ObjectiveTo explore the composition of intestinal microbiota between patients with fixed airflow obstruction asthma, reversible airflow obstruction asthma, and healthy control, and analyze the correlation between key differential bacterial distribution and clinical characteristics. MethodsFifteen patients with fixed airflow obstruction asthma (FAO) and 13 patients with reversible airflow obstruction asthma (RAO) were included, along with 11 matched healthy control subjects. Clinical data were collected, and lung function tests and induced sputum examination were performed. Blood and stool samples were tested to compare the gut microbiota status among the groups, and analyze the relationship between gut microbiota abundance and patients' blood routine, IgE levels, lung function, and induced sputum. Results The dominant bacterial compositions were similar in the three groups, but there were differences in the abundance of some species. Compared to the RAO group, the FAO group showed a significant increase in the genera of Bacteroides and Escherichia coli, while Pseudomonas was significantly decreased. The phylum Firmicutes was negatively correlated with the course of asthma, while the phylum Bacteroidetes and genus Bacteroides were positively correlated with the asthma course. Bacteroidetes was negatively correlated with Pre-BD FEV1/FVC, Pseudomonas was positively correlated with Pre-BD FEV1, Escherichia coli was negatively correlated with Post-BD FEV1/FVC, and Bacteroides was negatively correlated with Post-BD MMEF. The class Actinobacteria and the order Actinomycetales were negatively correlated with peripheral blood EOS%, while the order Enterobacteriales and the family Enterobacteriaceae were positively correlated with peripheral blood IgE levels. Furthermore, Actinobacteria and Actinomycetales were negatively correlated with induced sputum EOS%. Conclusions There are differences in the gut microbiota among patients with fixed airflow obstruction asthma, reversible airflow obstruction asthma, and healthy individuals. Bacteroides and Escherichia coli are enriched in the fixed airflow obstruction asthma group, while the Firmicutes are increased in the reversible airflow obstruction asthma group. These three microbiota may act together on Th2 cell-mediated inflammatory responses, influencing the process of airway remodeling, and thereby interfering with the occurrence of fixed airflow obstruction in asthma.
【摘要】 目的 探讨强化益生元膳食纤维的肠内营养在腹部外科术后患者中的临床应用。 方法 2008年7月-2010年11月30例接受腹部外科中等以上手术的患者术前随机分为研究组和对照组，每组15例。研究组患者于术后接受肠内营养，并予以强化益生元膳食纤维；对照组只接受相同的肠内营养支持。观察指标为术后感染并发症、胃肠道并发症、住院时间、抗生素治疗时间、C反应蛋白水平和病死率等。 结果 研究组术后住院时间为（10±5） d，对照组为（15±7） d，两组差异有统计学意义（t=2.251，P=0.033）；研究组C反应蛋白水平为（6.6±3.2） mg/L，对照组为（9.8±2.1） mg/L，两组差异有统计学意义（t=3.238，P=0.003）；研究组抗生素治疗时间为（5.0±3.5） d，对照组为（6.0±4.8） d，两组差异无统计学意义（t=0.652，P=0.520）。两组均无死亡病例；术后研究组2例发生感染并发症，对照组3例，两组感染并发症发生率差异无统计学意义（P=1.000）。两组患者均能耐受经肠内补充营养素。 结论 与常规肠内营养比较，给予强化益生元膳食纤维的肠内营养能减少腹部外科术后患者的住院时间，降低急性期炎症反应。【Abstract】 Objective To investigate the effect of early enteral supply of prebiotic fiber in patients undergoing major abdominal surgery. Methods Between July 2008 and November 2010, 30 patients undergoing major gastrointestinal surgery were randomized into the study group and the control group before operation with 15 patients in each group. Prebiotic fiber was administered combined with enteral nutrition support for patients in the study group. Patients in the control group only received conventional enteral nutrition without fiber. The main endpoints included the development of bacterial infection, the duration of hospital stay, antibiotic therapy, the serum level of C-reaction protein (CRP), side effects of the enteral nutrition and morbidity. Results Compared with the control group, the median duration of hospital stay was shorter in the study group [(15±7) days in the control group vs. (10±5) days in the study group; t=2.251, Plt;0.05]. The mean level of CRP was also lower in the study group [(6.6±3.2) mg/L] than that in the control group [(9.8±2.1) mg/L] (t=3.238, Plt;0.05). The enteral nutrition and fibers were well tolerated. The incidence of infectious complications (3 cases in the control group vs. 2 cases in the study group) and the median duration of antibiotic therapy [(6.0±4.8) days in the control group vs. (5.0±3.5) days in the study group] were not significantly different between the two groups (t=0.652, Pgt;0.05). No patients died in both the two groups. Conclusion Compared with the conventional enteral nutrition, early enteral supply of prebiotic fiber can reduce the duration of hospital stay and acute phase response.
