实用医学杂志 ›› 2026, Vol. 42 ›› Issue (17): 3074-3082.doi: 10.3969/j.issn.1006-5725.2026.17.005

• 慢性病防治专栏 • 上一篇    下一篇

基于肠-脑轴探讨肠道菌群干预小胶质细胞在艾滋病相关神经认知障碍中的机制研究与干预策略

李炫颖1,2, 王丹妮1,2,3(), 贾光宗1,2, 彭成林1,2, 苏鋆梦童1,2, 郭会军1,3, 刘真1,3   

  1. 1. 河南中医药大学第一附属医院艾滋病临床研究中心 (河南 郑州 450000 )
    2. 河南中医药大学第一临床医学院 (河南 郑州 450046 )
    3. 河南省病毒性疾病中医药防治重点实验室 (河南 郑州 450000 )
  • 收稿日期:2026-06-08 出版日期:2026-09-10 发布日期:2026-10-10
  • 通讯作者: 王丹妮
  • 基金资助:
    国家自然科学基金项目(U1904153); 国家自然科学基金项目(82274474); 河南省科技研发计划联合基金(学科类)项目(252301420098); 河南省科技攻关项目(262102310488); 河南省卫生健康中青年学科带头人培养项目(豫人才[2024]3号); 河南省第三批中医药学科拔尖人才培养项目(豫卫中医药科教函[2025]14号); 河南省卫生健康委员会国家中医药传承创新中心联合共建科研专项(2024ZXZX1097); 仲景三名人才工程仲景名医项目(河中医政[2025]116号)

Mechanistic research and intervention strategies on gut microbiota modulating microglia via the gut-brain axis in hiv-associated neurocognitive disorders

Xuanying Li1,2, Danni Wang1,2,3(), Guangzong Jia1,2, Chenglin Peng1,2, Yunmengtong Su1,2, Huijun Guo1,3, Zhen Liu1,3   

  1. 1. AIDS Clinical Research Center of the First Affiliated Hospital of Henan University of Traditional Chinese Medicine,Zhengzhou 450000,Henan,China
    2. The First Clinical Medical College,Henan University of Traditional Chinese Medicine,Zhengzhou 450046,Henan,China
    3. Key Laboratory of Traditional Chinese Medicine for the Prevention and Control of Viral Diseases in Henan Province,Zhengzhou 450000,Henan,China
  • Received:2026-06-08 Online:2026-09-10 Published:2026-10-10
  • Contact: Danni Wang
  • About author:

    Li Xuanying consulted relevant referencesand wrote the article. Jia Guangzong, Peng Chenglin and Su Yunmengtong revisedthe article. Wang Danni, Guo Huijun and Liu Zhen gave the guidance and reviewed the article. All authors read and approved the final manuscript as submitted.

摘要:

艾滋病相关神经认知功能障碍是人类免疫缺陷病毒感染者常见的慢性神经系统并发症,以认知功能受损为临床特征,严重影响患者的生活质量与治疗依从性。近年来,研究发现小胶质细胞在HAND的神经炎症和神经元损伤过程中扮演着关键角色。肠道菌群通过“肠-脑”轴对中枢神经系统稳态的调节作用机制研究日益受到重视。本文系统综述了肠道微生物如何通过介导肠-脑对话调控小胶质细胞的代谢与功能极化,进而影响HAND发生发展的相关机制;并总结归纳了当前肠-脑轴视角下HAND的干预策略,以期为HAND的机制研究和临床防治提供新思路。

关键词: 肠道菌群, 小胶质细胞, 艾滋病相关神经认知障碍, 神经炎症

Abstract:

HIV-associated neurocognitive disorder (HAND) is a prevalent chronic neurological complication among people living with human immunodeficiency virus (HIV), clinically characterized by cognitive impairment that significantly reduces patients' quality of life and compromises antiretroviral treatment adherence. In recent decades, accumulating evidence has confirmed that microglia are core mediators of neuroinflammation and neuronal injury in the pathogenesis of HAND. Concurrently, research on the regulatory role of gut microbiota in central nervous system homeostasis via the gut-brain axis has attracted growing scholarly attention. This systematic review elaborates on the mechanisms by which gut microbiota modulate the metabolism and functional polarization of microglia by mediating gut-brain crosstalk, thereby influencing the onset and progression of HAND. It also summarizes existing HAND intervention strategies from the gut-brain axis perspective, aiming to provide novel insights for the mechanistic investigation and clinical prevention and treatment of HAND.

Key words: gut microbiota, microglial cells, HIV-associated neurocognitive disorder, neuroinflammation

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