基于肠道菌群的放射性肠损伤发病机制及治疗研究进展

Advancements in research on the pathogenesis and treatment of radiation⁃induced intestinal injury based on gut microbiota

肠道菌群失调与放射性肠损伤的发生和进展密切相关,但具体作用机制尚不明确。人体的共生细菌在肠道微环境稳态维持中发挥重要作用,并参与代谢、免疫调节、炎症、肿瘤发生等多种生理病理过程。电离辐射导致肠上皮屏障破坏,形成氧化应激微环境,引起菌群组成和结构改变,并通过下游炎症因子作用共同导致菌群失调,菌群失调则可进一步通过减弱肠上皮屏障抵抗力、激活炎症信号通路、上调辐射诱导的细胞凋亡反应等加重放射性肠损伤。益生菌补充、粪菌移植等方法可以通过调节肠道菌群平衡减轻放射性肠损伤。本文基于肠道微生物的放射性肠炎发病机制及临床防护研究进展作一综述,期望为放射性肠炎的防治提供理论依据和参考。

The intestinal dysbacteriosis is closely associated with the occurrence and progress of radiation⁃induced intestinal injury.However,the specific mechanism remains unclear.Symbiotic bacteria in the human body play a significant role in maintaining the homeostasis of the intestinal microenvironment while participating in various physiological and pathological processes such as metabolism,immunoregulation,inflammation,and tumorigenesis.Ionizing radiation can destroy the intestinal epithelial barrier,creating an oxidative stress microenvironment.Consequently,the composition and structure of microbiota change,leading to dysbacteriosis through downstream inflammatory factors.Dysbacteriosis can further exacerbate radiation⁃induced intestinal injury by weakening the resistance of the intestinal epithelial barrier,activating inflammatory signaling pathways,and upregulating radiation⁃induced apoptosis response.The probiotic supplementation and fecal bacteria transplantation can reduce radiation⁃induced intestinal injury by regulating the balance of intestinal microbiota.This study reviews the advances in research on the pathogenesis and clinical protection of radiation enteritis based on gut microbiota,in order to provide a theoretical basis and reference for the prevention and treatment of radiation enteritis.