肠道微生态调节在外科营养治疗中的作用

人体肠道内动态定植着机体最庞大、有着重要生理功能的微生态系统,其对宿主的健康起着重要作用,是激活和维持肠道生理功能的关键因素。外科相当一部分病人由于肠道功能和生理结构发生根本性改变,必然带来肠道微生态的影响,而在临床营养治疗过程中,长期禁食、应用制酸剂及疾病本身的应激更会导致微生态系统的破坏,伴随的肠源性感染、抗生素耐药等增加了治疗风险并延长了住院时间。因此,在肠道微生态重要性日益凸显的背景下,在外科营养治疗中如何兼顾纠正肠道菌群紊乱、保护肠屏障、加速康复是一个值得关注的问题。     

皮肤和肠道微生态与益生菌

微生态是研究人类、动物和植物与自身定居的正常微生物群互相依赖、相互制约的学科。皮肤是人体最大的器官,而皮肤表面定植着复杂的微生物群落。皮肤微生物在表皮所接触的外环境影响下,形成了其独特且复杂的菌群结构。同时也受到人体固有免疫和获得性免疫系统的影响,与人体免疫系统共同进化。皮肤菌群出现异常往往与许多皮肤疾病有关,益生菌的使用在皮肤疾病的治疗过程中逐渐凸显出其特殊的作用。皮肤疾病的有效控制对皮肤的代谢、营养、再生有直接的影响,对皮肤抗衰老美容、面部年轻化等有非常重要的意义。而肠道菌群微生态平衡与抗衰老的相关性也十分密切。对皮肤和肠道菌群的深入研究,将会为皮肤与肠道疾病的诊断和治疗,以及抗衰老美容开辟出一条新的途径。     

肠道微生态制剂及其临床应用和研究进展

目的 了解微生态制剂的临床应用和最新研究进展。方法 复习国内、外的文献，进行归纳总结，并加以综述。结果 微生态制剂广泛应用于临床，利用其来重建人体尤其是肠道内的菌群平衡，促进内环境的稳定，控制菌群失调及治疗与菌群易位相关的多种胃肠道疾病。结论 尽管肠道微生态制剂在临床上广泛应用，但有关肠道微生态制剂的治疗作用有待大样本的随机双盲试验证实和循证医学的评价。     

慢性肾脏病患者肠道微生态的改变和干预

正随着慢性肾脏病(chronic kidney disease,CKD)患者肾功能的进行性下降,各种毒素在人体内蓄积,最终进展至终末期肾病(end stage renal disease,ESRD),近年来ESRD在全球的发病率逐年提高,己成为全球范围内的严重危害人类健康、加重经济负担的公共卫生问题,我国也不例外。据流行病学调查数据显示,2011年美国成人慢性肾脏病患病率已高达15. 1%,     

肠道微生态变化及临床应用

近年来,随着基因组学、蛋白组学、代谢组学及分子生物学技术的进展,人类对人体微生态系统的认识步入了新境界。据估计,肠道微生态大约有15 000～36 000个菌种[1],几乎参与了所有与肠道有关的人体生理功能。Ley等[2]证实,肠道微生态改变与肥胖密切相关;O’Hara等[3]认为,肠道微生态是一个代谢器官;Cani等[4]进一步提出了肠道微     

肠道微生态与创伤的研究进展

目的 总结肠道微生态与创伤的研究现状和进展,以期为高质有效的创伤救治提供思路。方法 对近年来国内外研究肠道微生态与创伤的文献进行分析并综述。结果 创伤后肠道微生态发生变化,但创伤对肠道微生态的影响机制目前还不明确,肠道微生态制剂（如益生菌）、粪菌移植、中医治疗等可以维护创伤后肠道微生态。结论 创伤与肠道微生物态的关系可能为创伤后改善结局提供有价值的诊断、预防和治疗思路,但创伤对肠道微生态的影响、机制以及干预措施仍需要进一步研究。     

慢性肾脏病与肠道微生态的相互影响

随着对肠道微生态研究的深入,更多学者关注到肠道微生态与慢性肾脏病的相关性。数百万亿的肠道微生物成为了影响慢性肾脏病发展及转归的重要因素。慢性肾脏病患者多有肠道内环境及上皮屏障改变,导致肠道菌谱明显不同于正常人。而肠道菌群失调及其所造成的肠源性尿毒症毒素的蓄积,又进一步导致慢性肾脏病的加重。近年来,针对调节肠道微生态以治疗慢性肾脏病的一些研究又为控制慢性肾脏病进展提供了新思路。本文着重探讨慢性肾脏病与肠道微生态之间的相互影响,同时介绍了重建肠道微生态平衡的治疗方式。     

