Combinatorial effects of diet and genetics on inflammatory bowel disease pathogenesis.
Combinatorial effects of diet and genetics on inflammatory bowel disease pathogenesis.
复制标题
DOI：
10.1097/mib.0000000000000289
复制
发表时间：
2015-04
影响因子：
4.9
通讯作者：
McDonald C
中科院分区：
文献类型：
--
作者：
Dixon LJ;Kabi A;Nickerson KP;McDonald C
炎症性肠病（IBD）包括一组以急性和慢性炎症为特征的影响胃肠道的疾病。这些是复杂的多因素疾病，部分由遗传易感性引起。然而，发展中国家IBD发病率的增加表明，环境因素，如饮食，也是疾病易感性的关键因素。有证据表明，富含饱和脂肪、精制碳水化合物和食品添加剂的西方饮食与IBD风险增加有关。饮食成分，如ω -6脂肪酸、长链脂肪酸、蛋白质和可消化的碳水化合物，可能通过改变肠道微生物群、增加肠道通透性和促进炎症而促进IBD的发病；而omega-3脂肪酸、中链甘油三酯和不可消化的碳水化合物可以改善这些参数和肠道健康。然而，前瞻性研究的数量有限，样本量小，疾病亚型的异质性导致研究之间不一致，难以最终确定饮食对肠道内稳态的具体影响。IBD患者没有标准的临床饮食建议。然而，排他性饮食干预在缓解症状或诱导缓解方面显示出一定的功效，这表明需要更多的研究来充分了解饮食如何影响疾病行为或与其他IBD危险因素联合促进疾病。本文综述了临床研究和遗传易感IBD模型中各种饮食成分与IBD风险的关系。
Inflammatory bowel disease (IBD) encompasses a group of disorders affecting the gastrointestinal tract characterized by acute and chronic inflammation. These are complex and multifactorial disorders that arise in part from a genetic predisposition. However, the increasing incidence of IBD in developing countries suggests that environmental factors, such as diet, are also critical components of disease susceptibility. Evidence suggests that consumption of a Western diet, enriched with saturated fat, refined carbohydrates, and food additives, is associated with increased IBD risk. Dietary components, such as omega-6 fatty acids, long chain fatty acids, protein, and digestible carbohydrates, may contribute to IBD pathogenesis through altering intestinal microbiota, increasing intestinal permeability, and promoting inflammation; whereas omega-3 fatty acids, medium chain triglycerides, and non-digestible carbohydrates improve these parameters and intestinal health. However, the limited amount of prospective studies, small sample sizes, and the heterogeneity of disease subtype result in inconsistencies between studies and difficulty in conclusively determining the specific effects of diet on intestinal homeostasis. There are no standard clinical dietary recommendations for IBD patients. However, exclusionary diet interventions have shown some efficacy in relieving symptoms or inducing remission, suggesting more research is needed to fully understand how diet influences disease behavior or combines with other IBD risk factors to promote disease. This review focuses on the associations of various dietary components and IBD risk in clinical studies and genetically susceptible IBD models.