The dissemination, health risks, and mitigation approaches of antibiotic resistance genes in the gut microbiome

Antibiotic resistance has become an important public health issue that harms human health. Antibiotic resistance genes (ARGs) are not only widely distributed in the environment, but also in the human and animal intestines. ARGs in the environment can enter the body through the water cycle, food chain, and air flow. ARGs can further spread through horizontal and vertical transfer within the body, and then enter the environment with feces, constituting an ecological cycle with the external environment. ARGs persistently spread along this cycle, causing health hazards, such as a variety of intestinal and extraintestinal diseases. Located atop the food chain, humans will accumulate large ARGs and further spread them within their bodies. The spread of these ARGs will be affected by exogenous and endogenous factors, and will also interact with our bodies to promote the occurrence of these diseases (intestinal infection, IBD, cirrhosis and type 2 diabetes, among other diseases). Here, we evaluated the control effects of diet, fecal microbiota transplantation, probiotics, prebiotics, antimicrobial peptides, and bio-related therapies, and CRISPR technology on the spread of ARGs. This review systematically explores the dissemination, health risks, and potential mitigation strategies of ARGs in the gut microbiome, filling a knowledge gap in understanding how to prevent and control ARGs, which is crucial for addressing the global public health threat of antibiotic resistance.