肠–脑轴在溃疡性结肠炎中的研究进展

Advances in the Study of the Gut-Brain Axis in Ulcerative Colitis

摘要: 炎症性肠病(inflammatory bowel disease, IBD)是一种以肠道持续的慢性炎症和周期性发作为特征的复杂疾病，尽管相关研究越来越多，但其详细的发病机制至今仍未阐明。近年来，肠–脑轴在IBD发病机制中的作用受到了广泛的关注，肠–脑轴是指由中枢神经系统和肠道构成的双向通信系统，对于维持健康具有重要的意义。研究表明，IBD患者肠道微生物组及其代谢产物水平的改变可能通过影响肠道免疫反应和屏障功能，进一步对中枢神经系统产生作用，参与调节患者的情绪和行为模式，而情绪作为IBD重要的触发因素，一定程度的情绪变化可能通过激活下丘脑–垂体–肾上腺轴(HPA轴)和自主神经系统，加剧结肠的炎症，因此通过调节肠道菌群平衡或采取心理干预措施可能改善IBD的临床症状。本文就肠–脑轴在IBD中作用及其研究进展作一综述。

Abstract: Inflammatory bowel disease (IBD) is a complex disease characterized by persistent chronic inflammation and periodic flare-ups in the intestinal tract, and its detailed pathogenesis has not been elucidated so far, despite an increasing number of related studies. In recent years, the role of the gut-brain axis in the pathogenesis of IBD has received widespread attention. The gut-brain axis refers to a bidirectional communication system consisting of the central nervous system and the gut, which is important for maintaining health. Research has shown that changes in the levels of the gut microbiome and its metabolites in IBD patients may, through affecting intestinal immune response and barrier function, further influence the central nervous system and participate in regulating the mood and behavioral patterns of patients. Emotions, as an important trigger for IBD, and a certain degree of emotional changes may exacerbate inflammation in the colon by activating the hypothalamo-pituitary-adrenal axis (HPA axis) and the autonomic nervous system. Therefore, regulating the balance of intestinal flora or taking psychological intervention measures may help improve the clinical symptoms of IBD. This article summarizes the role of the gut-brain axis in IBD and its research progress.