综述
ENGLISH ABSTRACT
肠-视网膜轴机制及其与眼科疾病的相互作用
黄银花
陈建苏 [综述]
唐仕波 [综述]
作者及单位信息
·
DOI: 10.3760/cma.j.cn115989-20210201-00083
Interaction mechanism between gut-retina axis and eye diseases
Huang Yinhua
Chen Jiansu
Tang Shibo
Authors Info & Affiliations
Huang Yinhua
Shanghai Aier Eye Hospital, Shanghai 200336
Chen Jiansu
Aier Eye Institute, Changsha 410015
Tang Shibo
Guangzhou Aier Eye Hospital, Jinan University, Guangzhou 510071
·
DOI: 10.3760/cma.j.cn115989-20210201-00083
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摘要

肠道菌群是维持机体稳态的重要组成部分,近年来,随着16S rRNA和宏基因组等测序技术的快速发展,人们对微生物有了更加深入而全面的认识,在动物和人类中的研究证实肠道菌群不仅参与免疫性、代谢性和神经系统等全身性疾病的病变过程,还与眼病的发生密切相关。宿主高血糖、免疫异常、衰老和高眼压等因素可引起肠道菌群失调,肠-血屏障通透性增加。肠道菌群相关的脂多糖和肽聚糖等病原相关分子模式穿过受损的肠道屏障进入体循环,最终沉积到视网膜和葡萄膜组织中,参与免疫及炎症反应过程,而肠道来源的宿主免疫细胞或损伤相关的分子模式又可加重眼部炎症的级联反应。同时,包括饮食和环境诱导在内的肠道菌群代谢产物,如胆红素、胆汁酸和短链脂肪酸等,通过调节免疫T细胞平衡、miRNA表达和视网膜细胞炎性活化等参与视网膜疾病的进展。本文拟对近年来国内外关于肠道菌群与糖尿病视网膜病变、葡萄膜炎、年龄相关性黄斑变性和青光眼的相关研究进行综述,探讨肠道菌群通过肠-视网膜轴参与眼科疾病的可能机制,为眼部疾病的机理研究和防治提供一些新的思路。

肠道菌群;肠-视网膜轴;糖尿病视网膜病变;葡萄膜炎;年龄相关性黄斑变性;青光眼
ABSTRACT

Gut microbiome is an important part of maintaining human homeostasis.In recent years, with the rapid development of sequencing technologies such as 16S rRNA and metagenome, people have a deeper and more comprehensive understanding about microorganisms.Studies in animals and humans have confirmed that the gut microbiome is not only involved in the pathological process of systemic diseases such as immune, metabolic and neurological disorders, but is also closely related to eye diseases.Factors such as host high blood glucose, immune disorders, aging, high intraocular pressure can cause gut microbiota dysbiosis and increase gut-blood barrier permeability.Lipopolysaccharide, peptidoglycan and other pathogen-associated molecular patterns enter the systemic circulation through the damaged gut barrier and eventually reach the retina and uveitis where they participate the immune and inflammatory response process.In addition, gut-derived host immune cells or injury-related molecular patterns may exacerbate the ocular inflammatory cascade.At the same time, metabolites of microbiota, including those induced by diet and environment factors, such as bilirubin, bile acids and short-chain fatty acids, are involved in the progression of retinal diseases via regulating immune T cell balance, miRNA expression and retinal cell inflammatory activation.This article aims to review the domestic and foreign studies on gut microbiome in diabetic retinopathy, uveitis, age-related macular degeneration and glaucoma in recent years, and discuss the possible mechanisms of gut microbiome in eye diseases via the gut-retina axis in order to provide some new ideas for further study and treatment of eye diseases.

Gut microbiome;Gut-retina axis;Diabetic retinopathy;Uveitis;Age-related macular degeneration;Glaucoma
Chen Jiansu, Email: mocdef.3ab610002usnaijnehc;
Tang Shibo, Email: mocdef.3ab61.pivobihsgnat
引用本文

黄银花,陈建苏,唐仕波. 肠-视网膜轴机制及其与眼科疾病的相互作用[J]. 中华实验眼科杂志,2024,42(11):1053-1059.

DOI:10.3760/cma.j.cn115989-20210201-00083

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肠道菌群是机体内环境的重要组成部分,在成人肠道中,细菌数量高达10 14数量级,是人体细胞总数(10 13个)的10倍,所携带基因数量是人体总基因的200~300倍,主要由拟杆菌门、厚壁菌门、放线菌门和变形菌门组成 [ 1 ]。肠道菌群参与物质代谢,为机体提供营养并维持其正常生理功能,与宿主处于一种复杂的动态平衡。当遗传、免疫、代谢、营养或外界环境等因素打破这种平衡时,可引起菌群失调,激活自体免疫细胞和炎性通路导致机体免疫异常和全身慢性低度炎症状态,而这些都是视网膜、视神经疾病发生的危险因素。随着测序方法和技术的快速发展,人们对肠道菌群组成和功能的研究更加广泛和深入,肠道菌群已成为当前眼病机理和防治策略研究的新兴热门领域。本文拟对肠-视网膜轴的理念及近年来其在眼科相关疾病的研究进行综述,以期为后续的机理和防治研究提供参考。
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备注信息
A
陈建苏,Email: mocdef.3ab610002usnaijnehc
B
唐仕波,Email: mocdef.3ab61.pivobihsgnat
C
所有作者均声明不存在利益冲突
D
爱尔眼科集团科研基金项目 (AGF2301D38)
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