背景:尽管微生物群与HIV发病机制广泛相关,大多数研究,特别是那些使用组学技术的人,在很大程度上是相关的,主要是作为假设产生的基础。此外,大多数人专注于表征细菌成分的分类组成,通常忽略其他级别的微生物组。微生物群影响HIV免疫反应的复杂机制仍然知之甚少。对肠道微生物群的干预研究提供了一个强大的工具来检验我们是否可以利用微生物群来改善HIV感染者的健康结果的假设。
结果:这里,我们综述了肠道微生物组在HIV/SIV疾病进展中的多方面作用及其作为治疗靶点的潜力.我们探索肠道微生物菌群失调和全身性炎症之间的复杂相互作用,强调基于微生物组的疗法为艾滋病毒管理开辟新途径的潜力。这些包括探索益生菌的功效,益生元,粪便微生物移植,和有针对性的饮食调整。我们还解决了这一研究领域固有的挑战,如难以诱导持久的微生物组改变和研究设计的复杂性,包括益生菌菌株的变异,FMT的供体选择,抗生素调理方案,以及将研究结果转化为临床实践的障碍。最后,我们推测这个快速发展的领域的未来方向,强调需要更细致地了解微生物组-免疫相互作用,基于微生物组的个性化治疗的发展,以及新技术的应用,以确定潜在的治疗药物。
结论:我们的综述强调了肠道微生物组在HIV/SIV疾病中的重要性及其作为创新治疗策略靶标的潜力。
BACKGROUND: Although the microbiota has been extensively associated with HIV pathogenesis, the majority of studies, particularly those using omics techniques, are largely correlative and serve primarily as a basis for hypothesis generation. Furthermore, most have focused on characterizing the taxonomic composition of the bacterial component, often overlooking other levels of the microbiome. The intricate mechanisms by which the microbiota influences immune responses to HIV are still poorly understood. Interventional studies on gut microbiota provide a powerful tool to test the hypothesis of whether we can harness the microbiota to improve health outcomes in people with HIV.
RESULTS: Here, we review the multifaceted role of the gut microbiome in HIV/SIV disease progression and its potential as a therapeutic target. We explore the complex interplay between gut microbial dysbiosis and systemic inflammation, highlighting the potential for microbiome-based therapeutics to open new avenues in HIV management. These include exploring the efficacy of probiotics, prebiotics, fecal microbiota transplantation, and targeted dietary modifications. We also address the challenges inherent in this research area, such as the difficulty in inducing long-lasting microbiome alterations and the complexities of study designs, including variations in probiotic strains, donor selection for FMT, antibiotic conditioning regimens, and the hurdles in translating findings into clinical practice. Finally, we speculate on future directions for this rapidly evolving field, emphasizing the need for a more granular understanding of microbiome-immune interactions, the development of personalized microbiome-based therapies, and the application of novel technologies to identify potential therapeutic agents.
CONCLUSIONS: Our review underscores the importance of the gut microbiome in HIV/SIV disease and its potential as a target for innovative therapeutic strategies.