Review article: the role of the gut flora in health and disease, and its modification as therapy

被引:66
作者
Hart, AL
Stagg, AJ
Frame, M
Graffner, H
Glise, H
Falk, P
Kamm, MA
机构
[1] St Marks Hosp, Harrow HA1 3UJ, Middx, England
[2] Imperial Coll Sch Med, Northwick Pk Inst Med Res, Antigen Presentat Res Grp, Harrow, Middx, England
[3] AstraZeneca R&D Molndal, Molndal, Sweden
关键词
D O I
10.1046/j.1365-2036.2002.01310.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
The gut flora is a vast interior ecosystem whose nature is only beginning to be unravelled, due to the emergence of sophisticated molecular tools. Techniques such as 16S ribosomal RNA analysis, polymerase chain reaction amplification and the use of DNA microarrays now facilitate rapid identification and characterization of species resistant to conventional culture and possibly unknown species. Life-long cross-talk between the host and the gut flora determines whether health is maintained or disease intervenes. An understanding of these bacteria-bacteria and bacteria-host immune and epithelial cell interactions is likely to lead to a greater insight into disease pathogenesis. Studies of single organism-epithelial interactions have revealed the large range of metabolic processes that gut bacteria may influence. In inflammatory bowel diseases, bacteria drive the inflammatory process, and genetic predisposition to disease identified to date, such as the recently described NOD2/CARD15 gene variants, may relate to altered bacterial recognition. Extra-intestinal disorders, such as atopy and arthritis, may also have an altered gut milieu as their basis. Clinical evidence is emerging that the modification of this internal environment, using either antibiotics or probiotic bacteria, is beneficial in preventing and treating disease. This natural and apparently safe approach holds great appeal.
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页码:1383 / 1393
页数:11
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