Darmmikrobiom des Menschen: Status quo und Perspektiven

Der Mensch besteht aus körpereigenen Zellen und Billionen von Mikroorganismen, die alle seine Körperoberflächen kolonisieren. Der Darm beherbergt das dichteste dieser mikrobiellen Ökosysteme, die sog. Darmmikrobiota. Die Identifizierung, Isolation und Charakterisierung physiologisch relevanter Bakterienstämme unseres Darmmikrobioms ist eine Voraussetzung für die weitere Entwicklung und Implementierung erfolgreicher mikrobieller Therapiestrategien.

Kernaussagen

• Das intestinale Ökosystem beherbergt Viren, Bakterien und eukaryotische Mikroorganismen.

• Darmbakterien übernehmen wichtige Funktionen für ihren Wirt (z. B. die Vermeidung von Darminfektionen durch Pathogene und die Stimulation des Immunsystems).

• Molekularmethoden erlauben einen schnellen und umfangreichen Überblick über die Diversität und Zusammensetzung eines Mikrobioms zu gewinnen, sie bleiben jedoch in den meisten Fällen beschreibend.

• Die Kultivierung von Darmmikroorganismen ermöglicht die Nutzung der isolierten Stämmen zur Aufklärung von Mikroben-Wirt-Interaktionen, viele Darmbakterien sind jedoch nur schwer zu kultivieren.

• Die Erstkolonisierung des Menschen erfolgt bei der Geburt. Die frühkindliche intestinale Mikrobiota ist sehr empfindlich gegenüber Umwelteinflüssen und die Ernährung ist ein zentraler Einflussfaktor in der Entwicklung des frühkindlichen intestinalen Ökosystems.

• Die Darmmikrobiota eines erwachsenen Menschen ist in ihrer Gesamtheit relativ stabil, kann jedoch durch wiederholte Störfaktoren und erhebliche Veränderungen im Lebensstil dauerhaft Veränderungen aufweisen.

• Es existiert keine einheitliche „gesunde“ Standardmikrobiota. Viele metabolische und immunologische Erkrankungen sind mit Veränderungen in der Zusammensetzung und Funktion des intestinalen Ökosystems assoziiert.

• Die pathophysiologische Relevanz der beobachteten krankheitsassoziierten Veränderungen ist meist unbekannt.

• Bei FMT wird das gesamte fäkale Ökosystem eines Spenders auf den Empfänger übertragen. FMT weist bei der Infektion mit C. difficile eine hervorragende Wirksamkeit auf, bei anderen Erkrankungen ist die Datenlage unklar.

• Die Entwicklung effektiver und risikoarmer mikrobieller Therapien ist von der erfolgreichen Identifizierung und Kultivierung protektiver Mikroorganismen abhängig.

Schlüsselwörter

intestinales Mikrobiom - intestinale Mikrobiota - Darmbakterien - Mikroben-Wirt-Interaktion - Ernährung - mikrobielle Therapien

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