幽门螺杆菌在人体的角色之谜:游离于寄生菌和病原体之间
在过去的半个世纪内，幽门螺杆菌的成功分离使胃肠病学家、免疫学家、遗传学家、病理学家和微生物学家对胃十二指肠疾病的认识发生了重大变化。但是近十几年的研究结果显示，幽门螺杆菌感染相关疾病往往只发生于40岁以上的人群，而且幽门螺杆菌阴性亦与一些新兴疾病的发生相关，尤其在青少年群体中。幽门螺杆菌定植的不同结果导致了于幽门螺杆菌的两种相反的观点：“好的”和“坏的”幽门螺杆菌菌。这也说明我们需要对幽门螺杆菌进行重新审视，其有可能是古代人类胃微生物中的正常一员，只是随着环境的变化，在人类体内正逐渐消失。
译者小结：根据近年来人们对幽门螺杆菌和胃肠外疾病关系的研究结果，有学者提出该细菌可能与某些免疫相关疾病如哮喘、炎症性肠病等呈负相关。结合随着历史上人类迁徙的幽门螺杆菌的迁徙，有人提出幽门螺杆菌原本就是胃内定植菌的假说。对于“好”菌和“坏”菌的争论由来已久。在争论与探索中，无论怎样曲折，总会离真理越来越近。
Best Pract Res Clin Gastroenterol. 2014 Dec;28(6):1017-29. doi: 10.1016/j.bpg.2014.09.003. Epub 2014 Sep 28.
Helicobacter pylori: the balance between a role as colonizer and pathogen.
Otero LL1, Ruiz VE2, Perez Perez GI3.
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Abstract
The isolation of Helicobacter pylori from the human stomach produced significant changes in how gastroenterologists, immunologists, epidemiologists, pathologists and microbiologists have approached gastro-duodenal diseases in the last half of the XX century. However, research of this organism has progressed greatly in the first decade of this century, evidence suggest that H. pylori is associated with disease only in humans older than 40 years, while, the lack of H. pylori colonization is associated with the emergence of new diseases, particularly in younger individuals. These differing effects of H. pylori colonization have created two contrasting concepts: the 'bad' and the 'good' Helicobacter. Following from renewed interest in the normal human microbiome, we need to reconsider our definitions and perhaps recognize that H. pylori might be a normal member of the human gastric microbiome in ancient humans that gradually, as results of the improvement in our environment, is disappearing.
Copyright © 2014 Elsevier Ltd. All rights reserved.
KEYWORDS:
Commensal; Gastric microbiome; Helicobacter pylori; Pathogen