胰腺疾病的肠道微生物群研究进展

Gut microbiota in pancreatic diseases:research progress

肠道微生物群是指存在于人体消化道内的微生物组成的复杂群落。随着16S rRNA基因测序和宏基因组测序等高通量测序技术的发展,肠道微生物群已被证明与多种疾病息息相关。三大胰腺疾病与肠道微生物群密切相关,急性胰腺炎(acute pancreatitis,AP)、慢性胰腺炎(chronic pancreatitis,CP)和胰腺癌患者肠道微生物群的构成和丰度均与健康人群不同。反之,肠道微生物群的改变会减慢或加速胰腺疾病的发生发展。益生菌和抗菌药物的使用及粪菌移植等可减轻胰腺炎症反应,缓解胃肠道症状,影响胰腺癌化疗和免疫治疗的效果,因此可为胰腺疾病的诊疗提供新策略。本文总结了AP、CP和胰腺癌的肠道微生物群研究,阐述了疾病发生时肠道微生物群的变化、与胰腺相互作用的机制以及目前的主要研究技术,探讨了肠道微生物群在胰腺疾病诊疗中的研究进展。

Gut microbiota refers to the complex community composed of microorganisms existing in human gastrointestinal tract.With the development of high-throughput sequencing techniques such as 16S rRNA gene sequencing and metagenomic sequencing,gut microbiota has been proved to be closely related to a variety of diseases.There are three major types of pancreatic diseases,acute pancreatitis,chronic pancreatitis and pancreatic cancer,which interact with gut microbiota,and the composition and abundance of gut microbiota in these diseases were different from those in healthy condition.On the contrary,changes in gut microbiota can slow or accelerate the occurrence and development of pancreatic diseases.The use of probiotics,antibiotics and fecal microbiota transplantation can alleviate pancreatic inflammation,relieve gastrointestinal symptoms,affect the efficacy of chemotherapy and immunotherapy for pancreatic cancer,and provide a new strategy for the diagnosis and treatment of pancreatic diseases.This review summarizes the gut microbiota in acute pancreatitis,chronic pancreatitis and pancreatic cancer,describes the changes of gut microbiota during the disease courses,the mechanism of interaction of gut microbiota and pancreas and main research techniques at present,and discusses the recent advances in research on gut microbiota in the diagnosis and treatment of pancreatic diseases.