A review of potential microbiome-gut-brain axis mediated neurocognitive conditions in persons living with HIV.
A review of potential microbiome-gut-brain axis mediated neurocognitive conditions in persons living with HIV.
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DOI：
10.1016/j.bbih.2020.100168
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发表时间：
2020-12
期刊：
影响因子：
--
通讯作者：
Cook R
中科院分区：
文献类型：
--
作者：
Rich S;Klann E;Bryant V;Richards V;Wijayabahu A;Bryant K;Mai V;Cook R
微生物组-肠-脑轴，或肠道微生物组与大脑之间的各种相互作用，最近在各种疾病状态的精准医学研究中引起了人们的兴趣。人类免疫缺陷病毒（PLWH）感染者的神经认知能力下降程度高于一般人群，这与正常肠道微生物组组成的破坏（即生态失调）有关。虽然这种相关性的性质仍有待确定，但微生物群-肠-脑轴有可能促进这种疾病的进展。先前的研究已经确定，与HIV相关的病理诱导肠道微生物组组成的改变，包括从拟杆菌到普雷沃氏菌的优势转变，并破坏肠道屏障的完整性，这可能促进微生物易位和随之而来的全身炎症和神经炎症的加剧。此外，尽管已经发现抗逆转录病毒疗法的使用可以部分抵消hiv相关的生态失调，但它也可能诱发自身的生态失调模式，这对本研究提出了独特的挑战。最近的研究表明，肠道微生物组是治疗干预的目标，可以改善与各种疾病状态相关的症状，包括艾滋病毒。早期发现很有希望，值得进一步研究肠道微生物组作为改善PLWH健康结果的潜在可改变因素。本文将讨论目前关于HIV在大脑中的神经发病机制，肠道微生物组在神经炎症中的作用，以及HIV状态与肠道微生物组之间的关系，然后在PLWH中微生物组-肠道-脑轴的背景下综合这些信息得出结论。本综述还将强调现有研究的局限性，并提出今后的研究方向。微生物组-肠-脑轴最近作为精准医学的潜在新靶点而引起了人们的兴趣。艾滋病毒感染者会经历相当大的神经认知能力下降和正常肠道微生物组成的破坏。补充益生菌已被发现可以减少艾滋病毒感染者的神经炎症并改善神经认知。未来的研究需要控制混杂因素，使用不同的样本，并评估长期干预措施。
The microbiome-gut-brain axis, or the various interactions between the gut microbiome and the brain, has been of recent interest in the context of precision medicine research for a variety of disease states. Persons living with human immunodeficiency virus (PLWH) experience higher degrees of neurocognitive decline than the general population, correlating with a disruption of the normal gut microbiome composition (i.e. dysbiosis). While the nature of this correlation remains to be determined, there is the potential that the microbiome-gut-brain axis contributes to the progression of this disease. Previous research has established that the pathology associated with HIV induces alterations in the composition of gut microbiome, including a shift from Bacteroides to Prevotella dominance, and compromises gut barrier integrity, which may promote microbial translocation and consequent systemic inflammation and exacerbation of neuroinflammation. Further, though the use of antiretroviral therapy has been found to partially counteract HIV-related dysbiosis, it may also induce its own dysbiosis patterns, presenting a unique challenge for this research. More recent research has suggested the gut microbiome as a target for therapeutic interventions to improve symptoms associated with a variety of disease states, including HIV. Early findings are promising and warrant further research regarding the gut microbiome as a potential modifiable factor to improve health outcomes for PLWH. This review will discuss the current knowledge concerning the neuropathogenesis of HIV in the brain, role of the gut microbiome in neuroinflammation, and the relationship between HIV-status and the gut microbiome, followed by a conclusion that synthesizes this information within the context of the microbiome-gut-brain axis among PLWH. This review will also highlight the limitations of existing studies and propose future directions of this research. The microbiome-gut-brain axis has been of recent interest as a potential novel target for precision medicine. Individuals with HIV experience considerable neurocognitive decline and disruption of the normal gut microbiome composition. Probiotic supplementation has been found to reduce neuroinflammation and improve neurocognition in individuals with HIV. Future research controlling for confounders, using diverse samples, and evaluating long-term interventions is needed.
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4.6
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