犬尿喹啉酸在肠易激综合征中的作用机制  

Mechanism of Action of Kynurenic Acid in Irritable Bowel Syndrome

作　　者：陆锦南 赵春华 闵寒[1] LU Jinnan;ZHAO Chunhua;MIN Han(Department of Gastroenterology,the Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou,Jiangsu 215001,China)

机构地区：[1]南京医科大学附属苏州医院(苏州市立医院)消化内科,江苏苏州215001

出　　处：《协和医学杂志》2023年第2期353-358,共6页Medical Journal of Peking Union Medical College Hospital

基　　金：苏州市姑苏卫生人才科研项目(GSWS2021041);南京医科大学姑苏学院科研项目(GSKY20210401);苏州市科技局民生科技指导性项目(SYSD2020140)。

摘　　要：肠易激综合征(irritable bowel syndrome,IBS)是一种常见的肠道功能紊乱性疾病,以持续或间歇性腹痛及排便习惯改变为主要临床表现,常伴有焦虑、抑郁等精神症状,严重影响患者生活质量。目前,IBS的病因及发病机制尚不明确,现有研究表明IBS是由内脏感觉异常、肠道感染与炎症反应、肠道菌群失调、社会心理等多种因素共同作用的结果。近期研究表明IBS患者中存在肠道菌群-犬尿氨酸(kynurenine,KYN)代谢紊乱,且KYN代谢产物犬尿喹啉酸(kynurenic acid,KA)与炎症反应、疼痛刺激及心理症状相关,在IBS中可能起到抗炎、缓解疼痛等保护性作用,有望成为诊断和治疗IBS的新方法。本文就KYN代谢途径及其代谢产物KA在IBS中的作用机制作一综述,以期为临床相关专业人员提供参考和借鉴。Irritable bowel syndrome(IBS)is a common digestive psychosomatic diseases,mainly mani⁃fested as recurrent abdominal pain and abnormal bowel movements.The intestinal dysfunction is often comor⁃bidized with anxiety,depression and other emotional problems,resulting in increased intestinal burden and even a decrease in the quality of life.The etiology and pathogenesis of IBS are unclear,but it is currently be⁃lieved that IBS involves abnormal gut⁃brain interaction caused by a combination of various factors,including visceral hypersensitivity,intestinal immune activation,intestinal infection,intestinal dysbacteriosis,and psy⁃chosocial stress.Recent studies have observed the disorders of gut microbiota⁃regulated kynurinaine metabolism in IBS patients,and found that the metabolite kynurenic acid(KA)has important correlations with inflammato⁃ry responses,pain stimuli and mood changes.KA may play a protective role in IBS such as anti⁃inflammatory and pain relief and thus has the potential to become a new approach for the diagnosis and treatment of IBS.In this work,studies related to KA and IBS are reviewed.

关 键 词：肠易激综合征 犬尿氨酸代谢 犬尿喹啉酸 肠道菌群失调 

分 类 号：R574.4[医药卫生—消化系统]