基于脑肠轴的肠道菌群调控腹泻型肠易激综合征的研究进展

Research progress on intestinal microbiota regulation of diarrhea-predominant irritable bowel syndrome based on brain gut axis

腹泻型肠易激综合征(IBS-D)是一种具有较高人群患病率的功能紊乱性疾病。内脏高敏是IBS-D最重要的生物学标志,其特征性症状是精神刺激会引发腹痛腹泻,与中医肝郁脾虚痛泻的症状情志过极诱发“腹痛欲泻,泻后痛减”极为相似。内脏高敏由中枢致敏(中枢过度伤害应答)和外周致敏(肠道痛觉增敏)两部分组成,其发生机制与脑肠轴密切相关。神经生长因子(NGF)是脑肠轴上的疼痛共情绪调控分子,可以同时从中枢和外周参与内脏高敏的发生。近期研究发现,肠道菌群是连接脑肠交互机制的中介;同时,肠道菌群的失调可以导致及加重内脏高敏。文章就肠道菌群影响脑肠轴上的NGF表达进而从中枢及外周调节内脏高敏的机制进行探讨。

Diarrhea-predominant irritable bowel syndrome(IBS-D) is a dysfunctional disease with high prevalence in the population. Visceral hypersensitivity is the most important biological marker of IBS-D, and its characteristic symptom is that mental stimulation can cause abdominal pain and diarrhea, which is very similar to the symptom of diarrhea due to liver depression and spleen deficiency in the traditional Chinese medicine, where the symptom is ‘abdominal pain causes diarrhea, and the pain will be reduced after diarrhea’. Visceral hypersensitivity is composed of central sensitization(central excessive injury response)and peripheral sensitization(intestinal pain sensitization). The mechanism of visceral hypersensitivity is closely related to brain gut axis. NGF is a pain co-emotion regulatory molecule on the brain gut axis, which can participate in visceral hypersensitivity from both central and peripheral. Recently, it has been found that intestinal microflora is the mediator of brain gut interaction, and the imbalance of intestinal flora can lead to and aggravate visceral hypersensitivity. In this paper, the mechanism of intestinal flora affecting NGF expression in brain gut axis to regulate visceral hypersensitivity from central and peripheral was discussed.