肠道菌群参与新生儿坏死性小肠结肠炎发病机制的研究进展

Progress on the pathogenesis of gut microbiota in neonatal necrotizing enterocolitis

新生儿坏死性小肠结肠炎(NEC)是常发生于早产儿的肠道急症, 肠道菌群失调可能是其病因之一。NEC患儿发病前后的肠道菌群均不同于健康儿。虽然尚未发现NEC的特定致病菌及相关代谢产物, 但潜在致病菌及代谢产物如短链脂肪酸、石胆酸、色氨酸衍生代谢物等或在NEC中起着保护或促进作用。靶向调控肠道菌群如益生菌、粪便菌群移植等可以通过改变肠道菌群构成, 从而起到防治NEC的作用。另外, NEC的早期症状和体征不典型且临床诊断较为困难, 一旦确诊往往即为重症, 基于菌群寻找合适的标志物对于NEC的早期诊断可能具有重要意义。

Necrotizing enterocolitis(NEC)is an acute inflammatory disease of the intestine which is related to gut dysbiosis.Gut microbiota of NEC patients in meconium or feces are different from those of healthy infants.Although the pathogenic bacteria and metabolites of NEC have not been specified,short-chain fatty acids,lithocholic acid and tryptophan derived metabolites may play protective or aggravating roles in NEC.Probiotics and fecal microbiota transplantation that target on gut microbiota may optimize the composition of gut microbiota and thereby decrease the incidence of NEC.Besides,the early diagnosis of NEC is challenging due to its unspecific presentations.Once diagnosed,it is often severe.More research about disease biomarkers based on gut microbiota is needed.