肠道菌群与炎症性肠病的关联及发病机制 研究进展

Research Progress on the Association between Gut Microbiota and Inflammatory Bowel Disease and Its Pathogenesis

摘要: 炎症性肠病(inflammatory bowel disease, IBD)是以肠道慢性非特异性炎症为主要特征的一类疾病，与肠道微生态失衡密切相关。人体最大的微生态系统就是肠道菌群，其中包括细菌、真菌、病毒等众多微生物，它参与了营养代谢、免疫调节和肠道屏障的保护等工作，从而保证了肠道的稳定状态。近年来多组学技术的发展使我们对IBD患者的肠道菌群在组成、功能和代谢产物上具有特异性的变化有了更多的认识，这些变化又通过调控先天免疫、适应性免疫以及神经–免疫–微生物轴来影响IBD的发生和发展。本文系统地综述了IBD患者肠道菌群(细菌、真菌、病毒)的失衡特征，对菌群介导的IBD发病机制进行了详细的阐述，并总结了相关的靶向治疗研究进展，为IBD的精准诊疗提供了理论依据。

Abstract: Inflammatory bowel disease (IBD) is a group of diseases characterized primarily by chronic nonspecific inflammation of the intestines and is closely associated with intestinal microbial imbalance. The largest microbial ecosystem in the human body is the gut microbiota, which includes a variety of microorganisms such as bacteria, fungi, and viruses. It participates in nutrient metabolism, immune regulation, and the protection of the intestinal barrier, thereby ensuring intestinal homeostasis. In recent years, the development of multi-omics technologies has enhanced our understanding of the specific changes in the composition, function, and metabolites of the gut microbiota in IBD patients. These changes, in turn, influence the occurrence and progression of IBD by regulating innate immunity, adaptive immunity, and the neuro-immune-microbiota axis. This article systematically reviews the imbalance characteristics of the gut microbiota (bacteria, fungi, viruses) in IBD patients, elaborates on the microbiota-mediated mechanisms of IBD pathogenesis, and summarizes the progress of related targeted therapy research, providing a theoretical basis for precise diagnosis and treatment of IBD.