益生菌干预对慢性乙肝患者肠道菌群、炎症因子及肝功能等的影响

目的探讨益生菌干预对慢性乙型肝炎(乙肝)患者肠道菌群、炎症因子、内毒素及肝功能的影响。方法将2010年3月至2015年12月在我院诊治的乙肝患者380例按照随机数表法分为观察组和对照组,每组190例。对照组患者给予常规治疗,观察组在常规治疗基础上联合益生菌干预治疗,比较两组患者治疗前后肠道菌群变化、血清内毒素水平、炎症因子水平和肝功能的变化。结果观察组患者治疗后肠球菌、双歧杆菌和乳酸杆菌均显著增加(P0.05),肠杆菌和梭菌无显著变化(P0.05);对照组患者治疗前后肠道菌群无显著变化(P0.05)。两组患者治疗后内毒素、肝功能、炎症因子水平均显著降低(P0.05);观察组患者内毒素、ALT、AST、TBIL、IL-6、TNF-α水平均显著低于对照组(P0.01)。结论在常规治疗的基础上联合益生菌干预治疗慢性乙肝患者,能有效改善肠道菌群失调,降低炎症反应,改善肝功能,可作为乙肝患者的辅助治疗。     

慢性功能性便秘的微生态治疗进展

慢性功能性便秘是一种常见的肠道疾病,目前的治疗方法主要为药物治疗。肠道微生态的深入研究揭示了肠道微生态紊乱与肠道疾病的相互关联作用,而恢复肠道微生态平衡也逐渐成为疾病治疗的一种手段。近几年肠道微生态的治疗在慢性功能性便秘领域取得了一定的进展,口服益生菌以及粪菌移植等治疗手段均获得了良好的效果。本文对慢性功能性便秘的微生态治疗的研究进行初步总结,为后续的益生菌种类的完善和治疗手段的改进提供思路。     

乳杆菌属治疗肠易激综合征的机制

肠易激综合征(IBS)是一种常见的功能性胃肠病,其病因及发病机制尚未完全明确。临床研究表明益生菌能有效治疗IBS,其中应用较多的是乳杆菌属。本文将从改善内脏高敏感性、肠道动力、调节肠道微生态平衡、改善肠道通透性、抑制炎症反应、改善精神心理异常及抑菌作用等方面对乳杆菌属治疗IBS的疗效机制作一概述。     

植物化学成分、益生菌和脂肪酸对炎症性肠病的治疗作用

炎症性肠病(IBD)是一种慢性非特异性肠道炎症性疾病,近年其发病率在全亚洲范围内呈快速上升趋势,饮食结构的改变如高饱和脂肪、低果蔬饮食可能与其发病率升高有关。研究发现一些天然产物如植物化学成分、益生菌、膳食纤维、脂类等具有抗IBD作用,但确切机制不明。本文对植物化学成分、益生菌和脂肪酸对IBD的治疗作用及其可能机制作一综述。     

益生菌在炎症性肠病中的治疗进展

炎症性肠病(inflammatory bowel disease,IBD)是一种病因不明的慢性非特异性肠道炎症性疾病,包括溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(Crohn’s disease,CD)。许多研究显示肠道菌群的生态失调在IBD的发病中起着重要作用,而临床上相当一部分患者对常规治疗应答不佳或发生严重的不良反应,因此尝试益生菌调节肠道菌群来治疗IBD越来越受到重视。     

新型益生菌与肠道疾病防治

益生菌指在足量条件下能对宿主产生确切有益健康功效的微生物。在肠道疾病防治中, 传统益生菌如乳杆菌属(Lactobacillus)、双歧杆菌属(Bifidobacteria)、链球菌属(Streptococcus)经过长期的研究已被证实安全、有效, 但使用二代测序技术和生物信息学工具鉴定出的新型益生菌的具体作用和机制亟待阐明。本文重点回顾脆弱拟杆菌(Bacteroides fragilis)、嗜黏蛋白阿克曼菌(Akkermansia muciniphila)、普氏栖粪杆菌(Faecalibacterium prausnitzii)3种新型益生菌与肠道疾病防治的研究进展, 其通过改善肠道炎症, 维护肠黏膜屏障结构和功能完整, 抑制肠道肿瘤的进程, 辅助诊断, 以及预测疗效等多种作用促进肠道疾病的防治。虽然现阶段仍面临安全性、准确性和可利用性的挑战, 但相关研究与转化的不断改进将使新型益生菌更好地服务于肠道疾病防治。     

肠道菌群与血管内炎症

最新研究表明,肠道菌群与血管内炎症性疾病具有重要关联,肠道菌群通过多种机制促进肥胖及动脉粥样硬化。同时,肠道菌群可通过破损的肠黏膜进入血循环,诱发内毒素血症,引起多种炎症性疾病。针对上述发病机制,近年来多种益生菌在临床与实验研究中均表现出一定效果,如抑制炎症状态、改善肠道症状、恢复菌群稳态等。现对近年肠道菌群与血管内炎症性疾病的相关性研究做一综述。     

