基于微生物角度探讨“口-肠”轴与胃癌防治研究进展  

Research Progress on Relationship Between"Mouth-Gut"Axis and Prevention and Treatment of Gastric Cancer from Perspective of Microorganism

作　　者：陈露露 宋忠阳 赵海宏 刘瑜 郝国雄 张志明 CHEN Lulu;SONG Zhongyang;ZHAO Haihong;LIU Yu;HAO Guoxiong;ZHANG Zhiming(Graduate School of Gansu University of Chinese Medicine,Lanzhou Gansu China 730000;Department of Oncology,The Affiliated Hospital to Gansu University of Chinese Medicine,Lanzhou Gansu China 730020;Famous Medical Studio,Gansu Provincial Hospital of Chinese Medicine,Lanzhou Gansu China 730050)

机构地区：[1]甘肃中医药大学研究生院,甘肃兰州730000 [2]甘肃中医药大学附属医院肿瘤科,甘肃兰州730020 [3]甘肃省中医院名医工作室,甘肃兰州730050

出　　处：《中医学报》2024年第2期334-342,共9页Acta Chinese Medicine

基　　金：2022年甘肃省科技厅重点研发计划项目(22YFTFA102);高端人才承担省级科技计划项目(“长江学者奖励计划”特聘教授){甘科技(2021)20号-9}。

摘　　要：近年来,随着宏基因测序技术的广泛应用及对微生物研究的深入,口腔、肠道微生物在胃癌发病中的作用机制逐渐明确,从微生物角度探讨胃癌的早期诊断及防治研究已成为当下热点。中西医结合多靶点调控微生物作为一种新兴治疗方法,可快速调控微生物紊乱,恢复微生态平衡,在维持正常肠道上皮屏障功能、减轻炎症反应、免疫调控等方面发挥双向调节作用,为胃癌防治开辟了新的模式。目前,基于“口-肠”微生物角度防治胃癌相关研究仍存在如下不足之处:多数口腔、肠道微生物与肠黏膜上皮细胞的相互作用及中医药干预机制尚不明确,多集中于对肠道微生物炎症反应、免疫调节等的研究,对细菌移位与定植、位点、细菌表位的识别多停留在动物实验阶段,亟需大样本临床试验及研究证实,同时结合宏基因组学及基于微生态理念筛选不同中医证型胃癌及癌前病变的标志性、特异性菌群,针对胃癌、癌前病变风险预测及中医药干预疗效评估建立口腔-肠道微生物数据库及模型,为胃癌早期诊断和中西医结合防治研究提供新的科学依据。In recent years,with the widespread application of metagenomic sequencing technology and the deepening of microbial research,the mechanisms of oral and intestinal microbiota in the pathogenesis of gastric cancer have gradually become clear.Exploring the early diagnosis and prevention of gastric cancer from a microbial perspective has become a hot topic.The combination of traditional Chinese and Western medicine with multi-target regulation of microorganisms is an emerging treatment method that can quickly regulate microbial disorders,restore microecological balance,and play a bidirectional regulatory role in maintaining normal intestinal epithelial barrier function,reducing inflammatory reactions,and immune regulation,opening up a new model for the prevention and treatment of gastric cancer.At present,there are still shortcomings in research related to the prevention and treatment of gastric cancer from the perspective of"mouth-gut"microorganism:the interaction between most oral and intestinal microbiota and intestinal mucosal epithelial cells,as well as the intervention mechanism of traditional Chinese medicine,are not yet clear.Most studies focus on the inflammatory response of intestinal microbiota,immune regulation,etc.,and the identification of bacterial translocation and colonization,sites,and bacterial epitopes mostly stays in the animal experimental stage,There is an urgent need for large-scale clinical trials and research confirmation,combined with metagenomics and microecological concepts to screen for biomarkers and specific microbial communities of different traditional Chinese medicine syndrome types of gastric cancer and precancerous lesions.A database and model of oral and intestinal microbiota are established for predicting the risk of gastric cancer and precancerous lesions and evaluating the effectiveness of traditional Chinese medicine intervention,providing new scientific basis for early diagnosis of gastric cancer and integrated prevention and treatment of traditional Chinese and Western medi

关 键 词：胃癌 微生物 口-肠轴 益生菌 益生元 粪菌移植 中医药 

分 类 号：R285.5[医药卫生—中药学]