臨牀消化器内科 Vol.32 No.10(1-4)


特集名 腸内細菌と臨床
題名 腸内細菌と消化器疾患(4)腸内細菌と炎症性腸疾患
発刊年月 2017年 09月
著者 大草 敏史 順天堂大学大学院腸内フローラ研究講座/東京慈恵会医科大学附属柏病院消化器・肝臓内科
【 要旨 】 自然免疫系の解明により,腸管炎症に対する腸内細菌の役割が注目されるようになった.そして炎症性腸疾患(IBD)は腸内細菌感染症ではないかともいわれてきている.近年,細菌DNAを解析する方法が開発され,膨大な腸内細菌からIBDの原因菌や菌群を探索するといったことが行われてきた.16S rRNAのメタゲノム解析においてIBDでは腸内細菌叢の乱れ(dysbiosis)があり,Firmicutes門のLactobacillus属やFaecalibacterium parausnitzii, Roseburia hominisとActinobacteria門のBifidobacterium属が減少し,Proteobacteria門のEnterobacteriaceae,硫酸還元細菌やBacteroidetes門のBacteroides属が増加していたという報告が多い.このdysbiosisは高脂肪食(動物性,植物性)や肉食(鉄分)の負荷でも共通に認められることから,IBDに対する脂肪や肉食制限といった食事指導が治療の一助となるとも考えられる.
Theme Roles and Importance of Microbiota in Clinical Medicine
Title Gut Microbiota and Inflammatory Bowel Disease
Author Toshifumi Ohkusa Department of Microbiota Research, Juntendo University Graduate School of Medicine / Department of Gastroenterology and Hepatology, Jikei University Kashiwa Hospital
[ Summary ] Recent studies on innate immunity have evidenced a role for intestinal bacteria in intestinal inflammation. In addition, inflammatory bowel disease (IBD) has been recognized as an intestinal bacterial infection. Recently developed methods for analyzing bacterial DNA have been used to try to identify the causative bacteria, or bacterial groups, of IBD within the great variety of intestinal bacteria. In the metagenomic analysis of 16S rRNA and DNA, have shown that there is dysbiosis in IBD with an increase in abundance of bacteria of the phylum Firmicutes, such as Lactobacillus, Faecalibacterium prausnitzii, and Roseburia hominis ; the phylum Actinobacteria ; the phylum Proteobacteria, such as Enterobacteriaceae and sulfate‒reducing bacteria ; and the phylum Bacteroidetes, such as Bacteroides. Since this dysbiosis is commonly observed in association with high‒fat diets (animal and vegetable) and high red meat consumption (which results in high levels of iron), dietary guidance such as fat and red meat restriction may be helpful for treatment of IBD.
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