胆汁酸代谢-TGR5轴调控腹泻型肠易激综合征的作用机制及中医药相关研究进展

The Mechanism and Related Research Progress of Traditional Chinese Medicine of Bile Acid Metabolism-TGR5 Axis Regulating Diarrhea-predominant Irritable Bowel Syndrome

腹泻型肠易激综合征(Diarrhea-predominant IBS,IBS-D)是一种功能性肠病,其发病机制尚未完全阐明,目前亦缺乏确切有效的治愈方法。近年来大量研究显示,胆汁酸代谢失常可激活G蛋白偶联胆汁酸受体5(G-protein-coupled bile acid receptor 5,TGR5)信号通路的活性,诱导肠嗜铬细胞、肠L细胞、肠巨噬细胞等异常分泌5-羟色胺、降钙素基因相关肽、胰高血糖素样肽-1及炎症因子等,从而导致肠道动力异常、内脏敏感性增加以及肠黏膜低级别炎症等,最终引发IBS-D,因此,胆汁酸代谢-TGR5轴在IBS-D的发生发展中起着重要的调节作用。本文从胆汁酸代谢-TGR5轴入手,总结近年来国内外文献,旨在阐明其调控IBS-D的作用及其机制,并与中医药论治相结合,为IBS-D的治疗提供新的思路。

Diarrhea-predominant Irritable bowel syndrome(IBS-D) is a functional bowel disease,whose pathogenesis has not been fully elucidated,and there is no exact and effective cure.In recent years,a large number of studies have shown that abnormal bile acid metabolism can activate the activity of the TGR5 signaling pathway and induce the abnormal secretion of 5-HT,CGRP,GLP-1 and inflammatory factors by intestinal EC cells,intestinal L cells,and intestinal macrophages,resulting in intestinal motility disorders,visceral hypersensitivity and low-grade intestinal inflammation of the intestinal mucosa,which eventually trigger IBS-D.Therefore,the bile acid metabolism-TGR5 axis plays an important regulatory role in the occurrence and development of IBS-D.Starting from the bile acid metabolismTGR5 axis,this article summarizes recent domestic and international literature,aiming to elucidate its role in regulating IBS-D and its mechanism,and to provide new ideas for the treatment of IBS-D by combining it with Chinese medicine theory of treatment.