New Approaches for Bacteriotherapy: Prebiotics, New-Generation Probiotics, and Synbiotics
New Approaches for Bacteriotherapy: Prebiotics, New-Generation Probiotics, and Synbiotics
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DOI：
10.1093/cid/civ177
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发表时间：
2015-05-15
影响因子：
11.8
通讯作者：
DuPont, Herbert L.
中科院分区：
文献类型：
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作者：
Patel, Rachna;DuPont, Herbert L.
肠道微生物区系在人类健康和疾病中起着重要作用。肠道生态系统的失调有助于某些疾病的发展，这些疾病可以通过益生菌的有利改变而逆转。回顾已发表的文献，以确定表明肠道细菌失衡与可通过生物产品改善的疾病的发展之间的关系的科学数据。医疗条件各不相同，从传染性和抗生素相关的腹泻到肥胖，再到慢性神经疾病。已经进行了一些对照临床试验，通过给药益生菌、益生菌和合生菌，在这些条件下显示了重要的生物效应。对照临床试验已经确定了数量有限的益生元、益生菌菌株和合生元，它们可以有效地预防或改善各种疾病的症状，包括炎症性肠病、肠易激综合征、感染性和抗生素相关性腹泻、糖尿病、非酒精性脂肪性肝病、极低出生体重婴儿的坏死性小肠结肠炎和肝性脑病。研究表明，益生菌改变肠道菌群并导致菌群代谢产物的精致，通过以下三种一般机制之一影响健康：直接抗菌作用，增强粘膜屏障完整性，以及免疫调节。通过引入益生菌预防和治疗疾病，恢复肠道菌群平衡，可能有利于人类健康。同样清楚的是，不同的益生菌物种之间存在着显著的差异。元基因组学和元转录组学以及生物信息学使我们能够研究肠道微生物区系和宿主之间的相互作用，进一步洞察下一代生物产品。
The gut microbiota has a significant role in human health and disease. Dysbiosis of the intestinal ecosystem contributes to the development of certain illnesses that can be reversed by favorable alterations by probiotics. The published literature was reviewed to identify scientific data showing a relationship between imbalance of gut bacteria and development of diseases that can be improved by biologic products. The medical conditions vary from infectious and antibiotic-associated diarrhea to obesity to chronic neurologic disorders. A number of controlled clinical trials have been performed to show important biologic effects in a number of these conditions through administration of prebiotics, probiotics, and synbiotics. Controlled clinical trials have identified a limited number of prebiotics, probiotic strains, and synbiotics that favorably prevent or improve the symptoms of various disorders including inflammatory bowel disease, irritable bowel syndrome, infectious and antibiotic-associated diarrhea, diabetes, nonalcoholic fatty liver disease, necrotizing enterocolitis in very low birth weight infants, and hepatic encephalopathy. Studies have shown that probiotics alter gut flora and lead to elaboration of flora metabolites that influence health through 1 of 3 general mechanisms: direct antimicrobial effects, enhancement of mucosal barrier integrity, and immune modulation. Restoring the balance of intestinal flora by introducing probiotics for disease prevention and treatment could be beneficial to human health. It is also clear that significant differences exist between different probiotic species. Metagenomics and metatranscriptomics together with bioinformatics have allowed us to study the cross-talk between the gut microbiota and the host, furthering insight into the next generation of biologic products.