2022 年第 8 期 第 17 卷

肺部微生态在特发性肺纤维化中的作用研究进展

Research progress on the role of pulmonary microecology in idiopathic pulmonary fibrosis

作者：魏珊辰王立娜时铭蔚李君孙春萍刘新民林连君

英文作者：Wei Shanchen Wang Lina Shi Mingwei Li Jun Sun Chunping Liu Xinmin Lin Lianjun

单位：北京大学第一医院老年科，北京100034

英文单位：Department of Geriatrics Peking University First Hospital Beijing 100034 China

关键词：特发性肺纤维化；肺部微生态；靶向抗菌治疗

英文关键词：Idiopathicpulmonaryfibrosis;Lungmicrobiota;Targetedantibacterialtherapy

• 摘要：

• 特发性肺纤维化（IPF）是一种原因不明的进行性和致命性间质性肺疾病。随着分子生物测序技术的发展和肺部微生态的研究，文献发现在IPF患者的肺泡灌洗样品中细菌负荷增加，与健康受试者相比，嗜血杆菌属、奈瑟菌属、链球菌属和韦荣球菌属丰度更高。研究表明肺部微生态失调可通过释放外膜囊泡，将抗原呈递给巨噬细胞，激活Toll样受体-Myd88-白细胞介素17B固有免疫通路来促进肺纤维化。本文总结肺部微生态在IPF中的作用，旨在为IPF靶向抗菌治疗和寻找免疫治疗靶点提供思路。

• Idiopathic pulmonary fibrosis (IPF) is a progressive and fatal interstitial lung disease of unknown cause. With the development of sequencing techniques in molecular biology and research of the pulmonary microecology, studies have found that the bacterial load increases in the alveolar lavage samples of IPF patients. Haemophilus, Neisseria, Streptococcus and Veillonella spp. are more abundant compared with the healthy control group. Recent studies have proved that dysregulated pulmonary microecology can promote pulmonary fibrosis by releasing outer membrane vesicles, presenting antigens to macrophages and activating the Toll-like receptor-Myd88-IL-17B innate immune pathway. This paper reviews the role of pulmonary microecology in IPF, so as to provide ideas for targeted antibacterial therapy and searching for immunotherapy targets in IPF patients.