) Recent Advances in Pharmacological Research on the Management of Irritable Bowel Syndrome. Archives of Pharmacal Research, 41, 955-966. https://doi.org/10.1007/s12272-018-1068-5 |
| [18] | Naliboff, B.D., Frese, M.P. and Rapgay, L. (2008) Mind/Body Psychological Treatments for Irritable Bowel Syndrome. Evidence-Based Complementary and Alternative Medicine, 5, Article ID: 919413.
https://doi.org/10.1093/ecam/nem046 |
| [19] | Jeffery, I.B., Quigley, E.M., Ohman, L., et al. (2012) The Microbiota Link to Irritable Bowel Syndrome: An Emerging Story. Gut Microbes, 3, 572-576. https://doi.org/10.4161/gmic.21772 |
| [20] | Parkes, G.C., Rayment, N.B., Hudspith, B.N., et al. (2012) Distinct Mi-crobial Populations Exist in the Mucosa-Associated Microbiota of Sub-Groups of Irritable Bowel Syndrome. Neurogas-troenterology & Motility, 24, 31-39.
https://doi.org/10.1111/j.1365-2982.2011.01803.x |
| [21] | Jeffery, I.B., O’toole, P.W., ？hman, L., et al. (2012) An Irritable Bowel Syndrome Subtype Defined by Species-Specific Alterations in Faecal Microbiota. Gut, 61, 997-1006. https://doi.org/10.1136/gutjnl-2011-301501 |
| [22] | Labus, J.S., Hollister, E.B., Jacobs, J., et al. (2017) Differences in Gut Microbial Composition Correlate with Regional Brain Volumes in Irritable Bowel Syndrome. Microbiome, 5, Article No. 49.
https://doi.org/10.1186/s40168-017-0260-z |
| [23] | Tap, J., Derrien, M., Tornblom, H., et al. (2017) Identification of an Intestinal Microbiota Signature Associated with Severity of Irritable Bowel Syndrome. Gastroenterology, 152, 111-123.E8.
https://doi.org/10.1053/j.gastro.2016.09.049 |
| [24] | Hugerth, L.W., Andreasson, A., Talley, N.J., et al. (2020) No Distinct Microbiome Signature of Irritable Bowel Syndrome Found in a Swedish Random Population. Gut, 69, 1076-1084. https://doi.org/10.1136/gutjnl-2019-318717 |
| [25] | Jeffery, I.B., O’herlihy, E., Shanahan, F. and O’Toole, P.W. (2020) Microbiome Alterations in IBS. Gut, 69, 2263-2264.
https://doi.org/10.1136/gutjnl-2020-320919 |
| [26] | Kennedy, P.J., Cryan, J.F., Dinan, T.G. and Clarke, G. (2014) Ir-ritable Bowel Syndrome: A Microbiome-Gut-Brain Axis Disorder? World Journal of Gastroenterology, 20, 14105-14125. https://doi.org/10.3748/wjg.v20.i39.14105 |
| [27] | Crouzet, L., Gaultier, E., Del’homme, C., et al. (2013) The Hypersensitivity to Colonic Distension of IBS Patients Can Be Transferred to Rats through Their Fecal Mi-crobiota. Neurogastroenterology & Motility, 25, e272-e282.
https://doi.org/10.1111/nmo.12103 |
| [28] | De Palma, G., Lynch, M.D.J., Lu, J., et al. (2017) Transplantation of Fecal Microbiota from Patients with Irritable Bowel Syndrome Alters Gut Function and Behavior in Recipient Mice. Science Translational Medicine, 9, eaaf6397. |
| [29] | Johnsen, P.H., Hilpusch, F., Cavanagh, J.P., et al. (2018) Faecal Microbiota Transplantation versus Placebo for Moderate-to-Severe Irritable Bowel Syndrome: A Double-Blind, Randomised, Place-bo-Controlled, Parallel-Group, Single-Centre Trial. The Lancet Gastroenterology and Hepatology, 3, 17-24.
https://doi.org/10.1016/S2468-1253(17)30338-2 |
| [30] | El-Salhy, M., Hatlebakk, J.G., Gilja, O.H., et al. (2020) Ef-ficacy of Faecal Microbiota Transplantation for Patients with Irritable Bowel Syndrome in a Randomised, Double-Blind, Placebo-Controlled Study. Gut, 69, 859-867.
https://doi.org/10.1136/gutjnl-2019-319630 |
| [31] | Goll, R., Johnsen, P.H., Hjerde, E., et al. (2020) Effects of Fecal Microbiota Transplantation in Subjects with Irritable Bowel Syndrome Are Mirrored by Changes in Gut Microbiome. Gut Microbes, 12, Article ID: 1794263.
https://doi.org/10.1080/19490976.2020.1794263 |
| [32] | El-Salhy, M., Winkel, R., Casen, C., et al. (2022) Efficacy of Fecal Microbiota Transplantation for Patients with Irritable Bowel Syndrome at 3 Years after Transplantation. Gastroen-terology, 163, 982-994.E14.
https://doi.org/10.1053/j.gastro.2022.06.020 |
| [33] | Halkjaer, S.I., Christensen, A.H., Lo, B.Z.S., et al. (2018) Faecal Microbiota Transplantation Alters Gut Microbiota in Patients with Irritable Bowel Syndrome: Results from a Randomised, Double-Blind Placebo-Controlled Study. Gut, 67, 2107-2115. https://doi.org/10.1136/gutjnl-2018-316434 |
| [34] | Zhou, S.Y., Gillilland III., M., Wu, X., et al. (2018) FODMAP Diet Modulates Visceral Nociception by Lipopolysaccharide-Mediated Intestinal Inflammation and Barrier Dysfunction. Journal of Clinical Investigation, 128, 267-280.
https://doi.org/10.1172/JCI92390 |
| [35] | Vervier, K., Moss, S., Kumar, N., et al. (2022) Two Microbiota Subtypes Identified in Irritable Bowel Syndrome with Distinct Responses to the Low FODMAP Diet. Gut, 71, 1821-1830. https://doi.org/10.1136/gutjnl-2021-325177 |
| [36] | Mcintosh, K., Reed, D.E., Schneider, T., et al. (2017) FODMAPs Alter Symptoms and the Metabolome of Patients with IBS: A Randomised Controlled Trial. Gut, 66, 1241-1251. https://doi.org/10.1136/gutjnl-2015-311339 |
| [37] | Staudacher, H.M., Lomer, M.C.E., Farquharson, F.M., et al. (2017) A Diet Low in FODMAPs Reduces Symptoms in Patients with Irritable Bowel Syndrome and a Probiotic Re-stores Bifidobacterium Species: A Randomized Controlled Trial. Gastroenterology, 153, 936-947. https://doi.org/10.1053/j.gastro.2017.06.010 |
| [38] | Ispiryan, L., Zannini, E. and Arendt, E.K. (2022) FODMAP Modulation as a Dietary Therapy for IBS: Scientific and Market Perspective. Comprehensive Reviews in Food Science and Food Safety, 21, 1491-1516.
https://doi.org/10.1111/1541-4337.12903 |
