Zusammenfassung
Der menschliche Körper wird von einer Vielzahl von Mikroorganismen besiedelt, die zusammen das humane Mikrobiom bilden. Das Darmmikrobiom macht hiervon den größten Anteil aus. Es stellt eine wichtige Barriere gegen die Ansiedlung von pathogenen Erregern dar, übernimmt wichtige Stoffwechselfunktionen und wirkt regulativ auf das Immunsystem ein. Das macht es essenziell für die Erhaltung der Gesundheit. Die wichtigsten Determinanten der Mikrobiomzusammensetzung in der Allgemeinbevölkerung sind exokrine Pankreasfunktion, Genetik, Ernährung, Alter, Geschlecht und Adipositas. Darüber hinaus werden Veränderungen des Darmmikrobioms mit einer Vielzahl verschiedener, nicht nur gastrointestinaler, Erkrankungen in Verbindung gebracht. Typische Mikrobiomveränderungen beim Kranken sind beispielsweise ein Verlust mikrobieller Diversität und gesundheitsförderlicher Bakterien oder eine Zunahme potenziell pathogener Erreger. Dies kann zu einem proinflammatorischen und instabilen Mikrobiom führen. Der Wissensstand rund um das Thema Mikrobiom nimmt mit rasanter Geschwindigkeit zu, und auf eine Modulation des Mikrobioms zielende Therapien haben inzwischen in unterschiedlichsten Indikationen ihren Weg in die Praxis gefunden. Grundkenntnisse über das Darmmikrobiom sind daher für alle Behandelnden essenziell, um in diesem sich schnell entwickelnden Feld die Übersicht zu behalten und Patientinnen und Patienten adäquat beraten zu können.
Abstract
The human body is colonized by a multitude of different microbes that are collectively referred to as the human microbiome. Gut microbes account for the largest proportion of these. They constitute a barrier against foreign pathogens, carry out important metabolic functions and regulate the immune system, thereby making them essential for the maintenance of health. The most important determinants of the gut microbiome structure in the general population include exocrine pancreatic function, genetics, nutrition, age, sex, and obesity. Changes in the gut microbiome have also been linked to a variety of diseases not limited to gastrointestinal disorders. Typical microbiome changes in disease include a loss of diversity and beneficial bacteria or an increase in opportunistic pathogens. This may result in a proinflammatory and unstable microbiome. Knowledge about the microbiome is rapidly increasing and microbiome modulation therapies have already been implemented in clinical practice. Therefore, basic knowledge about the microbiome is essential for all medical professionals in order for them to advise and treat their patients properly.
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Fabian Frost, Greifswald
Markus M. Lerch, München
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Frost, F. Einführung in das Mikrobiom. Innere Medizin 63, 1015–1021 (2022). https://doi.org/10.1007/s00108-022-01395-9
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DOI: https://doi.org/10.1007/s00108-022-01395-9