目的:微生物在维持身体健康方面起着至关重要的作用,通过对新陈代谢的积极影响,防御性,营养过程和细胞间通讯。肠道菌群失衡,随着有害细菌物种的增殖(生态失调)在慢性疾病中一直被报道,包括神经退行性疾病(ND)。纠正生态失调可以对ND的症状和演变产生有益的影响。这篇综述探讨了通过施用益生菌调节微生物群的影响,益生元,共生生物,或益生元代谢产物(postbiotics)在ND样多发性硬化症(MS)患者中,阿尔茨海默病(AD),帕金森病(PD)和肌萎缩侧索硬化症(ALS)。
方法:PubMed,WebofScience,Medline数据库和ClinicalTrials.gov注册表搜索使用前/前/后元和ND相关术语进行。通过检查相关文章获得了进一步的参考文献。
结果:尽管与动物研究相比很少,人类研究通常显示对疾病特异性症状的积极影响,整体健康,代谢参数,氧化应激和免疫学标记。用各种形式的益生菌治疗(细菌菌株的混合物,粪便微生物移植,富含发酵食品的饮食)对患者的心理健康产生有利影响,认知,和生活质量,靶向致病ND机制和诱导细胞水平的分离机制。在某些ND中,在益生元/后元治疗中观察到了更令人鼓舞的结果。
结论:益生菌相关干预措施的效果取决于患者的ND阶段和预先存在的同种疗法药物。对更大的队列和长期综合神经精神病学的进一步研究,新陈代谢,生化检测,和神经影像学监测对于优化ND的治疗方案是必要的。
OBJECTIVE: Microbiota plays an essential role in maintaining body health, through positive influences on metabolic, defensive, and trophic processes and on intercellular communication. Imbalance in intestinal flora, with the proliferation of harmful bacterial species (dysbiosis) is consistently reported in chronic illnesses, including neurodegenerative diseases (ND). Correcting dysbiosis can have a beneficial impact on the symptoms and evolution of ND. This review examines the effects of microbiota modulation through administration of probiotics, prebiotics, symbiotics, or prebiotics\' metabolites (postbiotics) in patients with ND like multiple sclerosis (MS), Alzheimer\'s disease (AD), Parkinson\'s disease (PD) and amyotrophic lateral sclerosis (ALS).
METHODS: PubMed, Web of Science, Medline databases and ClinicalTrials.gov registry searches were performed using pre-/pro-/postbiotics and ND-related terms. Further references were obtained by checking relevant articles.
RESULTS: Although few compared to animal studies, the human studies generally show positive effects on disease-specific symptoms, overall health, metabolic parameters, on oxidative stress and immunological markers. Therapy with probiotics in various forms (mixtures of bacterial strains, fecal microbiota transplant, diets rich in fermented foods) exert favorable effects on patients\' mental health, cognition, and quality of life, targeting pathogenetic ND mechanisms and inducing reparatory mechanisms at the cellular level. More encouraging results have been observed in prebiotic/postbiotic therapy in some ND.
CONCLUSIONS: The effects of probiotic-related interventions depend on the patients\' ND stage and pre-existing allopathic medication. Further studies on larger cohorts and long term comprehensive neuropsychiatric, metabolic, biochemical testing, and neuroimaging monitoring are necessary to optimize therapeutic protocols in ND.