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摘要: 肠易激综合征(irritable bowel syndrome，IBS) 是一种常见的肠道功能紊乱性疾病，以持续或间歇性腹痛及排便习惯改变为主要临床表现，常伴有焦虑、抑郁等精神症状，严重影响患者生活质量。目前，IBS的病因及发病机制尚不明确，现有研究表明IBS是由内脏感觉异常、肠道感染与炎症反应、肠道菌群失调、社会心理等多种因素共同作用的结果。近期研究表明IBS患者中存在肠道菌群-犬尿氨酸(kynurenine, KYN)代谢紊乱，且KYN代谢产物犬尿喹啉酸(kynurenic acid，KA)与炎症反应、疼痛刺激及心理症状相关，在IBS中可能起到抗炎、缓解疼痛等保护性作用，有望成为诊断和治疗IBS的新方法。本文就KYN代谢途径及其代谢产物KA在IBS中的作用机制作一综述，以期为临床相关专业人员提供参考和借鉴。Abstract: Irritable bowel syndrome (IBS) is a common digestive psychosomatic diseases, mainly manifested as recurrent abdominal pain and abnormal bowel movements. The intestinal dysfunction is often comorbidized with anxiety, depression and other emotional problems, resulting in increased intestinal burden and even a decrease in the quality of life. The etiology and pathogenesis of IBS are unclear, but it is currently believed that IBS involves abnormal gut-brain interaction caused by a combination of various factors, including visceral hypersensitivity, intestinal immune activation, intestinal infection, intestinal dysbacteriosis, and psychosocial stress. Recent studies have observed the disorders of gut microbiota-regulated kynurinaine metabolism in IBS patients, and found that the metabolite kynurenic acid (KA) has important correlations with inflammatory responses, pain stimuli and mood changes. KA may play a protective role in IBS such as anti-inflammatory and pain relief and thus has the potential to become a new approach for the diagnosis and treatment of IBS. In this work, studies related to KA and IBS are reviewed.作者贡献：陆锦南负责文献检索及论文撰写；赵春华、闵寒负责论文写作指导及修订。利益冲突：所有作者均声明不存在利益冲突
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图 1 KA调节IBS的潜在作用机制
TPH：色氨酸羟化酶；5-HT：5-羟色胺；IDO：吲哚胺2，3-双加氧酶；TLR：Toll样受体；LPS：脂多糖；SCFAs：短链脂肪酸；H2O2：过氧化氢；AA：邻氨基苯甲酸；QA：喹啉酸；KYN：犬尿氨酸；KMO：犬尿氨酸-3-单加氧酶；KAT：犬尿氨酸转氨酶；KA：犬尿喹啉酸；NMDAR：N-甲基-D-天门冬氨酸受体；IL：白细胞介素；HNP1-3：人中性粒细胞防御素1-3；TNF-α：肿瘤坏死因子-α；AMPAR：α-氨基-3-羟基-5-甲基-4-异恶唑丙酸受体；α7-nAChR：α7-烟碱型乙酰胆碱受体；IBS：肠易激综合征
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