ObjectiveTo explore the influence of enhanced recovery after surgery (ERAS) on intestinal flora in patients with colorectal cancer.MethodsBy convenient sampling method, 60 patients with colorectal cancer were selected from August 2018 to December 2019 in the Department of Gastrointestinal Surgery of West China Hospital of Sichuan University and randomly divided into ERAS group and traditional treatment group (traditional group). Among them, the perioperative clinical management was carried out according to the ERAS management and traditional treatment process in the the ERAS group and in the traditional group, respectively. The fresh fecal samples were collected within 24 h after admission and the first natural defecation after operation. The bacterial 16 Sr DNA V3–V4 region was sequenced by Illumina MiSeq sequencer, and the results were analyzed by bioinformatics.ResultsA total of 60 patients with colorectal cancer were included, 30 cases in the traditional group and 27 cases in the ERAS group (3 people temporarily withdrew from the study). There were no significant differences in the basic informations between the two groups (P>0.05). ① Before or after operation, there were no significant differences in Shannon index and Simpson index between the two groups. The difference between preoperative and postoperative comparison in the same group was also not statistically significant (P>0.05). ② Beta diversity analysis showed that there was no significant difference in community composition between the traditional group and the ERAS group before operation, and there was a clear boundary between the traditional group and the ERAS group after operation. ③ At the phylum level, compared with the preoperative abundance, the postoperative abundance Firmicutes decreased by 26.5% and 5.5% in the traditional and ERAS group, respectively; Bacteroidetes increased by 21.6% and 4.7% in the traditional and ERAS group, respectively; Proteobacteria increased by 7.2% and 2.2% in the traditional and ERAS group, respectively. At the genus level, compared with the preoperative abundance, the postoperative abundance of Bacteroides in the traditional group increased by 17.6% and in the ERAS group decreased by 1.6%; Bifidobacterium decreased by 1.8% and 1.3% in the traditional group and in the ERAS group, respectively.ConclusionsERAS does not affect species diversity of intestinal flora. Although ERAS has some damage to structure of intestinal flora, it is weaker than traditional process, so it is more conducive to reconstruction and restoration of intestinal microecological environment.
Objective To introduce the research progress on the relationship between gut microbiota dysbiosis and osteoarthritis (OA), focus on the possible mechanism of gut microbiota dysbiosis promoting OA, and propose a new therapeutic direction. Methods The domestic and foreign research literature on the relationship between gut microbiota dysbiosis and OA was reviewed. The role of the former in the occurrence and development of OA and the new ideas for the treatment of OA were summarized. Results The gut microbiota dysbiosis promotes the development of OA mainly in three aspects. First, the gut microbiota dysbiosis destroys intestinal permeability and causes low-grade inflammation, which aggravate OA. Secondly, the gut microbiota dysbiosis promotes the development of OA through metabolic syndrome. Thirdly, the gut microbiota dysbiosis is involved in the development of OA by regulating the metabolism and transport of trace elements. Studies have shown that improving gut microbiota dysbiosis by taking probiotics and transplanting fecal microbiota can reduce systemic inflammation and regulate metabolic balance, thus treating OA. Conclusion Gut microbiota dysbiosis is closely related to the development of OA, and improving gut microbiota dysbiosis can be an important idea for OA treatment.
