基于肠道菌群-脑-肌轴探讨炎症性肠病与老年肌少症的共病机制及治疗策略

doi:10.3969/j.issn.1003-9198.2026.06.017

Abstract

Abstract: Inflammatory bowel disease (IBD) and sarcopenia are two common diseases that seriously affect the quality of life of elderly patients. Recent studies have shown that there is a close connection between the two diseases in terms of pathological mechanisms. The gut microbiota-brain-muscle axis, as an important regulatory pathway connecting the intestinal microecology, nervous system, and muscle function, provides a new perspective for revealing the comorbidity mechanism of IBD and sarcopenia. This article systematically reviews how gut microbiota dysbiosis affects brain function and muscle metabolism through neuroimmune regulation, thereby promoting the occurrence and development of these two diseases. It focuses on key links such as inflammatory responses, neuroendocrine regulation, and metabolic abnormalities. Combining the latest basic and clinical research results, it explores potential therapeutic targets and intervention strategies, providing theoretical basis and direction guidance for future research and clinical treatment.

Key words: gut microbiota-brain-muscle axis, inflammatory bowel disease, sarcopenia, neuroimmune regulation, microecological imbalance

CLC Number:

R 574
R 68

WANG Wanhong, SUN Wenyu, ZHANG Yu, QIU Zhengang, LI Changhao, ZHANG Xin. Exploring the comorbidity mechanism and treatment strategies of inflammatory bowel disease and sarcopenia in the elderly based on the gut microbiota-brain-muscle axis[J]. Practical Geriatrics, 2026, 40(6): 630-634.

