[摘要] 肠道微生物群的改变被认为肠易激综合征（IBS）发病机制的病因。肠道菌群-免疫失调导致肠道微环境的改变，诱发肠道的低度炎症。肠道碱性磷酸酶（IAP）通常能保护宿主免受肠道炎症和主要在结肠内的组织损伤，是维持肠道内环境稳定所必需的重要黏膜防御因子，被认为是肠道微生物群组成的潜在调节器。基于此，IAP相关通路可能是阐明针刺对肠道菌群-免疫稳定作用分子生物学机制的新切入点，促进对从脾论治与调控肠道菌群关系的认识，丰富中医从脾论治的科学内涵。
[关键词] 肠易激综合征;肠道微生物;肠道碱性磷酸酶;肠道菌群-免疫失调
[中图分类号] R246.1 [文献标识码] A [文章编号] 1673-7210（2019）10（a）-0126-04
Based on intestinal alkaline phosphatase signaling pathway to discuss the mechanism of acupuncture maintaining intestinal flora-immune stability
MAO Wenjiao1 ZHANG Hongmei2
1.Department of Acupuncture， the Second Hospital of Nanjing， Jiangsu Province， Nanjing 210003， China; 2.Department of Clinical Testing Center， the Second Hospital of Nanjing， Jiangsu Province， Nanjing 210003， China
[Abstract] The alteration of intestinal microflora is considered to be the cause of the pathogenesis of Irritable bowel syndrome （IBS）. Intestinal flora-immune disorders lead to changes in the intestinal microenvironment， which induce low-grade inflammation of the intestines. Intestinal alkaline phosphatase （IAP） considered as a potential regulator of intestinal microflora， protects the host from intestinal inflammation and tissue damage mainly in the colon， while is an important mucosal defense factor necessary to maintain the stability of the intestinal environment. Based on the above poinits， IAP-related pathway may be a new entry point to elucidate the molecular biological mechanism of acupuncture on intestinal flora-immune stability， to promote the understanding of the relationship between treatment from spleen and regulation of intestinal flora， and to eich the scientific connotation of treatment from spleen in Chinese medicine.
[Key words] Irritable bowel syndrome; Intestinal microbiota; Intestinal alkaline phosphatase; Intestinal flora-immune disorders
腸道菌群-免疫异常导致多种疾病，肠易激综合征（irritable bowel syndrome，IBS）是最常见的由肠道菌群异常引起的胃肠病之一，肠道菌群-免疫失调导致肠道微环境的改变，诱发肠道的低度炎症[1]。肠道微生物群的改变被认为是IBS发病机制的病因[2]。中医理论认为，肠道微生态平衡是脾主运化的主要生理特征，肠道菌群失调和中医脾失健运互为因果。肠道炎症破坏肠道内平衡，并引起免疫介导的组织损伤。肠道碱性磷酸酶（intestinal alkaline phosphatase，IAP）是一种在肠道中表达的内源性蛋白质，被认为是一种免受定植细菌损伤的保护机制。IAP活性通常能保护宿主免受肠道炎症和主要在结肠内的组织损伤。IAP是维持肠道内环境稳定所必需的重要黏膜防御因子[3]。IAP被认为是肠道微生物群组成的潜在调节器[4]。越来越多的研究显示，IAP缺乏是肠道炎症性疾病发病的主要原因[5-7]。IAP缺乏会自发增加未感染动物肠道组织中的炎性细胞因子，包括白细胞浸润、上皮层不连续等，并且能诱导杯状细胞数量减少[8]。基于前期研究基础，推测IAP相关通路可能是阐明针刺对肠道菌群-免疫调节的分子生物学机制新的切入点，能提高从脾论治与调控肠道菌群关系的认识，丰富中医从脾论治的科学内涵。