泌尿系结石与肠道微生态关系研究进展

泌尿系结石是最常见的泌尿外科疾病之一,在泌尿外科住院患者中占居首位,并且近年来的发病率正逐年上升。导致尿石形成和复发的危险因素很多,主要与遗传、代谢及环境因素有关,其中以草酸代谢异常导致的草酸钙结石最为常见,随着医学发展,对于泌尿系结石已经形成一套比较完善的诊疗体系,近年来尿石的成因及预防开始引起了越来越多的关注。肠道微生态体系是以肠道正常定植菌群为核心的人体微生态系统,与肥胖、糖尿病、炎性肠病等多种人体疾病有直接关系,目前发现肠道微生物可能在泌尿系结石的发病机制和预防中起作用,其中研究较多的产甲酸草酸杆菌参与人体内草酸的代谢,可能通过"肠道微生态-肾脏"轴参与泌尿系结石的形成。本综述主要阐述泌尿系结石与肠道微生态关系的研究进展,为泌尿系结石的成因及预防提供参考。     

Diabetes and gut microbiota

The prevalence of diabetes has increased rapidly throughout the world in recent years. Currently, approximately 463 million people are living with diabetes, and the number has tripled over the last two decades. Here, we describe the global epidemiology of diabetes in 2019 and forecast the trends to 2030 and 2045 in China, India, USA, and the globally. The gut microbiota plays a major role in metabolic diseases, especially diabetes. In this review, we describe the interaction between diabetes and gut microbiota in three aspects: probiotics, antidiabetic medication, and diet. Recent findings indicate that probiotics, antidiabetic medications, or dietary interventions treat diabetes by shifting the gut microbiome, particularly by raising beneficial bacteria and reducing harmful bacteria. We conclude that targeting the gut microbiota is becoming a novel therapeutic strategy for diabetes.     

Clostridium difficile infection and gut microbiota

Clostridium difficile infection (CDI) is associated with disturbance of intestinal microbiota. Microbiota of CDI patients usually shows decreased diversity, increase of facultative anaerobes, and decreased levels of bifidobacteria, Bacteroidetes, Lachnospiraceae, and butyrate-producing bacteria. Studies including symptomatic, asymptomatic, recurrent, and fecal therapy-treated patients could result in the recognition of microbial markers for CDI risk or could provide the combination of beneficial microbes for a C. difficile-specific probiotic.     

The gut microbiota regulates bone mass in mice

The gut microbiota modulates host metabolism and development of immune status. Here we show that the gut microbiota is also a major regulator of bone mass in mice. Germ-free (GF) mice exhibit increased bone mass associated with reduced number of osteoclasts per bone surface compared with conventionally raised (CONV-R) mice. Colonization of GF mice with a normal gut microbiota normalizes bone mass. Furthermore, GF mice have decreased frequency of CD4(+) T cells and CD11b(+) /GR 1 osteoclast precursor cells in bone marrow, which could be normalized by colonization. GF mice exhibited reduced expression of inflammatory cytokines in bone and bone marrow compared with CONV-R mice. In summary, the gut microbiota regulates bone mass in mice, and we provide evidence for a mechanism involving altered immune status in bone and thereby affected osteoclast-mediated bone resorption. Further studies are required to evaluate the gut microbiota as a novel therapeutic target for osteoporosis.     

The gut microbiota and its relationship with chronic kidney disease

International Urology and Nephrology - Chronic kidney disease (CKD) is a worldwide health problem, because it is one of the most common complications of metabolic diseases including obesity and...     

重视肠道细菌的代谢作用研究

<正>人类肠道含有丰富的细菌,从上往下细菌越来越多:十二指肠细菌总数102/ml～103/ml,空肠103/ml～105/ml,回肠105/ml～107/ml,大肠1010/ml～1012/ml。最新研究表明肠道细菌和宿主能量代谢有着密切的联系[1]。一、肠道细菌调节脂肪存储     

Crosstalk between gut microbiota and antidiabetic drug action

Type 2 diabetes(T2 D) is a disorder characterized by chronic inflated blood glucose levels(hyperglycemia), at first due to insulin resistance and unregulated insulin secretion but with tendency towards global spreading. The gut microbiota is recognized to have an influence on T2 D, although surveys have not formed a clear overview to date. Because of the interactions between gut microbiota and host homeostasis, intestinal bacteria are believed to play a large role in various diseases, including metabolic syndrome, obesity and associated disease. In this review, we highlight the animal and human studies which have elucidated the roles of metformin, α-glucosidase inhibitors, glucagon-like peptide-1 agonists,peroxisome proliferator-activated receptors γ agonists, inhibitors of dipeptidyl peptidase-4, sodium/glucose cotransporter inhibitors, and other less studied medications on gut microbiota. This review is dedicated to one of the most widespread diseases, T2 D, and the currently used antidiabetic drugs and most promising new findings. In general, the gut microbiota has been shown to have an influence on host metabolism, food consumption, satiety, glucose homoeostasis, and weight gain. Altered intestinal microbiota composition has been noticed in cardiovascular diseases, colon cancer, rheumatoid arthritis, T2 D,and obesity. Therefore, the main effect of antidiabetic drugs is on the microbiome composition, basically increasing the short-chain fatty acids-producing bacteria,responsible for losing weight and suppressing inflammation.     

