肠道菌群与阿尔茨海默病的关系

The Gut Microbiota-Alzheimer’s Disease Connection

摘要: 阿尔茨海默病(Alzheimer’s disease, AD)是一种普遍的神经退行性疾病，其病因复杂，治疗手段有限。近期研究揭示了肠道菌群可能通过肠–脑轴(Gut-brain axis, GBA)影响AD的发展，为疾病管理和治疗提供了新的视角。本文集中讨论了肠道菌群与AD之间的联系，肠道菌群失调的特征，以及通过调节肠道菌群来治疗AD的潜在策略。肠道菌群产生的代谢产物，如短链脂肪酸和脂多糖，已被证明能够影响神经炎症和血脑屏障的完整性。AD患者的肠道菌群组成变化与疾病的病理过程有关，这为肠道菌群作为治疗靶点提供了科学依据。动物模型和人类研究表明，肠道菌群的改变与AD的进展密切相关，而粪便微生物群移植(FMT)和益生元、益生菌、合生元等肠道菌群靶向治疗策略显示出改善AD症状的潜力。此外，本综述还探讨了饮食和生活方式如何通过调节肠道菌群而影响AD的风险。特别是地中海饮食等饮食模式可能对降低AD风险具有潜在益处。未来的研究方向应包括深入理解GBA的作用机制，开展临床试验，以及开发个性化的饮食和微生物调节策略。总之，肠道菌群与AD的关系为疾病的预防和治疗提供了新的策略。尽管这一领域仍处于早期阶段，但已有证据表明，肠道菌群的调节可能成为治疗AD的有效手段。

Abstract: Alzheimer’s disease (AD) is a prevalent neurodegenerative disorder characterized by progressive cognitive decline and brain degeneration. The complex etiology of AD and the lack of effective treatments have led to an exploration of novel perspectives in disease management. Recent research has highlighted the potential role of the gut microbiota in the pathogenesis of AD through the gut-brain axis (GBA), offering new insights for disease intervention. This review focuses on the interplay between the gut microbiota and AD, the characteristics of gut microbiota dysbiosis in AD, and the therapeutic potential of modulating the gut microbiota for AD treatment. Metabolites produced by the gut microbiota, such as short-chain fatty acids and lipopolysaccharides, have been shown to influence neuroinflammation and the integrity of the blood-brain barrier. Alterations in the gut microbiota composition of AD patients are associated with the disease’s pathological processes, suggesting the gut microbiota as a therapeutic target. Evidence from animal models and human studies indicates a close relationship between changes in gut microbiota and AD progression. Fecal microbiota transplantation (FMT) and targeted interventions with prebiotics, probiotics, and synbiotics have demonstrated the potential to ameliorate AD symptoms. Furthermore, the review discusses how diet and lifestyle can modulate the gut microbiota and subsequently impact AD risk, with dietary patterns such as the Mediterranean diet potentially reducing the risk of AD. Future research directions should include a deeper understanding of the mechanisms underlying the GBA’s role in AD, conducting clinical trials, and developing personalized dietary and microbial modulation strategies. In summary, the relationship between the gut microbiota and AD provides novel avenues for disease prevention and treatment. Although this field is in its nascent stages, there is emerging evidence to suggest that modulation of the gut microbiota could become an effective therapeutic approach for AD.