Akkermansia muciniphila (AKK) is a key commensal bacterium colonizing the intestinal mucus layer, playing a crucial role in maintaining intestinal barrier integrity, regulating immune homeostasis and participating in metabolic control. Recent studies indicate that the abundance of AKK is significantly reduced in the intestines of patients with inflammatory bowel disease (IBD), with its dynamic changes closely correlated with disease activity. Animal experiments demonstrate that supplementing this bacterium or its functional proteins can alleviate intestinal inflammation by regulating the “intestinal barrier-immune inflammation-metabolism” triple pathway. However, under specific pathological conditions, AKK may also exacerbate barrier damage by excessively degrading the mucus layer, suggesting that they exhibit significant context-dependent bidirectional regulatory characteristics. Traditional Chinese medicine (TCM) and its active components can bidirectionally regulate the abundance and function of AKK through multiple pathways, including the direct supply of nutritional substrates, promotion of mucus secretion, remodeling of the microbial community structure and regulation of metabolic interactions, thereby maintaining the homeostasis of the gut microbiome and exerting an anti-IBD effect. This article systematically reviews the dual mechanisms of action of AKK in IBD and their roles in intestinal barrier repair, immune regulation and metabolic remodeling. It focuses on summarizing research progress of TCM in improving IBD by targeting the AKK-mediated “microbiota-barrier-immunity” axis, with the aim of providing a theoretical basis and research directions for TCM microbiota intervention strategies based on the regulation of key bacteria.

Akkermansia muciniphila  /  inflammatory bowel disease  /  ulcerative colitis  /  traditional Chinese medicine  /  gut microbiota