The respiratory microbiome after lung transplantation: Reflection or driver of respiratory disease?

With the introduction of high-throughput sequencing methods, our understanding of the human lower respiratory tract's inhabitants has expanded significantly in recent years. What is now termed the “lung microbiome” has been described for healthy patients, as well as people with chronic lung diseases and lung transplants. The lung microbiome of lung transplant recipients (LTRs) has proven to be unique compared with nontransplant patients, with characteristic findings associated with disease states, such as pneumonia, acute rejection, and graft failure. In this review, we summarize the current understanding of the lung microbiome in LTRs, not only focusing on bacteria but also highlighting key findings of the viral and the fungal community. Based on our knowledge of the lung microbiome in LTRs, we propose multiple opportunities for clinical use of the microbiome to improve outcomes in this population.     

慢性肾脏病与肠道菌群相关性研究进展概述

中国慢性肾脏病(chronic kidney disease,CKD)发病率高,呈逐年增长趋势,目前尚无根治手段,积极探索CKD进展的危险因素是目前肾脏病领域的研究重点。近年越来越多学者指出,肠道菌群变化与CKD发生发展存在一定相关性,肠道微生态平衡对人体健康有着举足轻重的作用,而CKD患者肠道黏膜受损后可引起肠道菌群紊乱,继发肠源性毒素堆积,加重CKD进展;本文就目前国内外有关CKD与肠道菌群研究进行概述,进一步探讨以调节肠道菌群紊乱作为CKD防治新靶点的可能性。     

肠道菌群介导生脉方对脓毒症小鼠的治疗作用

探究生脉方（Shengmai formula,SMF）对脓毒症小鼠组织损伤、血清炎症因子和外周血固有免疫细胞比例的作用;考察肠道菌群在SMF治疗脓毒症中的作用。灌胃0.3,0.6,1.2 g/kg或腹腔注射0.6 g/kg SMF 4 d后腹腔注射20 mg/kg脂多糖（LPS）建立脓毒症模型,考察小鼠生存率,通过H&E染色观察小鼠肝、肺、肾组织病理改变,检测血清IL-6、TNF-α、谷丙转氨酶（ALT）、谷草转氨酶（AST）、尿素氮（BUN）和肌酐（Cr）水平;建立LPS和盲肠结扎穿刺（CLP）脓毒症模型,通过流式细胞术检测SMF灌胃或腹腔注射对外周血单核细胞、巨噬细胞和中性粒细胞比例的影响;考察抗生素（ABX）处理对SMF灌胃治疗脓毒症的影响;考察SMF灌胃小鼠的粪菌对脓毒症的治疗作用。结果表明,SMF灌胃显著提高LPS模型小鼠生存率,减轻肝、肺、肾损伤和炎性浸润,降低血清IL-6、ALT、AST、BUN、Cr水平;显著降低LPS模型24 h外周血巨噬细胞比例,下调CLP模型24 h外周血单核、巨噬细胞和中性粒细胞比例。SMF腹腔注射对脓毒症模型上述指标均无显著作用。ABX...     

表皮生长因子对放射性肠炎全肠外营养大鼠谷氨酰胺代谢酶的影响

目的：探讨表皮生长因子（ＥＧＦ）对接受长期全肠外营养（ＴＰＮ）的放射性肠炎大鼠组织谷氨酰胺代谢酶的影响,方法大鼠皮下注射ＥＧＦ,观察其对大鼠肝,骨骼肌及小肠粘膜组织内谷酰胺酶和谷氨酰胺合成酶的变化。结果应用ＥＧＦ后大鼠肝、,骨骼肌肉的谷氨酰胺合成酶及肝、小肠粘膜的谷氨酰胺酶活性,动脉血、小肠和肝谷氨酰胺浓度增加,小肠谷氨酰胺摄取率增加。结论ＥＧＦ显著增加谷氨酰胺代谢酶的活性,增加肠粘膜代谢的主要能     

Pediatric intestinal transplantation

Advancements in donor management, organ preservation and operative techniques, as well as immunosuppressive therapies, have provided children with intestinal failure and its complications a chance not only for enteral autonomy but also long-term survival through intestinal transplantation (ITx). First described in the 1960’s, experience has grown in managing these complex patients both pre- and post-transplant. The goals of this review are to provide a brief history of intestinal transplantation and intestinal rehabilitation in pediatric patients, followed by focused discussions of the indications for ITx, induction and maintenance immunosuppression therapies, common post-operative complications, and outcomes/quality of life post-transplant.     

Decreased expression of protectin (CD59) in gut epithelium in ulcerative colitis and Crohn's disease

Without adequate protection, the cells of the human body would be susceptible to destruction by the complement system. The main defense against complement lysis is a molecule called protectin (CD59) that is widely distributed in human tissues. Because the complement system has been suggested to be involved in the pathogenesis of inflammatory bowel diseases, we examined the expression of protectin in the colonic epithelium of patients with ulcerative colitis or Crohn's disease and controls. Colorectal specimens from 6 patients with ulcerative colitis, 8 patients with Crohn's disease, and 4 controls were obtained from surgical resections. Frozen sections of the specimens were immunostained for protectin using the Bric 229 monoclonal antibody. The expression of protectin was found to be decreased in the epithelium of patients with ulcerative colitis. In patients with Crohn's disease, the epithelial expression of protectin was decreased in diseased areas of gut while the expression did not significantly differ from that in controls in macroscopically normal areas. There was no difference in the expression of protectin on vascular endothelium, mononuclear cells, or smooth muscle. The reduction in epithelial expression of protectin in patients with ulcerative colitis or Crohn's disease may render epithelial cells vulnerable to complement lysis and lead to the destruction of gut epithelium as seen typically in these diseases.     

胎鼠肠管上皮细胞增殖分化与间质血管形成的关系

目的：探讨胎鼠肠管上皮细胞增殖分化与间质血管形成的关系。方法：通过免疫组织化学及电子计算机形态学分析方法,对血管内应生长因子（VEGF）和Ⅳ型胶原在胚胎期13～18d之胎鼠肠管的表达进行研究。结果：①在E13～15时,胎鼠肠管上度增殖胜盛,此后维持在20％左右;②间质血管一直占机体体积的20％左右,比较恒定;③VEGF呈波峰式表达,先在间充质中高表达而后则有上皮表达高峰;④E15～16时,Ⅳ型胶原显示血管基底膜形成完整。结论：胚胎期肠等血管形成不随上皮细胞的增殖而增多,与机体总体积有比较恒常的关系。     

中药保护肠屏障功能研究概况

对近年来中药保护肠黏膜屏障功能的研究进展进行分析和归纳，内容包括保护肠黏膜、调节免疫、改善微循环、减轻化学物质对肠黏膜的损伤、调节肠道菌群、降低内毒素水平等方面，并就中药在这方面的应用前景作了展望。