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Gut:膳食纤维和IBS:在个性化医疗时代如何将功能特性转化为临床价值?

2021-08-21 haibei MedSci原创

最近,研究人员综述讨论了围绕纤维的功能特征和随后在IBS患者中引起的生理反应的数据和概念,以期将这些知识应用于纤维补充剂的精确使用。

膳食纤维包括在植物性食物中发现的广泛的不可消化的碳水化合物,并被食品法典定义为至少由三个单体组成的不可消化的碳水化合物。对于临床医生来说,了解个别纤维的功能特点和随之而来的生理反应,可以指导临床决策,在此基础上,可以操纵它们的摄入量以获得特定的临床益处。

目前,对IBS患者使用纤维补充剂的临床指南提供了一刀切的建议,其价值有限。最近,研究人员综述讨论了围绕纤维的功能特征和随后在IBS患者中引起的生理反应的数据和概念,以期将这些知识应用于纤维补充剂的精确使用。

研究人员的主要发现是:第一,个别纤维引起了高度不同的生理反应,这与它们的功能特性而不是溶解度有关。第二,目前的证据集中在使用纤维作为IBS症状的单一疗法,而没有试图利用这些功能特性来引起特定的、针对症状的效果,或使用不同类型的膳食纤维作为辅助疗法。

 

纯膳食纤维类型(和麦麸)及其重叠的功能特性概述

因此,纤维疗法的个性化可以针对几个治疗目标,包括实现肠道习惯的正常化,调节肠道微生物群的功能,使之走向健康,并纠正其他饮食疗法的微生物效应。从这个角度来看,发酵程度较低的膨化纤维可以提供调节肠道习惯指数的效用;缓慢发酵的纤维可以增强肠道微生物群的活动;两种纤维的组合有可能提供两种益处,同时优化整个结肠不同区域的微生物群的活动

为此,研究人员提出了以下四点建议:1. 了解个别纤维的功能特点和随之而来的生理反应可以为我们提供一个框架,在此基础上可以对病人的治疗应用进行个性化设计;2. 没有任何一种纤维能涵盖全部的膨化、粘性和发酵作用,利用纤维组合可能具有附加值;3.与健康对照组相比,IBS患者的生理异质性反映在对纤维反应的异质性上,这可能掩盖了纤维的真正疗效;4.将生理反应作为调节IBS消化道症状的策略,可能是个性化纤维疗法的发展方向。

总之,了解消化道对特定纤维的反应,特别是与个人生理学有关的反应,将是未来个性化纤维疗法的方向,可以帮助加强对IBS患者的个性化管理

 

原始出处:

Daniel So et al. Dietary fibres and IBS: translating functional characteristics to clinical value in the era of personalised medicine. Gut (2021). 

 

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    2021-08-23 yulin2006
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style='color:#2F92EE;'>#膳食#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85904, encryptionId=224a85904ad, topicName=膳食)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Aug 23 10:39:43 CST 2021, time=2021-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010445, encodeId=36df1010445ef, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=435f5579553, createdName=ms7000001545202350, createdTime=Sun Aug 22 23:48:11 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010371, encodeId=a96d10103e186, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=42915385505, createdName=ms7000000902810585, createdTime=Sun Aug 22 19:48:08 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010215, encodeId=6b1e10102155a, content=学习一下~, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b7a31928393, createdName=学医无涯, createdTime=Sun Aug 22 07:55:29 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010214, encodeId=e8fb101021415, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210811/0c6eb4f5fee8448087495d56e0d2ae29/a6db9aa5bc1e46fca976ef34024b8bd1.jpg, createdBy=af7a5463863, createdName=鹅不吃草, createdTime=Sun Aug 22 07:51:22 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010212, encodeId=14a7101021200, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/02/21/921b54b93d63153615e73e4a2cd2bb1b.jpg, createdBy=d99c2144917, createdName=斐斐斐, createdTime=Sun Aug 22 07:33:28 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010156, encodeId=ab451010156d5, content=可, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d6345078026, createdName=145a8bebm75暂无昵称, createdTime=Sat Aug 21 21:59:39 CST 2021, time=2021-08-21, status=1, ipAttribution=)]
    2021-08-23 zhaojie88
  5. [GetPortalCommentsPageByObjectIdResponse(id=1700270, encodeId=bc661e002706a, content=<a href='/topic/show?id=ec08213328c' target=_blank style='color:#2F92EE;'>#个性化医疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21332, encryptionId=ec08213328c, topicName=个性化医疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16e930021335, createdName=w363522459, createdTime=Thu Jun 02 01:39:43 CST 2022, time=2022-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1993550, encodeId=13df19935501a, content=<a href='/topic/show?id=440a226e6c4' target=_blank style='color:#2F92EE;'>#临床价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22676, encryptionId=440a226e6c4, topicName=临床价值)], attachment=null, authenticateStatus=null, 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style='color:#2F92EE;'>#膳食#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85904, encryptionId=224a85904ad, topicName=膳食)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Aug 23 10:39:43 CST 2021, time=2021-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010445, encodeId=36df1010445ef, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=435f5579553, createdName=ms7000001545202350, createdTime=Sun Aug 22 23:48:11 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010371, encodeId=a96d10103e186, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=42915385505, createdName=ms7000000902810585, createdTime=Sun Aug 22 19:48:08 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010215, encodeId=6b1e10102155a, content=学习一下~, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b7a31928393, createdName=学医无涯, createdTime=Sun Aug 22 07:55:29 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010214, encodeId=e8fb101021415, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210811/0c6eb4f5fee8448087495d56e0d2ae29/a6db9aa5bc1e46fca976ef34024b8bd1.jpg, createdBy=af7a5463863, createdName=鹅不吃草, createdTime=Sun Aug 22 07:51:22 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010212, encodeId=14a7101021200, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/02/21/921b54b93d63153615e73e4a2cd2bb1b.jpg, createdBy=d99c2144917, createdName=斐斐斐, createdTime=Sun Aug 22 07:33:28 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010156, encodeId=ab451010156d5, content=可, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d6345078026, createdName=145a8bebm75暂无昵称, createdTime=Sat Aug 21 21:59:39 CST 2021, time=2021-08-21, status=1, ipAttribution=)]
    2021-08-22 ms7000001545202350

