了解肠道微生物群机制和焦虑、抑郁、睡眠障碍和便秘干预策略的进展

摘要(中文译文)

焦虑、抑郁症状、睡眠障碍和慢性便秘经常同时发生，并共同造成相当大的临床负担。尽管这些疾病可能涉及部分重叠的神经、内分泌、免疫和代谢过程，但其共同的病理生理学基础尚未完全明确。本叙述性综述探讨了微生物群-肠-脑轴在将情感症状、睡眠障碍和慢性便秘联系起来方面的潜在作用。来自人类观察性研究、孟德尔随机化分析、动物模型和初步干预性研究的证据表明，肠道微生物组成和功能的改变可能通过微生物代谢产物、免疫信号传导、神经内分泌调节和神经通路促成这些临床关联。本综述还总结了针对微生物群的干预措施，包括益生菌、益生元、饮食调整和粪菌移植。然而，研究人群、微生物学发现、实验方法和干预方案方面存在相当大的异质性，限制了因果解释和临床推广。因此，在评估基于微生物群的策略的治疗潜力时，需要更严格地区分关联性、机制性、遗传性和干预性证据。

Abstract

Anxiety, depressive symptoms, sleep disorders, and chronic constipation frequently co-occur and collectively impose a substantial clinical burden. Although these conditions may involve partially overlapping neural, endocrine, immune, and metabolic processes, their shared pathophysiological basis has not been fully established. This narrative review examines the potential role of the microbiota-gut-brain axis in linking affective symptoms, sleep disturbances, and chronic constipation. Evidence from human observational studies, Mendelian randomization analyses, animal models, and preliminary interventional studies suggests that alterations in gut microbial composition and function may contribute to these clinical associations through microbial metabolites, immune signaling, neuroendocrine regulation, and neural pathways. The review also summarizes microbiota-targeted interventions, including probiotics, prebiotics, dietary modification, and fecal microbiota transplantation. However, substantial heterogeneity in study populations, microbial findings, experimental methods, and intervention protocols limits causal interpretation and clinical generalization. A more rigorous distinction among associative, mechanistic, genetic, and interventional evidence is therefore required when evaluating the therapeutic potential of microbiota-based strategies.

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