肠道菌群在减重手术后的变化及作用

Role and change of the gut microbiota after bariatric surgery

肠道菌群对机体代谢起重要的调控作用,减重手术作为目前治疗肥胖及其合并症最有效的方法能够显著改变肠道菌群。术后肠道菌群的变化具有时空特异性,术后不同时间点上和不同肠段中的菌群组成与结构不尽相同。减重术后肠道菌群改变的原因可能在于手术引起的胃肠道解剖及相应生理功能的变化。通过移植术后菌群发现肠道菌群参与减重手术改善代谢,其中的机制可能和菌群-宿主相互作用的众多分子途径有关。同时,术后肠道菌群的变化还与减重手术患者的预后相关。此外,减重术后所引起的菌群变化不仅与改善肥胖和代谢有关,还可能存在潜在危害,其中减重手术后的营养吸收不良与肠道菌群的改变密切相关。因此,阐明减重术后肠道菌群的变化特征及相关机制有助于深入理解菌群在减重手术中的作用和影响,本文为此作一综述。

Gut microbiota have been validated to play a pivotal role in metabolic regulation.As the most effective treatment for obesity and related comorbidities,bariatric surgery has been shown to result in significant alterations to the gut microbiota.Literature have recently suggested temporal and spatial features of alterations to the intestinal bacteria following bariatric surgery,which is possibly attributed to the gut adaptation to the surgical modification on the gastrointestinal tract.More importantly,the gut microbiota have been appreciated as a critical contributor to the metabolic improvements following bariatric surgery.Although not fully elucidated,the underlying mechanisms are associated with the molecular pathways mediating the crosstalk between gut microbiota and host.On the other hand,change of the gut microbiota has been found to be related to the prognosis of patients receiving bariatric surgery.Some studies even point out negative effects of the gut microbiota on certain surgical complications.In this review,we summarize the characteristics of alterations to the gut microbiota following bariatric surgery as well as its relevant impacts to better understand the role of gut microbiota in bariatric surgery.