    学习了

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1700270, encodeId=bc661e002706a, content=<a href='/topic/show?id=ec08213328c' target=_blank style='color:#2F92EE;'>#个性化医疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21332, encryptionId=ec08213328c, topicName=个性化医疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16e930021335, createdName=w363522459, createdTime=Thu Jun 02 01:39:43 CST 2022, time=2022-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1993550, encodeId=13df19935501a, content=<a href='/topic/show?id=440a226e6c4' target=_blank style='color:#2F92EE;'>#临床价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22676, encryptionId=440a226e6c4, topicName=临床价值)], attachment=null, authenticateStatus=null, 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likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=42915385505, createdName=ms7000000902810585, createdTime=Sun Aug 22 19:48:08 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010215, encodeId=6b1e10102155a, content=学习一下~, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b7a31928393, createdName=学医无涯, createdTime=Sun Aug 22 07:55:29 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010214, encodeId=e8fb101021415, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210811/0c6eb4f5fee8448087495d56e0d2ae29/a6db9aa5bc1e46fca976ef34024b8bd1.jpg, createdBy=af7a5463863, createdName=鹅不吃草, createdTime=Sun Aug 22 07:51:22 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010212, encodeId=14a7101021200, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/02/21/921b54b93d63153615e73e4a2cd2bb1b.jpg, createdBy=d99c2144917, createdName=斐斐斐, createdTime=Sun Aug 22 07:33:28 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010156, encodeId=ab451010156d5, content=可, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d6345078026, createdName=145a8bebm75暂无昵称, createdTime=Sat Aug 21 21:59:39 CST 2021, time=2021-08-21, status=1, ipAttribution=)]
    2021-08-22 ms7000000902810585

    学习了

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1700270, encodeId=bc661e002706a, content=<a href='/topic/show?id=ec08213328c' target=_blank style='color:#2F92EE;'>#个性化医疗#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21332, encryptionId=ec08213328c, topicName=个性化医疗)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16e930021335, createdName=w363522459, createdTime=Thu Jun 02 01:39:43 CST 2022, time=2022-06-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1993550, encodeId=13df19935501a, content=<a href='/topic/show?id=440a226e6c4' target=_blank style='color:#2F92EE;'>#临床价值#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22676, encryptionId=440a226e6c4, topicName=临床价值)], attachment=null, authenticateStatus=null, 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style='color:#2F92EE;'>#膳食#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=85904, encryptionId=224a85904ad, topicName=膳食)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Mon Aug 23 10:39:43 CST 2021, time=2021-08-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010445, encodeId=36df1010445ef, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=95, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=435f5579553, createdName=ms7000001545202350, createdTime=Sun Aug 22 23:48:11 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010371, encodeId=a96d10103e186, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=42915385505, createdName=ms7000000902810585, createdTime=Sun Aug 22 19:48:08 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010215, encodeId=6b1e10102155a, content=学习一下~, beContent=null, objectType=article, channel=null, level=null, likeNumber=92, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b7a31928393, createdName=学医无涯, createdTime=Sun Aug 22 07:55:29 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010214, encodeId=e8fb101021415, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210811/0c6eb4f5fee8448087495d56e0d2ae29/a6db9aa5bc1e46fca976ef34024b8bd1.jpg, createdBy=af7a5463863, createdName=鹅不吃草, createdTime=Sun Aug 22 07:51:22 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010212, encodeId=14a7101021200, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/02/21/921b54b93d63153615e73e4a2cd2bb1b.jpg, createdBy=d99c2144917, createdName=斐斐斐, createdTime=Sun Aug 22 07:33:28 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010156, encodeId=ab451010156d5, content=可, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d6345078026, createdName=145a8bebm75暂无昵称, createdTime=Sat Aug 21 21:59:39 CST 2021, time=2021-08-21, status=1, ipAttribution=)]
    2021-08-22 学医无涯

    学习一下~

    0

  8. 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    2021-08-22 鹅不吃草

    学习了

    0

  9. 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createdAvatar=https://img.medsci.cn/20210811/0c6eb4f5fee8448087495d56e0d2ae29/a6db9aa5bc1e46fca976ef34024b8bd1.jpg, createdBy=af7a5463863, createdName=鹅不吃草, createdTime=Sun Aug 22 07:51:22 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010212, encodeId=14a7101021200, content=学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=97, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/02/21/921b54b93d63153615e73e4a2cd2bb1b.jpg, createdBy=d99c2144917, createdName=斐斐斐, createdTime=Sun Aug 22 07:33:28 CST 2021, time=2021-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1010156, encodeId=ab451010156d5, content=可, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, 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    2021-08-22 斐斐斐

    学习

    0

  10. 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    2021-08-21 145a8bebm75暂无昵称

    0

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