微生物-肠-脑轴在阿尔茨海默病中的相关研究进展

Advances in research related to the microbial-intestinal-brain axis in Alzheimer’s disease

阿尔茨海默病(AD)是一种以进行性认知功能障碍和记忆力减退为特征的退行性中枢神经系统疾病,是最常见的痴呆类型之一。研究表明胃肠道能够通过微生物-肠-脑轴(MGBA)与大脑进行双向沟通,这为神经系统疾病的治疗提供新靶点。已有研究发现AD患者肠道微生物的丰度发生改变,导致各神经递质和微生物产物变化,进而影响大脑功能,这可能是AD的潜在病理。微生物介导调节大脑功能的途径有神经、免疫、代谢和内分泌等,能影响肠上皮屏障和血脑屏障的完整性。研究基于肠道微生物这一新靶点,提出益生菌、饮食和粪便微生物移植等治疗方式。本综述将主要阐述肠道微生物通过神经、免疫和代谢等途径对大脑的影响,并总结潜在的以微生物为靶点的治疗方式,以期为AD的防治提供新思路。

Alzheimer’s disease(AD)is a degenerative central nervous system disorder characterized by progressive cognitive impairment and memory loss and is the most common type of dementia.Research has shown that the gastrointestinal tract can communicate with the brain bidirectionally through the microbiota-gut-brain axis(MGBA),providing a new target for the treatment of neurological disorders.Alterations in the abundance of gut microbes have been found in AD patients,further leading to changes in various neurotransmitters and microbial products to affect brain function and may be the underlying pathology of AD.Microbial-mediated pathways regulating brain function involve neurological,immunological,metabolic and endocrine pathways,and can also affect the integrity of the intestinal epithelial barrier and the blood-brain barrier.Treatment modalities such as probiotics,diet and fecal microbial transplantation are also proposed based on the new target of gut microbes.This review will focus on the effects of gut microbes on the brain through neurological,immunological and metabolic pathways,and summarize potential microbe-targeted therapeutic modalities with a view to bringing new ideas to the prevention and treatment of AD.