肠道微生态与代谢性疾病关系的研究进展

代谢性疾病已成为世界性的健康问题。长期摄入高脂肪和糖类饮食可改变肠道环境,尤其是肠道微生物组成,使微生物屏障功能减弱和肠道通透性增加,引起内毒素水平升高,诱发慢性低水平炎症,最终导致肥胖和胰岛素抵抗。采用益生菌和益生元调节宿主肠道菌群平衡,可能成为防治代谢性疾病的潜在手段。本文就肠道微生态与代谢性疾病关系的研究进展作一综述。     

肠道微生态影响动脉粥样硬化发生发展的机制

动脉粥样硬化(AS)不仅是一种炎症性疾病,而且属于一种代谢性疾病。肠道微生态的改变可对AS的发生发展产生双面影响。一方面,肠道菌群紊乱可以通过影响机体的胆碱代谢、氧化应激、炎症反应等机制直接促进AS产生发展,此外,可通过导致AS危险因素肥胖、高脂血症、糖尿病等的产生这些间接机制促AS的进展。另一方面,益生菌及益生元的增加则可有效地降低肠道微生物内毒素产生、增强肠道屏障、减轻机体质量、缓解炎症反应、改善胰岛素抵抗,进而在AS的进展方面发挥重要作用。因此,合理调控机体肠道微生态环境成为AS防治的新型重要手段。     

溃疡性结肠炎肠道菌群失调的治疗进展

溃疡性结肠炎(UC)是一种主要累及结直肠的慢性非特异性炎症性疾病,主要临床表现为黏液脓血便、腹痛、腹泻等。UC病因尚不完全明确,其治疗已成为临床工作的重点。近年研究认为UC发病与肠道菌群失调有一定相关性,并就益生菌制剂和粪菌移植(FMT)对UC的疗效开展了大量临床研究。本文就UC中肠道菌群失调的治疗进展作一综述。     

益生菌对妊娠期糖尿病的影响及相关机制

妊娠期糖尿病(gestational diabetes mellitus, GDM)可对母体及其后代产生近期和远期的不良影响,GDM患者的肠道菌群与正常孕妇存在差异,肠道菌群结构及功能的改变影响了其发生发展。近年来,国外研究发现,益生菌可不同程度地影响GDM患者糖脂代谢,但具体机制不甚明确,短链脂肪酸、过氧化物酶体增殖...     

Probiotics and Iletis

Probiotics have gained tremendous popularity amongst individuals searching for alternative and "natural" means to promote intestinal health. It has been suggested that the probiotic formulation VSL#3 promotes several aspects of intestinal health including attenuation of inflammatory bowel diseases (IBD). Although a definitive mechanism of action has not been clearly identified, it is generally accepted that probiotics suppress development of chronic inflammation by inhibiting activation of various inflammatory signaling pathways. This concept however needs to be revisited in light of a recent publication by Pagnini et al. showing that VSL#3 prevents development of ileitis through activation of NF-kB and production of the prototypical inflammatory cytokine TNFa.     

Probiotics as a complementary therapeutic approach in nonalcoholic fatty liver disease

Nonalcoholic fatty liver disease(NAFLD) is currently recognized as one of the most common causes of chronic liver disease. It involves a spectrum of conditionsthat include pure steatosis without inflammation, steatohepatitis, fibrosis and cirrhosis. The key factor in the pathophysiology of NAFLD is insulin resistance that determines lipid accumulation in the hepatocytes and, thus, oxidative stress, which is followed by inflammatory response. However, NAFLD pathogenesis is still largely unknown and has been extensively investigated. Although life style modification with the aim of losing weight has been advocated to treat this disorder, its effectiveness is limited; additionally, there is no specific pharmacologic treatment until nowadays. Recent evidence suggests that the gut microbiota may play a role in the development of insulin resistance, hepatic steatosis, necroinflammation and fibrosis. Differences in gut microbiota between NAFLD patients and lean individuals as well as presence of small intestinal bacterial overgrowth in NAFLD subjects have been demonstrated. Furthermore, some data indicate that the immunoregulatory effects of probiotics may be beneficial in NAFLD treatment as they modulate the intestinal microbiota; improve epithelial barrier function and strengthen the intestinal wall decreasing its permeability; reduce bacterial translocation and endotoxemia; improve intestinal inflammation; and reduce oxidative and inflammatory liver damage. In this article, we review the clinical trials on the use of probiotics in the treatment of NAFLD and discuss the effects of these agents and their efficacy as an emerging therapeutic resource to treat NAFLD patients.     

Probiotics and ileitis: Could augmentation of TNF/NFκB activity be the answer?

