Abstract:
Disorders of Gut-Brain Interaction (DGBI) are widely prevalent and commonly encountered in gastroenterology practice. While several peripheral and central mechanisms have been implicated in the pathogenesis of DGBI, a recent body of work suggests an important role for the gut microbiome. In this review, we highlight how gut microbiota and their metabolites affect physiologic changes underlying symptoms in DGBI, with a particular focus on their mechanistic influence on GI transit, visceral sensitivity, intestinal barrier function and secretion, and CNS processing. This review emphasizes the complexity of local and distant effects of microbial metabolites on physiological function, influenced by factors such as metabolite concentration, duration of metabolite exposure, receptor location, host genetics, and underlying disease state. Large-scale in vitro work has elucidated interactions between host receptors and the microbial metabolome but there is a need for future research to integrate such preclinical findings with clinical studies. The development of novel, targeted therapeutic strategies for DGBI hinges on a deeper understanding of these metabolite-host interactions, offering exciting possibilities for the future of treatment of DGBI.
摘要:
肠-脑相互作用(DGBI)障碍在胃肠病学实践中广泛流行和常见。虽然一些外周和中枢机制与DGBI的发病机制有关,最近的一项研究表明,肠道微生物组有重要作用。在这次审查中,我们强调了肠道微生物群及其代谢物如何影响DGBI潜在症状的生理变化,特别关注它们对地理运输的机械影响,内脏敏感性,肠屏障功能和分泌,和CNS处理。这篇综述强调了微生物代谢物对生理功能的局部和远处影响的复杂性。受代谢物浓度等因素的影响,代谢物暴露的持续时间,受体位置,宿主遗传学,和潜在的疾病状态。大规模的体外工作已经阐明了宿主受体和微生物代谢组之间的相互作用,但是需要未来的研究将这种临床前发现与临床研究相结合。小说的发展,DGBI的靶向治疗策略取决于对这些代谢物-宿主相互作用的更深入理解,为DGBI治疗的未来提供令人兴奋的可能性。