Intestinal Microbiota and Celiac Disease: Cause, Consequence or Co-Evolution?
Intestinal Microbiota and Celiac Disease: Cause, Consequence or Co-Evolution?
复制标题
DOI：
10.3390/nu7085314
复制
发表时间：
2015-08-17
期刊：
影响因子：
5.9
通讯作者：
Sanz Y
中科院分区：
文献类型：
--
作者：
Cenit MC;Olivares M;Codoñer-Franch P;Sanz Y
人们普遍认为，在许多慢性疾病中，肠道微生物区系在肠道炎症的启动和持续中起着作用。大多数研究报道，与健康对照组相比，未经治疗和无麸质饮食(GFD)治疗的乳糜泻(CD)患者存在肠道生态失调。有胃肠道症状的CD患者与疱疹样皮炎患者和对照组相比，也有不同的微生物群，这表明微生物群参与了疾病的表现。此外，在接受治疗的CD患者中，非生物微生物区系似乎与持续的胃肠道症状有关，这表明它在这些特殊病例中具有致病意义。GFD本身影响肠道微生物区系组成，因此在CD患者的研究中构成了一个不可避免的混杂因素。为了提高我们对肠道生态失调是疾病的原因还是后果的理解，目前正在对有CD家族风险的健康婴儿进行前瞻性研究。这些研究表明，CD宿主基因选择了婴儿肠道的早期定居者，这与环境因素(例如母乳喂养、抗生素等)一起。会影响口腔对面筋的耐受性。事实上，一些CD基因和/或其改变的表达在细菌的定植和感知中发挥了作用。反过来，肠道生物失调可能会促进易感个体对面筋或其他环境镉促进因子(如感染)的异常反应。在这里，我们回顾了宿主-微生物相互作用的现有知识，以及宿主遗传学/表观遗传学和环境因素如何塑造肠道微生物区系，并可能影响疾病风险。我们还总结了目前关于肠道微生物区系和影响CD发病的特定成分的潜在作用机制的知识。
It is widely recognized that the intestinal microbiota plays a role in the initiation and perpetuation of intestinal inflammation in numerous chronic conditions. Most studies report intestinal dysbiosis in celiac disease (CD) patients, untreated and treated with a gluten-free diet (GFD), compared to healthy controls. CD patients with gastrointestinal symptoms are also known to have a different microbiota compared to patients with dermatitis herpetiformis and controls, suggesting that the microbiota is involved in disease manifestation. Furthermore, a dysbiotic microbiota seems to be associated with persistent gastrointestinal symptoms in treated CD patients, suggesting its pathogenic implication in these particular cases. GFD per se influences gut microbiota composition, and thus constitutes an inevitable confounding factor in studies conducted in CD patients. To improve our understanding of whether intestinal dysbiosis is the cause or consequence of disease, prospective studies in healthy infants at family risk of CD are underway. These studies have revealed that the CD host genotype selects for the early colonizers of the infant’s gut, which together with environmental factors (e.g., breast-feeding, antibiotics, etc.) could influence the development of oral tolerance to gluten. Indeed, some CD genes and/or their altered expression play a role in bacterial colonization and sensing. In turn, intestinal dysbiosis could promote an abnormal response to gluten or other environmental CD-promoting factors (e.g., infections) in predisposed individuals. Here, we review the current knowledge of host-microbe interactions and how host genetics/epigenetics and environmental factors shape gut microbiota and may influence disease risk. We also summarize the current knowledge about the potential mechanisms of action of the intestinal microbiota and specific components that affect CD pathogenesis.