Objective To investigate the effect of cholecystolithiasis with cholecystitis and cholecystectomy on intestinal flora in patients with colorectal cancer. Methods A total of 168 patients with colorectal cancer who admitted to the Department of Anorectal Surgery in Gansu Provincial Hospital from June 2020 to March 2021 were selected, and 29 patients with colorectal cancer who met the criteria were selected as the research objects, including 10 colorectal cancer patients with gallstones and cholecystitis (cholecystolithiasis with cholecystitis+colorectal cancer group), 10 colorectal cancer patients after cholecystectomy (cholecystectomy+colorectal cancer group), and 9 colorectal cancer patients with normal gallbladder (normal gallbladder+colorectal cancer group). Clinical data of the patients in three groups were collected and compared. The fresh fecal samples of the patients included in the study were collected, and the 16S rDNA high-throughput sequencing method was used to determine and analyze the composition and distribution of the intestinal flora in the obtained samples. Results The interleukin-6 level in the cholecystolithiasis with cholecystitis+colorectal cancer group was statistically higher than that in the normal gallbladder+colorectal cancer group and the cholecystectomy+colorectal cancer group (P<0.05). At the phylum level of the fecal flora in three groups patients: ① In the samples of three groups, the relative abundances of Bacteroidetes, Firmicutes, Proteobacteria, Fusobacteria and Verrucomicrobia phylums were all high, accounting for almost more than 95% of the total intestinal bacteria. ② The relative abundance of Fusobacteria phylum in the cholecystolithiasis with cholecystitis+colorectal cancer group was statistically higher than that in the normal gallbladder+colorectal cancer group (P<0.05). ③ The relative abundance of Verrucomicrobia phylum in the normal gallbladder+colorectal cancer group was statistically higher than that in the cholecystolithiasis with cholecystitis+colorectal cancer group and the cholecystectomy+colorectal cancer group (P<0.05). ④ The relative abundance of Synergistetes phylum in the cholecystectomy+colorectal cancer group was statistically higher than that in the cholecystolithiasis with cholecystitis+colorectal cancer group and the normal gallbladder+colorectal cancer group (P<0.05). At the genus level: ① The relative abundances of Bacteroidetes and Roseburia genus were lower in the gallstone with cholecystitis+colorectal cancer group than those in the cholecystectomy+colorectal cancer group and the normal gallbladder+colorectal cancer group (P<0.05). ② The relative abundance of Shigella genus in the cholecystectomy+colorectal cancer group was higher than that in the cholecystolithiasis with cholecystitis+colorectal cancer group (P<0.05). ③ The relative abundance of the Lachnospira genus in the cholecystolithiasis with cholecystitis+colorectal cancer group was lower than that in the normal gallbladder+colorectal cancer group (P<0.05). ④ The relative abundances of Prevotella and Fusobacteria genus were higher in the cholecystolithiasis with cholecystitis+colorectal cancer group than that in the cholecystectomy+colorectal cancer group and the normal gallbladder+colorectal cancer group (P<0.05). ⑤ The relative abundances of Clostridium and Akkermansia genus were lower in the cholecystolithiasis with cholecystitis+colorectal cancer group and the cholecystectomy+colorectal cancer group than that in the normal gallbladder+colorectal cancer group (P<0.05). ⑥ The relative abundance of Enterococcus genus was higher in the normal gallbladder+colorectal cancer group than that in the cholecystectomy+colorectal cancer group (P<0.05).Conclusions ① Long-term occurrence of cholecystolithiasis with cholecystitis can cause obvious decrease in the abundances of Bacteroides, Roseburia, Lachnospira, etc. ② Cholecystectomy can cause changes in the relative abundances of Clostridium, Enterococcus, Verrucomicrobia, Synergistetes, etc. ③ The relative abundance of Fusobacterium is obviously increased in colorectal cancer patients with gallstones and cholecystitis, then promotes the release of inflammatory cytokines and causes intestinal inflammation, which is conducive to the growth of opportunistic pathogens, thus may affect the occurrence and development of colorectal cancer.
ObjectiveTo summarize the progress of research on the interaction between bariatric surgery and intestinal flora at home and abroad in recent years, in order to provide new ideas for promoting recovery after bariatric surgery. MethodThe domestic and international literature of intestinal flora changes after bariatric surgery was searched and reviewed. ResultsThe main changes of the intestinal flora after bariatric surgery showed that the abundance of thick-walled bacteria was decreased and the numbers of Bacteroides and Aspergillus were increased. Some common complications after bariatric surgery such as anastomotic fistula, nutritional deficiencies, and inflammation were related to the intestinal flora imbalance. Supplementation with probiotics, prebiotics, dietary interventions, or fecal microbial transplantation were expected to reduce the incidence of complications after bariatric surgery. ConclusionsBariatric surgery is a durable and effective method for treating obesity and its comorbidities. Changes in individual intestinal flora after bariatric surgery have an impact on both weight loss outcomes and postoperative complications, and it is important to find ways to reduce postoperative complications after bariatric surgery by improving intestinal flora.
Gut microbiota and its metabolites in various human diseases have gradually become a research hotspot in the current medical community. And coronary artery disease is currently one of the most threatening clinical cardiovascular diseases in the world, so the use of gut microbiota and its metabolites in the development of its pathophysiology has also received more and more attention. Therefore, this paper reviews the effects of gut microbiota and its metabolites on coronary artery disease, as well as the research progress of intervening gut microbiota and its metabolites as therapeutic targets, hoping to expand the future research direction in this field and provide new ideas with treating coronary artery disease.
