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Le microbiote intestinal : un organe à part entière

Ce nouvel ouvrage collectif, coordonné par Joël Doré (Inra) et Philippe Marteau (Hôpital Saint-Antoine) propose un état des connaissances actuelles sur le microbiote intestinal. Ce livre apporte une base à la fois simple et solide au médecin moderne, quels qu’en soient l’exercice et la spécialité, pour comprendre le fragile équilibre de la symbiose microbiote-hôte et les répercussions que cette perspective ouvre dans la prise en charge des patients

Mis à jour le 11/04/2017
Publié le 10/04/2017

Comprendre cet écosystème pour bientôt le moduler : découvrez la révolution profonde qui est à l'oeuvre dans le champ de la microbiologie 

En quelques années, les connaissances sur le microbiote intestinal ont fait des progrès considérables non seulement dans sa description que permettent désormais de nombreux outils moléculaires mais aussi sur ses fonctions physiologiques. Le nombre de maladies qu’il peut moduler est beaucoup plus large qu’on ne l’imaginait jusqu’ici et les dysbioses intestinales sont désormais présentées au grand public dans des best-sellers, magazines, émissions ou sites Internet. Les expériences de transfert de phénotype, et notamment de maladies non infectieuses par le transfert de microbiote d’un animal à l’autre, ont ouvert des voies de recherche tout à fait inattendues dans les domaines de maladies intestinales, syndrome métabolique, obésité, mais aussi désordres psychologiques, hépatiques et cutanés. Les médecins dans leur formation doivent désormais tous acquérir ces concepts et résultats pour comprendre pourquoi des perturbations écologiques peuvent servir de bio-indicateurs de maladies (comme les abeilles nous aident à suivre des modifications d’environnement). Ils doivent aussi intégrer à leurs pratiques les modulations du microbiote intestinal pour en favoriser un bon développement (période néonatale) et en protéger l’équilibre et les fonctions (contrôle de l’antibiothérapie, soutien des phénomènes de résilience écologique, etc.).

Tout ce qui peut donc moduler le microbiote prend une beaucoup plus large envergure, et ce sont désormais des raisonnements fondés sur des lois écologiques que le thérapeute doit apprendre à maîtriser (résistance, résilience, biodiversité, richesse microbienne, pressions écologiques, etc.) pour mieux utiliser certains médicaments, dont des probiotiques à effets démontrés dans des essais en double aveugle et les nouvelles biothérapeutiques qui se profilent, basées sur l’utilisation de bactéries commensales. La transplantation fécale est apparue comme un moyen validé dans les recommandations internationales (certes extrême et qui doit le rester) de traitement de formes récidivantes d’infections à Clostridium difficile.

L’objet de cet ouvrage a été, tout au long de sa rédaction, de demander à des experts de partager avec le thérapeute généraliste ou spécialiste toute cette science en mouvement qui alimente en continu les meilleurs journaux scientifiques tels que Science, Nature, Cell, mais aussi médicaux (Lancet, Gastroenterology, Cancer, etc.). Les termes nouveaux peuvent sembler ardus au premier abord mais nous avons tenté de les rendre abordables et d’utiliser de nombreux schémas pour illustrer. Nous espérons donc que ce livre apporte une base à la fois simple et solide au médecin moderne, quels qu’en soient l’exercice et la spécialité, et sommes persuadés qu’elle sera utile à tous.

Philippe Marteau & Joël Doré

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Contact :
Joël DORÉ
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Alimentation humaine
Centre(s) associé(s) :
Jouy-en-Josas, Auvergne - Rhône-Alpes

Coordonnateurs

Philippe MARTEAU

Sorbonne Universités, UPMC Paris IV ; INSERM-ERL 1157, CHU Saint-Antoine 27, Paris ; UMR 7203, Paris ;
Services d'hépatologie, de gastro-entérologie et nutrition, AP-HP, Hôpital Saint-Antoine, Paris

Joël DORÉ

Directeur de recherche, directeur scientifique de l'Unité de service MetaGenoPolis, INRA, Jouy en Josas

Liste complète des auteurs

Lire aussi