Probiotics have gained tremendous popularity amongst individuals searching for alternative and "natural" means to promote intestinal health. It has been suggested that the probiotic formulation VSL#3 promotes several aspects of intestinal health including attenuation of inflammatory bowel diseases (IBD). Although a definitive mechanism of action has not been clearly identified, it is generally accepted that probiotics suppress development of chronic inflammation by inhibiting activation of various inflammatory signaling pathways. This concept however needs to be revisited in light of a recent publication by Pagnini et al. showing that VSL#3 prevents development of ileitis through activation of NFκB and production of the prototypical inflammatory cytokine TNFα.     

Probiotics and prebiotics in chronic inflammatory bowel diseases

INTRODUCTION At birth, the gastrointestinal tract is a sterile environment. Initial exposure of the gut to microbes occurs during the birthing process from the maternal fecal and vaginal ? ora. Within a few months after birth, a relatively stable microbia…     

Probiotics and chronic disease

In today's climate, changed lifestyles and the increased use of antibiotics are significant factors that affect the preservation of a healthy intestinal microflora. The concept of probiotics is to restore and maintain a microflora advantageous to the human body. Probiotics are found in a number of fermented dairy products, infant formula, and dietary supplements. Basic research on probiotics has suggested several modes of action beneficial for the human body and clinical research has proven its preventive and curative features in different intestinal and extraintestinal diseases. Chronic diseases cause considerable disablement in patients and represent a substantial economic burden on healthcare resources. Research has demonstrated a crucial role of nutrition in the prevention of chronic disease. Thus, positive, strain-specific effects of probiotics have been shown in diarrheal diseases, inflammatory bowel diseases, irritable bowel syndrome, and Helicobacter pylori-induced gastritis, and in atopic diseases and in the prevention of cancer. As the majority of probiotics naturally inhabit the human intestinal microflora, their use has been regarded as very safe. However, in view of the range of potential benefits on health that might be achieved by the use of some probiotic bacteria, major and thorough evaluation is still necessary. In conclusion, probiotics act as an adjuvant in the prevention and treatment of a wide variety of chronic diseases.     

Obesity and low-grade systemic inflammation

The aim of this review is to deal with the significance of obesity as a promotor of a chronic low-grade inflammatory reaction favouring the development of atherosclerosis and cardiovascular diseases. Adipose tissue synthetizes and releases inflammatory cytokines involved in various atherothrombotic mechanisms and in glucose and lipid metabolism. A local renin-angiotensin system may partially support the obesity related hypertension. Most obese subjects had elevated plasma levels of inflammatory markers which correlate with the degree of obesity and insulin resistance and decrease after weight reduction and exercise. Some evidences suggest that long-chain polyunsaturated fatty acids and thiazolidinediones may be useful in preventing atherosclerosis. Obesity, by itself, has been considered an independent risk factor for cardiovascular diseases. The hypothesis that it is linked to the associated low-grade chronic inflammation is supported by the existence of altered indexes of chronic inflammation also in obese children who are free of other pathological conditions. Further research will be required to determine the pathophysiological meaning of the chronic inflammation associated to obesity.     

Modulation of microbiota as treatment for intestinal inflammatory disorders: An uptodate

Alterations of intestinal microflora may significantly contribute to the pathogenesis of different inflammatory and autoimmune disorders. There is emerging interest on the role of selective modulation of microflora in inducing benefits in inflammatory intestinal disorders, by as probiotics, prebiotics, synbiotics, antibiotics, and fecal microbiota transplantation(FMT). To summarize recent evidences on microflora modulation in main intestinal inflammatory disorders, Pub Med was searched using terms microbiota, intestinal flora, probiotics, prebiotics, fecal transplantation. More than three hundred articles published up to 2015 were selected and reviewed. Randomized placebo-controlled trials and meta-analysis were firstly included, mainly for probiotics. A meta-analysis was not performed because of the heterogeneity of these studies. Most of relevant data derived from studies on probiotics, reporting some efficacy in ulcerative colitis and in pouchitis, while disappointing results are available for Crohn's disease. Probiotic supplementation may significantly reduce rates of rotavirus diarrhea. Efficacy of probiotics in NSAID enteropathy and irritable bowel syndrome is still controversial. Finally, FMT has been recently recognized as an efficacious treatment for recurrent Clostridium difficile infection. Modulation of intestinal flora represents a very interesting therapeutic target, although it still deserves some doubts and limitations. Future studies should be encouraged to provide new understanding about its therapeutical role.     

益生菌制剂在消化系统中的应用

益生菌制剂可以恢复肠道菌群平衡和黏膜屏障功能,从而治疗相关疾病,其安全性和有效性已在临床上得到验证。现就近年来益生菌制剂在抗生素相关性腹泻、溃疡性结肠炎、腹泻型肠易激综合征、功能性便秘和慢性肝病等常见消化道疾病中的临床应用作一概述,为更好地开发和医用益生菌制剂奠定基础。