摘要
肠道微生物对维持人类正常的生理功能具有重要意义,正常的肠道菌群在宿主营养代谢、药物代谢、维持肠道黏膜屏障结构完整、免疫调节和抵御病原体等方面发挥重要作用。肠道菌群不仅通过神经系统,而且通过内分泌系统、免疫系统和代谢系统对大脑产生影响,这种肠道和大脑之间的双向通信称之为脑-肠轴。人体内存在的脑-肠轴可能是大脑和胃肠道之间关键调控通路,而肠道菌群为该通路的重要参与者,肠道微生物群的变化可通过免疫机制作用于中枢和周围神经系统,导致脑功能改变,从而参与了帕金森氏病、老年痴呆症、精神分裂症和多发性硬化症等多种中枢神经系统疾病的发病机制。癫痫是一种以具有持久性的致痫倾向为特征的慢性脑部疾病,免疫机制在癫痫尤其是免疫性癫痫的发生和发展中发挥了重要作用。免疫性癫痫是免疫介导以反复或持续性癫痫发作为主要临床表现的疾病,其特征为频繁的局灶性癫痫发作、脑病、进行性认知障碍、局灶性神经功能受损或伴发其他中枢神经系统缺陷。机体免疫反应的异常激活(包括固有免疫和后天获得性免疫)参与了免疫性癫痫的发病机制,患者脑脊液中可检测到神经元特异性相关抗体具有诊断意义。临床上抗炎或免疫治疗在某些药物难治性癫痫,尤其是诊断明确的免疫性癫痫可能具有良好的治疗作用,通过免疫调控和肠道菌群重建可能是未来治疗自身免疫性癫痫的重要途径。
Gut microbiota is a complex community which plays an important role in the normal physiological functions of human beings. The normal gut mierobiota has many important functions which involving host nutrient metabolism, drug metabolism, maintenance of structural integrity of the intestinal mucosal barrier, immunomodulation, protection against pathogens, etc. Gut mierobiota exerts effects on the brain which not only through the nervous system, but also through the endocrine system, immune system and metabolic system. A bidirectional communication between the gut and the brain is referred to as the brain-gut axis. The brain-gut axis may be a key regulatol7 pathway between the brain and the gastroin- testinal tract, while gut mierobiota is an important participant in this pathway. The changes in gut mierobiota can act on the central and peripheral nervous system through immunologic mechanism, which leading to changes in the brain func- tion, and consequently participating in the pathogenesis of various central nervous system diseases, such as Parkinson ＇ s disease, Alzheimer＇ s disease, schizophrenia, and multiple sclerosis, etc. Epilepsy is a chronic neurologic disease char- acterized by a persistent tendency to cause epileptic seizures. Immunologic mechanism plays an important role in the gen- eration and development of epilepsy, especially autoimmune epilepsy. Autoimmune epilepsy is one of immune-mediated epileptic diseases characterized by repeated and continuous epileptic onset, its clinical features includes frequent onset of focal seizures, encephalopathy, progressive cognitive impairment, focal neurological injuries and/or other central neuro- logic deficits. The excessive activation of immune response（ the innate and acquired immunity）participates in the patho- genesis of autoimmune epilepsy, the neural-specific antibodies can be detected in the cerebrospinal fluid of the patient with autoimmune epilepsy. Anti-inflammation or immune therapy may have a good clinical therapeutic effect in some drug re
作者
卢燕
刘占利
LU Yan;LIU Zhan-li(Department of Pediatrics, Hangzhou Hospital Affiliated to Nanjing Medical University （ the First People＇s Hospital Hangzhou ） , Hangzhou , Zhejiang 310006, China)
出处
《中华全科医学》
2018年第9期1550-1553,1569,共5页
Chinese Journal of General Practice
基金
浙江省医药卫生科技项目(2012KYB151)
杭州市卫生科技计划项目(2013B03)
关键词
癫痫
肠道菌群
免疫
炎症
脑-肠轴
Epilepsy
Intestinal mierobiota
Immune
Inflammation
Brain-gut axis
