中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2024, Vol. 19 ›› Issue (3): 548-556.doi: 10.4103/1673-5374.380881

• 综述:周围神经损伤修复保护与再生 • 上一篇    下一篇

脊髓损伤与肠道菌群

  

  • 出版日期:2024-03-15 发布日期:2023-09-02

Dual-directional regulation of spinal cord injury and the gut microbiota

Yinjie Cui1, 2, 3, #, Jingyi Liu3, #, Xiao Lei4, Shuwen Liu3, Haixia Chen3, Zhijian Wei5, 6, Hongru Li3, Yuan Yang3, Chenguang Zheng1, *, #br# Zhongzheng Li3, * #br#   

  1. 1Academy of Medical Engineering and Translational Medicine, Tianjin University, Tianjin, China; 2School of Medical Technology, Tianjin University of Traditional Chinese Medicine, Tianjin, China; 3Research Center of Experimental Acupuncture Science, Tianjin University of Traditional Chinese Medicine, Tianjin, China; 4International Cooperation and Exchange Office, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan Province, China; 5International Cooperation Base of Spinal Cord Injury, Tianjin Key Laboratory of Spine and Spinal Cord Injury, Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China; 6Department of Orthopedics, Qilu Hospital of Shandong University, Jinan, Shandong Province, China
  • Online:2024-03-15 Published:2023-09-02
  • Contact: Chenguang Zheng, MD, cgzheng@tju.edu.cn; Zhongzheng Li, MD, lizhzh2008@163.com.
  • Supported by:
    The work was supported by the National Natural Science Foundation of China, Nos. 82105019 (to YC), 82271218 (to CZ) and Natural Science Foundation of Tianjin Municipality Foundation, No. 20JCZDJC00540 (to CZ).

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摘要：

越来越多的证据表明，肠道菌群通过脑肠轴影响中枢神经系统疾病的发生和进展，脊髓作为中枢神经系统的重要组成部分，脊髓损伤与肠道相互作用之间的潜在联系尚不清楚。最近的研究表明，脊髓损伤患者经常出现肠道功能障碍和肠道生态紊乱。脊髓损伤后肠道菌群的改变加重了肠屏障的破坏，加剧神经炎阻碍脊髓损伤神经功能修复及其并发症。因此，研究肠道菌群与脊髓损伤的相互调节作用具有重要的临床意义。文章详细论述了脊髓损伤与肠道菌群之间的双向调节作用。首先回顾了肠道微生物群在脊髓损伤合并神经源性肠功能障碍患者中的特点，讨论了肠道菌群作为表征脊髓损伤肠道与运动功能生物标记物的观点，并提出脊髓损伤后肠道菌群的失衡可能对脊髓损伤患者多器官多系统产生深远的影响。随后，详细分析了脊髓损伤后导致肠道菌群失衡的可能原因，即脊髓损伤后自主神经功能障碍导致肠道转运与肠道免疫功能紊乱以及频繁使用抗生素等。阐述了肠道菌群及其代谢产物影响脊髓损伤后神经重塑的可能机制，具体包括肠道菌群代谢途径（短链脂肪酸，色氨酸）；肠道菌群的免疫途径（细胞因子，Toll样受体，NLRP3炎症小体等）。文章通过总结靶向调节肠道菌群治疗脊髓损伤的临床与基础研究进展，揭示了粪菌移植、益生菌、饮食干预和康复训练等疗法在脊髓损伤中发挥的神经保护作用。最后讨论了目前脊髓损伤与肠道菌群的临床与基础研究存在的问题与不足，提出针对肠道微生物群或其代谢物的治疗方法可能成为促进脊髓功能恢复和改善脊髓损伤并发症的一种有前途的方法。

https://orcid.org/0000-0002-4782-8732 (Chenguang Zheng); https://orcid.org/0000-0002-3380-2793 (Zhongzheng Li)

Abstract: There is increasing evidence that the gut microbiota affects the incidence and progression of central nervous system diseases via the brain-gut axis. The spinal cord is a vital important part of the central nervous system; however, the underlying association between spinal cord injury and gut interactions remains unknown. Recent studies suggest that patients with spinal cord injury frequently experience intestinal dysfunction and gut dysbiosis. Alterations in the gut microbiota can cause disruption in the intestinal barrier and trigger neurogenic inflammatory responses which may impede recovery after spinal cord injury. This review summarizes existing clinical and basic research on the relationship between the gut microbiota and spinal cord injury. Our research identified three key points. First, the gut microbiota in patients with spinal cord injury presents a key characteristic and gut dysbiosis may profoundly influence multiple organs and systems in patients with spinal cord injury. Second, following spinal cord injury, weakened intestinal peristalsis, prolonged intestinal transport time, and immune dysfunction of the intestine caused by abnormal autonomic nerve function, as well as frequent antibiotic treatment, may induce gut dysbiosis. Third, the gut microbiota and associated metabolites may act on central neurons and affect recovery after spinal cord injury; cytokines and the Toll-like receptor ligand pathways have been identified as crucial mechanisms in the communication between the gut microbiota and central nervous system. Fecal microbiota transplantation, probiotics, dietary interventions, and other therapies have been shown to serve a neuroprotective role in spinal cord injury by modulating the gut microbiota. Therapies targeting the gut microbiota or associated metabolites are a promising approach to promote functional recovery and improve the complications of spinal cord injury.

Key words: chemokines, cytokines, gut microbiota, NLRP3, spinal cord injury, Toll-like receptor ligand, tryptophan