Impact of gut microbiota on kidney transplantation

Kidney transplantation is recognized as one of the most effective treatments for patients who suffer from end-stage renal disease. The major potential outcomes following kidney transplantation include engraftment, rejection, and associated complications. The outcomes are dependent on a variety of factors in those who underwent renal grafts or kidney transplant recipients. Those factors include the administration of immunosuppressive drugs and prophylactic antimicrobial agents to recipients. Recent studies have shown that gut microbiota play an important role in the outcome of subjects with kidney transplantation. An imbalance of the components/diversity of gut microbiota, known as gut dysbiosis, has been shown to have a big impact on the immune system of the host and the modification of host inflammatory cytokines. Although gut dysbiosis is affected by variation in diet and medication, a substantial amount of evidence showing a link between alteration in human gut microbiota and outcomes of kidney transplantation has recently been reported. Therefore, the objective of this review is to comprehensively summarize and discuss the major findings from in vivo and clinical data pertaining to the impact of gut microbiota on kidney transplantation. Any controversial findings are compiled to enable a clear overview of the role of gut microbiota and the outcome of kidney transplantation.     

Remodeling gut microbiota by Clostridium butyricum (C.butyricum) attenuates intestinal injury in burned mice

BackgroundThe dysbiosis of gastrointestinal microbiome is an important reason for burn-induced intestinal injury. Clostridium butyricum (C.butyricum) and its production butyrate are beneficial for the homeostasis of intestinal microflora and suppression of inflammatory response.PurposeThe roles of C.butyricum and butyrate in burn-induced intestinal injury were explored. The effects of oral administration of C.butyricum on intestinal injury were observed in burned mice.Materials and methodsThe skin surface of mice was exposed to 95 °C water to induce a burn injury. Then the intestinal microbiome structure, abundance of C.butyricum and level of butyrate were respectively observed. The correction between intestinal permeability indicated by FITC dextran level and abundance of C.butyricum or level of butyrate was analyzed. C.butyricum was cultured and orally administrated to burned mice. The levels of butyrate, FITC dextran and pro-inflammatory cytokines, including interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) were respectively measured.ResultsBurn injury altered the intestinal microbiome structure of mice, and especially decreased the abundance of C.butyricum and level of butyrate. Both the abundance of C.butyricum and the level of butyrate were negatively correlated with the intestinal permeability. Oral administration of C.butyricum increased the level of butyrate, decreased levels of TNF-α and IL-6, and suppressed intestinal damage in burn-injured mice.ConclusionOral administration of C.butyricum significantly alleviated the intestinal damage induced by burn injury. The therapeutic effects of C.butyricum and butyrate on burn injury should be further explored, which deserves further investigation.     

Correlation between gut microbiota diversity and psychogenic erectile dysfunction

BackgroundTo analyze the distribution of gut microbiota in erectile dysfunction (ED) patients and explore the relationship between the diversity of gut microbiota and psychogenic ED.MethodsStool specimen were collected from 30 patients with ED and 30 healthy persons (healthy donors, HDs) and analyzed Paired end (PE) 300 sequencing on V3-V4 region sequences of bacterial 16S rRNA gene by using Illumina’s Miseq platform, whereby sequencing results were analyzed to assess differences in species composition and diversity. The analysis comprised five modules: sequencing data quality control, operational taxonomic units (OTU) species clustering and annotation, alpha diversity, beta diversity and the use of t-tests and analysis of linear discriminant analysis effect size (LEfSe) differences.ResultsThe International Index of Erectile Function (IIEF-5) score ranged between 8 and 21. The scores of ED patients were ≥11 and ≤20, and the mean value was 15.67±2.94. The flora diversity in the group of ED patients was significantly different from that of HDs (P<0.01), with the ED group having low bacterial diversity. There were no significant differences in the genus level between the ED and HD group, and abundant bacteria (TOP10) and core flora (90%). Comparison of total flora (the abundance >1%) display, Alloprevotella genera showed differences, whereby Alloprevotella was only be identified in the HD group. Erectile dysfunction and HD showed good separation and clustering respectively in principal component analysis, showing significant differences in two kinds of microflora. T-tests showed that six species were significantly different, and that in the ED group, streptococci and Subdoligranulum were significantly increasing, and Prevotella sp.9, Blautia, Lachnospiraceae NK4A136 groups and Roseburia were significantly lower. Analysis using LEfSe analysis revealed 24 species were significantly different between ED and HD groups.ConclusionsWhen gene sequencing was performed of ED and HD specimens, the microbial community structure and diversity showed significant differences, suggesting that ED specimen had lower gut microbiota diversity.