The Impact of Oral Microecology on the Development of Inflammatory Bowel Disease

This article systematically reviews the associations and mechanisms between the oral microbiome and inflammatory bowel disease (IBD). Relevant literature was retrieved from the PubMed database from January 2000 to October 2025, and 77 articles meeting the criteria for inductive analysis were selected. The results confirm a bidirectional causal relationship between oral dysbiosis and IBD: patients with IBD exhibit reduced oral microbial diversity, increased abundance of pathogenic bacteria (such as Fusobacterium nucleatum and Porphyromonas gingivalis), and a more active oral immune environment. Oral pathogens can migrate to the gut via the oral-gut axis, directly disrupting the intestinal barrier and microbial homeostasis or activating systemic and intestinal immune responses through pathways such as miRNAs carried by exosomes and immune cell migration, thereby exacerbating IBD. However, current studies have several limitations, including small sample sizes, high heterogeneity in conclusions, lack of longitudinal data, and insufficient technical compatibility. Future research should expand investigations into the roles of oral fungi and viruses and integrate multiomics technologies to advance the clinical translation of oral microbiota in IBD diagnosis and treatment.

本文系统综述了口腔微生物组（oral microbiome）与炎症性肠病（inflammatory bowel disease, IBD）之间的关联及潜在作用机制。本文从PubMed数据库检索了2000年1月至2025年10月的相关文献，最终筛选出符合归纳分析标准的77篇文献。研究结果证实口腔菌群失调（oral dysbiosis）与IBD之间存在双向因果关联：IBD患者的口腔微生物多样性降低，致病菌（如具核梭杆菌（Fusobacterium nucleatum）与牙龈卟啉单胞菌（Porphyromonas gingivalis））丰度升高，且口腔免疫环境更为活跃。口腔致病菌可通过口肠轴（oral-gut axis）迁移至肠道，直接破坏肠屏障与微生物稳态，或通过外泌体（exosomes）携带的微小RNA（miRNA）、免疫细胞迁移等途径激活全身及肠道免疫应答，进而加重IBD病情。但当前相关研究仍存在若干局限，包括样本量较小、研究结论异质性较高、缺乏纵向数据以及技术兼容性不足等问题。未来研究应拓展对口腔真菌与病毒作用的探索，并整合多组学技术，以推动口腔微生物组在IBD诊疗中的临床转化应用。