References

[1] KOHLI I, THIND N, BHALLA A, et al. Sarcopenia is associated with worse outcomes in patients with inflammatory bowel disease: insights from US national hospitalization data[J]. Eur J Gastroenterol Hepatol, 2025, 37(1): 55-61.
[2] YUE C, XUE H. Identification and immune landscape of sarcopenia-related molecular clusters in inflammatory bowel disease by machine learning and integrated bioinformatics[J]. Sci Rep, 2024, 14(1): 17603.
[3] BERMUDEZ H, FAYE A S, KOCHAR B. Managing the older adult with inflammatory bowel disease: is age just a number? [J]. Curr Opin Gastroenterol, 2023, 39(4): 268-273.
[4] FENG X, JIA M, CAI M, et al. Central-peripheral neuroimmune dynamics in psychological stress and depression: insights from current research[J]. Mol Psychiatry, 2025, 30(10): 4881-4898.
[5] SHEN Y, FAN N, MA S X, et al. Gut microbiota dysbiosis: pathogenesis, diseases, prevention, and therapy[J]. MedComm, 2025, 6(5): e70168.
[6] YU S, SUN Y, SHAO X, et al. Leaky gut in IBD: intestinal barrier-gut microbiota interaction[J]. J Microbiol Biotechnol, 2022, 32(7): 825-834.
[7] PANDEY H, JAIN D, TANG D W T, et al. Gut microbiota in pathophysiology, diagnosis, and therapeutics of inflammatory bowel disease[J]. Intest Res, 2024, 22(1): 15-43.
[8] DANNE C, SKERNISKYTE J, MARTEYN B, et al. Neutrophils: from IBD to the gut microbiota[J]. Nat Rev Gastroenterol Hepatol, 2024, 21(3): 184-197.
[9] REN P, YUE H, TANG Q, et al. Astaxanthin slows down skeletal muscle atrophy in H22 tumor-bearing mice during sorafenib treatment by modulating the gut microbiota[J]. Food Funct, 2024, 15(2): 543-558.
[10] KUDELKA M R, STOWELL S R, CUMMINGS R D, et al. Intestinal epithelial glycosylation in homeostasis and gut microbiota interactions in IBD[J]. Nat Rev Gastroenterol Hepatol, 2020, 17(10): 597-617.
[11] LEMOS M P C, ZUCOLOTO T G, OLIVEIRA M C, et al. Dysbiosis and gut microbiota modulation in systemic sclerosis[J]. J Clin Rheumatol, 2022, 28(2): e568-e573.
[12] CHENG Y, LIU X, HAO Y, et al. Selenium-mediated alleviation of skeletal muscle atrophy through enterotype modulation in mice[J]. Food Funct, 2024, 15(23): 11619-11629.
[13] ZHOU Y, ZHANG F, MAO L, et al. Bifico relieves irritable bowel syndrome by regulating gut microbiota dysbiosis and inflammatory cytokines[J]. Eur J Nutr, 2023, 62(1): 139-155.
[14] GAO S, ZHAO X, LENG Y, et al. Dietary supplementation with inulin improves burn-induced skeletal muscle atrophy by regulating gut microbiota disorders[J]. Sci Rep, 2024, 14(1): 2328.
[15] EFREMOVA I, MASLENNIKOV R, KUDRYAVTSEVA A, et al. Gut microbiota and cytokine profile in cirrhosis[J]. J Clin Transl Hepatol, 2024, 12(8): 689-700.
[16] AKASH M S H, FIAYYAZ F, REHMAN K, et al. Gut microbiota and metabolic disorders: advances in therapeutic interventions[J]. Crit Rev Immunol, 2019, 39(4): 223-237.
[17] ZHAO C, HU X, QIU M, et al. Sialic acid exacerbates gut dysbiosis-associated mastitis through the microbiota-gut-mammary axis by fueling gut microbiota disruption[J]. Microbiome, 2023, 11(1): 78.
[18] WANG M, REN F, ZHOU Y, et al. Age-related sarcopenia and altered gut microbiota: a systematic review[J]. Microb Pathog, 2024, 195: 106850.
[19] RÜB A M, TSAKMAKLIS A, GRÄFE S K, et al. Biomarkers of human gut microbiota diversity and dysbiosis[J]. Biomark Med, 2021, 15(2):137-148.
[20] CHEN L, CHEN Y, CHEN W, et al. Gut microbiota in primary sarcopenia: mechanisms and potential therapeutic targets[J]. Front Biosci, 2025, 30(6): 36204.
[21] QIU Y, YU J, LI Y, et al. Depletion of gut microbiota induces skeletal muscle atrophy by FXR-FGF15/19 signalling[J]. Ann Med, 2021, 53(1): 508-522.
[22] KAMIOKA M, GOTO Y, NAKAMURA K, et al. Intestinal commensal microbiota and cytokines regulate Fut2⁺ Paneth cells for gut defense[J]. Proc Natl Acad Sci USA, 2022, 119(3): e2115230119.
[23] CHEN H, REN Y, YU J, et al. Crosstalk between the m6A modification and the gut microbiota in lipid metabolism[J]. Microbiol Res, 2026, 302: 128356.
[24] STAKENBORG N, BOECKXSTAENS G E. Bioelectronics in the brain-gut axis: focus on inflammatory bowel disease (IBD)[J]. Int Immunol, 2021, 33(6): 337-348.
[25] YI J, CHEN J, YAO X, et al. Myokine-mediated muscle-organ interactions: molecular mechanisms and clinical significance[J]. Biochem Pharmacol, 2025, 242(Pt 2): 117326.
[26] SAPONARO F, BERTOLINI A, BARAGATTI R, et al. Myokines and microbiota: new perspectives in the endocrine muscle-gut axis[J]. Nutrients, 2024, 16(23): 4032.
[27] YANG S, TIAN M, DAI Y, et al. Infection and chronic disease activate a systemic brain-muscle signaling axis[J]. Sci Immunol, 2024, 9(97): eadm7908.
[28] ZHOU L, WU Q, JIANG L, et al. Role of the microbiota in inflammation-related related psychiatric disorders[J]. Front Immunol, 2025, 16: 1613027.
[29] YAN C, YAO Y, ZHANG Z, et al. Gut microbiota-mediated betaine regulates skeletal muscle fiber type transition by affecting m⁶A RNA methylation and Myh7 expression[J]. Gut Microbes, 2025, 17(1): 2545434.
[30] FANG J, YAN W, SUN X, et al. The role of exercise-induced short-chain fatty acids in the gut-muscle axis: implications for sarcopenia prevention and therapy[J]. Front Microbiol, 2025, 16: 1665551.
[31] CUTULI D, DECANDIA D, GIACOVAZZO G, et al. Physical exercise as disease-modifying alternative against Alzheimer's disease: a gut-muscle-brain partnership[J]. Int J Mol Sci, 2023, 24(19): 14686.
[32] 高鑫,张培珍. 运动角度:肠道菌群对机体的益处及其机制[J]. 中南大学学报(医学版),2024, 49(4): 508-515.
[33] AZZOLINO D, CARNEVALE-SCHIANCA M, BOTTALICO L, et al. The oral-gut microbiota axis as a mediator of frailty and sarcopenia[J]. Nutrients, 2025, 17(15): 2408.
[34] AL-REFAI W, KEENAN S, CAMERA D M, et al. The influence of vegan, vegetarian, and omnivorous diets on protein metabolism: a role for the gut-muscle axis?[J]. Nutrients, 2025, 17(7): 1142.
[35] SADEGHI F, MOCKLER D, GUINAN E M, et al. The effectiveness of nutrition interventions combined with exercise in upper gastrointestinal cancers: a systematic review[J]. Nutrients, 2021, 13(8): 2842.
[36] CHRISTOPHER C N, KANG D W, WILSON R L, et al. Exercise and nutrition interventions for prehabilitation in hepato-pancreato-biliary cancers: a narrative review[J]. Nutrients, 2023, 15(24): 5044.

Exploring the comorbidity mechanism and treatment strategies of inflammatory bowel disease and sarcopenia in the elderly based on the gut microbiota-brain-muscle axis

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