短链脂肪酸(SCFAs)是肠道菌群发酵膳食纤维产生的主要代谢物(以乙酸、丙酸、丁酸为主),在维持肠黏膜屏障完整性及免疫稳态中发挥重要作用。近年来研究提示,SCFAs可通过调控肠-肺轴、激活G蛋白偶联受体、抑制组蛋白去乙酰化酶以及激活过氧化物酶体增殖物激活受体γ等途径,参与儿童过敏性鼻炎、特应性皮炎、哮喘与食物过敏的发生发展及转归。现有临床与动物研究总体显示,过敏性疾病患儿常伴肠道SCFAs及相关产酸菌减少,外源性补充SCFAs或促进产酸菌增殖可能改善过敏相关症状并增强屏障功能。然而,现有证据仍以动物实验、体外机制研究和观察性研究为主,高质量随机对照试验不足,干预时机、有效且安全的剂量与疗程仍需明确。未来应开展多中心、大样本、长期随访的干预研究,系统评估疗效与安全性,并探索SCFAs相关风险预测模型,以促进其在儿童过敏性疾病防治中的转化应用。
Abstract
Short-chain fatty acids (SCFAs), mainly including acetate, propionate and butyrate, are key metabolites produced by gut microbiota through the fermentation of dietary fiber.They play a crucial role in maintaining intestinal mucosal barrier integrity and immune homeostasis.Recent studies suggest that SCFAs may partucipate in the development, progression, and prognosis of allergic diseases in children, such as allergic rhinitis, atopic dermatitis, asthma, and food allergies, through various pathways.These pathways include modulating the gut-lung axis, activating G protein-coupled receptors, inhibiting histone deacetylases, and activating peroxisome proliferator-activated receptor γ.Current clinical and animal studies generally indicate that children with allergic diseases often exhibit decreased levels of SCFAs and related acid-producing bacteria in their gut.External supplementation of SCFAs or promotion of acid-producing bacterial proliferation may alleviate allergy-related symptoms and enhance barrier function.However, existing evidence is still predominantly based on animal experiments, in vitro mechanistic studies, and observational research, with a lack of high-quality randomized controlled trials.Key factors such as the optimal intervention timing, effective and safe dosages, and treatment durations remain to be clarified.Future research should focus on conducting multicenter, large-scale, long-term follow-up intervention studies to systematically evaluate efficacy and safety of SCFA-based approaches.Additionally, developing risk prediction models related to SCFAs could facilitate their translational application in the prevention and treatment of allergic diseases in children.
关键词
短链脂肪酸 /
过敏性疾病 /
肠道菌群 /
儿童
Key words
short-chain fatty acids /
allergic diseases /
gut microbiota /
children
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基金
国家自然科学基金面上项目(82170026);西京医院学科助推计划创新医学研究专项一般项目(XJZT24CY05);西安市技术攻关专项计划医学研究一般项目(2024JH-YLYB-0454)
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