肺肠轴对慢性阻塞性肺疾病进展的影响及其机制

The influence of gut-lung axis on chronic obstructive pulmonary disease and the mechanisms

肺肠轴是人体重要的内分泌调节轴,可以影响和调节慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)的进展。COPD患者的肺肠轴发生改变,具体体现在肺部微生物群落的改变、肠道微生物群落的改变及肺肠轴免疫调控网络的改变。在肺肠轴中,肺部微生物群落组分、肺-肠道微生物对话和肺-肠道微生物群落代谢产物均可导致疾病进展,但临床证据提示肺部微生物的多样性并不能完全引起COPD的进展,这可能与COPD患者肺部微生物群落的稳定性不足有关。肺肠轴影响COPD疾病进展的具体机制包括细菌代谢产物机制和免疫学机制,而免疫学机制涉及固有及适应免疫调控机制和炎症因子级联反应。除此以外,尚存在黏膜免疫调控机制和细胞学调控机制等。

Gut-lung axis is an important endocrine regulatory axis in the human body which can influence and regulate the progression of chronic obstructive pulmonary disease(COPD).The gut-lung axis changes in COPD patients,which are reflected in the changes of lung microbes,gut microbes,and gut-lung axis immune modulating network.In gut-lung axis,components of gut microbes,crosstalk of microbes in gut and lung,microbe metabolites of gut microbes can all result in the exacerbation of COPD.However,clinical evidence indicates that the diversity of lung microbes cannot completely cause exacerbation of COPD,which may be related to the poor stability of lung microbes in COPD patients.Mechanisms of gutlung axis on COPD progression include:the bacterial metabolite pathway and the immunity pathway,which further includes innate and adaptive immunity modulation and inflammatory agent cascades.In addition,there are still mucous immunity modulation and cytology modulation.