人体微生态与放疗之间的相互关系

The relationship between human microecology and radiotherapy

人体微生态,尤其肠道菌群是人体一个新的动态器官,菌群及其代谢物可直接作用于肠道或间接通过菌群‑肠‑器官轴作用全身组织器官而发挥着重要作用。人体微生态的主要生理作用包括:调节胃肠道运动和消化、肠道屏障,调节免疫稳态和炎症反应、物质代谢、细胞分化和周转,以及认知行为等。肿瘤放疗可引起人体菌群的明显改变,表现为菌群多样性和丰度的下降,这些菌群变化不仅与放疗有关,而且也与放射损伤、并发症和预后等密切相关。同时放射损伤存在性别差异,而这种差异与肠道菌群的性别差异有关。因此,维护和调节人体微生态平衡影响着肿瘤放疗、放射损伤和并发症的防治。应用微生态制剂(益生菌、益生元和后生元)和粪菌移植在减少辐射引起的组织器官损伤、提高放疗和减少并发症等方面产生明显的作用,作为抗肿瘤辅助治疗手段显示出良好的临床应用前景。因此,针对疾病特异性和个体化的益生菌制剂的优化组合及其应用将是未来重要的研究方向。

The human microecology,especially the intestinal flora,is a new dynamic organ of the human body.The intestinal flora and its metabolites can directly act on the intestine or indirectly through the microbiota⁃gut⁃organ axis to act on the whole body tissues and organs and play an important role.The main physiological functions of human microecology include:regulating gastrointestinal movement and digestion,intestinal barrier,regulating immune homeostasis and inflammatory response,material metabolism,cell differentiation and turnover,and cognitive behavior.Radiotherapy can cause significant changes in the human microbiota,manifested as changes in flora diversity and abundance.These changes are not only related to the efficacy of radiotherapy,but also closely related to radiotherapy injury,complications and prognosis.At the same time,it was found that there were gender differences in radiation efficacy and injury,which was related to the gender differences of intestinal flora.Therefore,maintaining and adjusting the human microecological balance has an important impact on the efficacy of tumor radiotherapy and the prevention and treatment of radiation damage and complications.The application of microecological preparations(probiotics,prebiotics and postbiotics)and faecal microbiota transplantation play an obvious role in reducing tissue and organ damage caused by radiation,improving the curative effect of radiotherapy and reducing complications.As an adjuvant anti⁃tumor therapy,it shows a good clinical application prospect.Therefore,the optimal combination and application of disease⁃specific and individualized probiotics will be an important research direction in the future.