中国神经再生研究(英文版) ›› 2025, Vol. 20 ›› Issue (8): 2153-2168.doi: 10.4103/NRR.NRR-D-24-00088

• 综述:脑损伤修复保护与再生 • 上一篇    下一篇

创伤性脑损伤后脑-肠-微生物轴的双向调节

  

  • 出版日期:2025-08-15 发布日期:2024-12-11

Bidirectional regulation of the brain–gut–microbiota axis following traumatic brain injury

Xinyu You1, 2, #, Lin Niu1, 2, #, Jiafeng Fu1, 2, Shining Ge1, 2, Jiangwei Shi3, 4, Yanjun Zhang3, 4, *, Pengwei Zhuang2, 3, *   

  1. 1 National Key Laboratory of Chinese Medicine Modernization, Tianjin University of Traditional Chinese Medicine, Tianjin, China;  2 Haihe Laboratory of Modern Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China;  3 First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China;  4 National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
  • Online:2025-08-15 Published:2024-12-11
  • Contact: Yanjun Zhang, MD, zyjsunye@163.com; Pengwei Zhuang, MD, zhuangpengwei@163.com.
  • Supported by:
    This work was supported by the National Natural Science Foundation of China, No. 82174112 (to PZ); Science and Technology Project of Haihe Laboratory of Modern Chinese Medicine, No. 22HHZYSS00015 (to PZ); and State-Sponsored Postdoctoral Researcher Program, No. GZC20231925 (to LN).

摘要:

创伤性脑损伤是一种常见的中枢神经系统疾病,除原发性脑实质损伤外,其造成的持久生物学后果也是患者的长期风险。目前,创伤性脑损伤的发病机制仍不完全清楚,尚缺乏有效的干预方法。肠道功能障碍是创伤性脑损伤的一个重要后果,其作为体内受神经支配最丰富的外周组织,拥有多种途径与中枢神经系统形成双向“脑肠轴”。此外,肠道拥有庞大的微生物群落。肠道生态位的改变通过神经元、激素、免疫的传入和传出通路参与创伤性脑损伤及其不良预后的进展。因此,深入了解微生物参与的周围神经-免疫调控机制,对创伤性脑损伤及其并发症的防御和治疗具有重要意义。此次综述全面概述了创伤性脑损伤后肠道微生态环境的变化,重点从脑-肠-微生物轴自上而下和自下而上的角度总结了创伤性脑损伤诱导的周围神经、免疫、微生物之间的复杂生物学过程,涉及自主神经功能障碍、神经内分泌紊乱、外周免疫抑制、肠屏障通透性增加、响应微生物的传入神经功能缺陷及中枢微生物潜在效应核团等机制的探索。此外,为更好的理解外周途径如何影响创伤性脑损伤患者的预后,文章还回顾了继发性生物损伤机制和损伤后的动态病理反应。文章提出与创伤性脑损伤恢复和未来中枢神经系统损伤类疾病风险相关的概念模型,揭示脑-肠-微生物轴双向影响的新见解。

https://orcid.org/0000-0003-2176-6657 (Yanjun Zhang); https://orcid.org/0000-0003-4308-3654 (Pengwei Zhuang)

关键词:

创伤性脑损伤, 脑-肠-微生物轴, 肠道微生物群, 神经免疫, 免疫抑制, 宿主防御, 迷走神经传入, 细菌感染, 背根神经节, 伤害感受神经回路

Abstract: Traumatic brain injury is a prevalent disorder of the central nervous system. In addition to primary brain parenchymal damage, the enduring biological consequences of traumatic brain injury pose long-term risks for patients with traumatic brain injury; however, the underlying pathogenesis remains unclear, and effective intervention methods are lacking. Intestinal dysfunction is a significant consequence of traumatic brain injury. Being the most densely innervated peripheral tissue in the body, the gut possesses multiple pathways for the establishment of a bidirectional “brain–gut axis” with the central nervous system. The gut harbors a vast microbial community, and alterations of the gut niche contribute to the progression of traumatic brain injury and its unfavorable prognosis through neuronal, hormonal, and immune pathways. A comprehensive understanding of microbiota-mediated peripheral neuroimmunomodulation mechanisms is needed to enhance treatment strategies for traumatic brain injury and its associated complications. We comprehensively reviewed alterations in the gut microecological environment following traumatic brain injury, with a specific focus on the complex biological processes of peripheral nerves, immunity, and microbes triggered by traumatic brain injury, encompassing autonomic dysfunction, neuroendocrine disturbances, peripheral immunosuppression, increased intestinal barrier permeability, compromised responses of sensory nerves to microorganisms, and potential effector nuclei in the central nervous system influenced by gut microbiota. Additionally, we reviewed the mechanisms underlying secondary biological injury and the dynamic pathological responses that occur following injury to enhance our current understanding of how peripheral pathways impact the outcome of patients with traumatic brain injury. This review aimed to propose a conceptual model for future risk assessment of central nervous system-related diseases while elucidating novel insights into the bidirectional effects of the “brain–gut–microbiota axis.”

Key words: traumatic brain injury, brain–gut–microbiome axis, gut microbiota, neuroimmune, immunosuppression, host defense, vagal afferents, bacterial infection, dorsal root ganglia, nociception neural circuitry