Objective To explore the relationship between the gut microbiome (GM) and psoriasis using a two-sample two-way Mendelian randomization (MR) approach. Methods The forward analysis uses the gut microbiota as the exposure factor, and its genetic data are derived from the genome-wide association study dataset published by the MiBioGen consortium. Psoriasis was used as the outcome variable, and its genetic data were obtained from the UK Biobank. The reverse MR analysis, on the other hand, took psoriasis as the exposure and the specific gut microbiota taxonomic units identified in the forward analysis as the outcome variable. MR analysis was conducted using maximum likelihood, MR Egger regression, weighted median, inverse variance weighting (IVW), and weighted models to study the causal relationship between the gut microbiota and psoriasis. Then, sensitivity analyses including horizontal pleiotropy test, Cochran’s Q test, and leave-one-out analysis were used to evaluate the reliability of the results. Results A total of 51 single nucleotide polymorphisms from 5 fungi were included in the forward study. The forward IVW analysis results showed that, the class Mollicutes [odds ratio (OR)=1.003, 95% confidence interval (CI) (1.001, 1.006), P=0.004], genus Lachnospiraceae FCS020 group [OR=1.003, 95%CI (1.000, 1.006), P=0.041], and phylum Tenericutes [OR=1.003, 95%CI (1.001, 1.006), P=0.004] were causally associated with an increased risk of psoriasis. The family Victivallaceae [OR=0.998, 95%CI (0.997, 1.000), P=0.005] and order Pasteurellales [OR=0.998, 95%CI (0.996, 1.000), P=0.047] were also linked to a decreased risk of psoriasis. The results of the sensitivity analysis were robust. There was no evidence of a reverse causal relationship from psoriasis to the identified bacterial taxa found in the results of reverse MR analysis results. Conclusions The abundance of three species, class Mollicutes, genus Lachnospiraceae and phylum Tenericutes, may increase the risk of psoriasis. The abundance of two species, family Victivallaceae and order Pasteurellales may reduce the risk of psoriasis. These results provide new directions for the prevention and treatment of psoriasis in the future, but further research is needed to explore how the aforementioned microbiome affects the progression of psoriasis.
Behcet's Disease (BD) is a multisystem vasculitis characterized by disease alternated with recurrent episodes and remissions, involving genital, oral, ocular uvea, cutaneous, and articular manifestations. The nuclear factor (NF)-κB signaling pathway paly an important role in the BD progression. It encompasses diverse gene, protein, and cellular regulatory mechanisms operating across various levels, alongside microbiological and experimental studies involving animals and cells. At the protein research findings, activation of the NF-κB pathway in BD patients is marked by elevated plasma levels of soluble CD40 ligand, which stimulates neutrophils to release reactive oxygen species and extracellular traps, thereby promoting inflammation. At the cellular research findings, macrophages in BD patients polarize towards classically activated macrophages phenotype through the NF-κB pathway, exacerbating the inflammatory response. The activation of NF-κB is associated with increased expression of anti-apoptotic proteins in T cells, leading to prolonged inflammation. Microbiological investigations reveal that the decreased gut microbiota diversity in BD patients compromises intestinal barrier integrity. NF-κB pathway involvement in regulating neutrophil and type 1 helper T cell (Th) 1/Th17 cell function worsens inflammation. Genetically, BD patients exhibit polymorphisms in immune regulatory genes, which contribute to inflammation through the NF-κB pathway. Mutations in NF-κB-associated genes elevate the risk of BD, while mutations in the endogenous inhibitor A20 lead to abnormal NF-κB activity, sustaining inflammation. Animal experiments and in vitro experiments corroborate the efficacy of NF-κB inhibitors in attenuating inflammation. Targeting upstream inflammatory factors within the NF-κB pathway yields positive outcomes in BD patients. In summary, the NF-κB signaling pathway plays a pivotal role in the development of BD. Developing NF-κB inhibitors may open new avenues for treating BD. Further research is necessary to comprehensively elucidate the precise mechanisms by which NF-κB operates in the pathogenesis of BD, as well as its potential clinical applications in therapy.
ObjectiveTo summarize the recent advances in the pathogenic mechanism of microorganisms and pancreatic cancer.MethodThrough the retrieval of relevant literatures, the recent progresses in the study of microorganism and pathogenesis of pancreatic cancer were reviewed.ResultsIn recent years, the potential role of intestinal microbiota in the pathogenic mechanism of pancreatic cancer had been studied. The studies found that the microbiome played an important role in the development of pancreatic cancer. Among them, the infections of Helicobacter pylori, oral pathogenic bacteria such as the Porphyromonas ginggivalis, Aggregatibacter actinomycetemcomitans and Phylum fusobacteria, and the changes of composition and diversity of intestinal microflora were closely related to the pancreatic cancer. The microorganisms induced the chronic inflammation and immune response through multiple pathways. The bacterial lipopolysaccharide stimulated the mutations in the KARS gene and mediated the inflammatory response by activating the nuclear factor-κB signaling pathway through Toll like receptor. The oral pathogenic microorganisms and Helicobacter pylori could also promote the cancer progression by secreting toxins that activated cancer-related signaling pathways.ConclusionsBacteria might be important carcinogens. These microorganisms promote development of cancer by causing chronic inflammation, activating cancer-related pathways, activating immune response, oxidative stress, and damaging DNA double strands.