The gut microbiome: A line of defense against tuberculosis development.
The gut microbiome: A line of defense against tuberculosis development.
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DOI：
10.3389/fcimb.2023.1149679
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发表时间：
2023
影响因子：
5.7
通讯作者：
中科院分区：
文献类型：
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结核病负担仍然是一个重大的全球公共卫生问题，特别是在欠发达国家。虽然肺结核（PTB）是最常见的疾病形式，但肺外结核，特别是肠结核（ITB），主要继发于PTB，也是一个重要问题。随着测序技术的发展，最近的研究已经调查了肠道微生物组在结核病发展中的潜在作用。在这篇综述中，我们总结了研究PTB和ITB患者（继发于PTB）与健康对照相比的肠道微生物组的研究。PTB和ITB患者均显示肠道微生物组多样性降低，其特征为厚壁菌门减少和机会性病原体定植增加;据报告，拟杆菌和普雷沃菌在PTB和ITB患者中的变化相反。在结核病患者中报告的改变可能导致代谢物如短链脂肪酸（SCFA）产生的不平衡，这可能通过“肠-肺轴”重塑肺部微生物组和免疫力。这些发现也可能有助于了解结核分枝杆菌在胃肠道中的定植以及PTB患者中ITB的发展。这些发现强调了肠道微生物组在结核病中的关键作用，特别是在ITB发展中，并表明益生菌和益生菌可能是结核病治疗期间形成平衡肠道微生物组的有用补充剂。
The tuberculosis (TB) burden remains a significant global public health concern, especially in less developed countries. While pulmonary tuberculosis (PTB) is the most common form of the disease, extrapulmonary tuberculosis, particularly intestinal TB (ITB), which is mostly secondary to PTB, is also a significant issue. With the development of sequencing technologies, recent studies have investigated the potential role of the gut microbiome in TB development. In this review, we summarized studies investigating the gut microbiome in both PTB and ITB patients (secondary to PTB) compared with healthy controls. Both PTB and ITB patients show reduced gut microbiome diversity characterized by reduced Firmicutes and elevated opportunistic pathogens colonization; Bacteroides and Prevotella were reported with opposite alteration in PTB and ITB patients. The alteration reported in TB patients may lead to a disequilibrium in metabolites such as short-chain fatty acid (SCFA) production, which may recast the lung microbiome and immunity via the “gut-lung axis”. These findings may also shed light on the colonization of Mycobacterium tuberculosis in the gastrointestinal tract and the development of ITB in PTB patients. The findings highlight the crucial role of the gut microbiome in TB, particularly in ITB development, and suggest that probiotics and postbiotics might be useful supplements in shaping a balanced gut microbiome during TB treatment.