探索微生物相在精準醫療的潛力—以犬異位性皮膚炎為例

Abstract

精準醫療是一種將個體特徵納入治療規劃的個體化疾病預防、診斷和治療方式，期望透過準確辨識病因以規劃出最佳療程，達到改善健康狀態且降低醫療成本的目的。精準醫療經常透過精準營養領域與微生物相相互連結，將個體獨特的微生物群落組成、基因組和生活方式等因素綜合分析，協助個體維持最佳的健康狀態。異位性皮膚炎是一種慢性發炎性皮膚疾病，常見症狀有癢、紅腫、皮膚龜裂等，是常見的免疫疾病，影響全球約15-30%的兒童和10%的成人。研究指出腸道微生物相可能是引發異位性皮膚炎和影響疾病進程中的關鍵角色，針對腸道微生物相進行介入被認為是一種潛在的治療方式。本研究結果發現，在6個接受為期60天的益生菌治療的參與者中，有5個顯示出症狀改善，推測可歸因於腸道中益菌的增加，進而產生抗發炎的細胞激素和免疫細胞，同時降低了誘發發炎反應的免疫系統接收器靈敏度，和提升腸道屏障完整性。我們的研究結果支持了益生菌療法運用在治療異位性皮膚炎症狀的有效性，突顯了精準醫療和微生物相在異位性皮膚炎治療中的潛力，未來需要進一步的研究更深入瞭解微生物相與異位性皮膚炎之間複雜的相互作用，為更加精準和有效的治療方法鋪路。

Precision medicine is a medical approach that aims to personalize disease prevention, diagnosis, and treatment based on an individual's unique characteristics. Its objective is to enhance health outcomes and reduce healthcare costs by identifying and addressing the underlying causes of diseases, rather than merely addressing symptoms. Precision medicine and the microbiota are commonly linked through the emerging field of precision nutrition, which considers an individual's unique microbiota composition, genetic makeup, and lifestyle factors to optimize health outcomes. Atopic dermatitis is a chronic inflammatory skin disease that results in itchy, red, swollen, and cracked skin. It is a common condition that affects 15-30% of children and 10% of adults worldwide. Research has suggested that the gut microbiota may play a key role in the development and progression of atopic dermatitis, and that microbiota-targeted interventions may have potential for treating the condition. Canine atopic dermatitis has been found to be similar to human atopic dermatitis in several aspects, and the welfare of dogs is a rising concern. In our study, 5 out of 6 participants demonstrated improvement after receiving a 60-day probiotic treatment. This improvement can be attributed to the increase in beneficial bacteria in the intestine, leading to the production of anti-inflammatory cytokines and activation of immune cells. Additionally, the treatment resulted in the down-regulation of immune receptors and enhanced integrity of the gut barrier. Our findings support the effectiveness of microbiota-targeted treatments in alleviating atopic dermatitis symptoms in dogs. Overall, our study highlights the potential of precision medicine and microbiota-targeted interventions in managing atopic dermatitis. Further research is needed to deepen our understanding of the intricate interactions between the microbiota and atopic dermatitis, paving the way for more tailored and effective therapeutic approaches in the future.