吡格列酮对高脂血症大鼠核转录因子kB活性和主动脉凋亡蛋白表达的影响

目的 观察吡格列酮对高脂血症大鼠NF-κB活性和主动脉凋亡蛋白Bax、Bcl-2表达的影响.方法 SD大鼠26只,随机分为对照组9只、高脂饮食组17只.高脂饮食组喂养12周后再随机分为模型组8只和吡格列酮组9只,干预4周后,检测各组血脂;HE染色观察主动脉组织形态学改变;免疫组织化学法检测NF-κB p65、Bax、Bcl-2 表达.结果 与对照组比较,高脂饮食组12周后,TG、TC、LDL-C明显升高(P＜0.01);与模型组比较,16周后,吡格列酮组TG、TC明显降低(P＜0.01);与对照组比较,模型组NF κB p65、Bax明显升高,Bcl-2和Bcl-2/Bax比值明显降低(P＜0.01);与模型组比较,吡格列酮组NF-κB p65、Bax明显降低,Bcl-2和Bcl-2/Bax比值明显升高(P＜0.01).结论 高脂饮食可引起主动脉凋亡蛋白Bax、Bcl-2及Bcl-2/Bax比值的改变,可能与NF-κB活性增加相关.吡格列酮可减少NF-κB p65表达,调节Bax、Bcl-2表达,从而改善内皮细胞功能和动脉粥样硬化病理进程.     

吡格列酮对高脂血症大鼠主动脉内皮细胞凋亡的作用

目的观察吡格列酮对高脂血症大鼠主动脉内皮细胞凋亡的影响,并探讨其可能的作用机制。方法清洁型SD大鼠26只,随机分为健康对照组(9只)、高脂饮食组(17只),高脂饮食组喂养12周后再随机分为模型组(8只)和吡格列酮组(9只),4周后,检测各组血脂水平,通过免疫组织化学法检测主动脉Bcl-2、Bax的表达,TUNEL染色法观察主动脉内皮细胞凋亡情况,计算细胞凋亡指数。结果 (1)高脂饮食组喂养12周后,血脂明显升高;给药4周后,与模型组比较,吡格列酮组TG、TC水平明显降低(P=0.000);(2)与健康对照组相比,模型组主动脉Bax蛋白表达明显增高(P=0.003),Bcl-2蛋白表达和Bcl-2/Bax比值明显降低(P=0.000);与模型组相比,吡格列酮组主动脉Bax蛋白表达明显降低(P=0.000),Bcl-2蛋白表达(P=0.001)和Bcl-2/Bax比值明显升高(P=0.000),且吡格列酮组主动脉内皮细胞凋亡指数较模型组明显降低,差异有统计学意义(17.5633±7.0584比6.0475±2.2370,P=0.000)。结论吡格列酮可改善高脂血症大鼠血脂水平,调节凋亡蛋白表达,减少主动脉内皮细胞凋亡。     

吡格列酮对高脂血症大鼠主动脉脂联素受体表达的影响

目的观察高脂血症大鼠主动脉脂联素受体(adiponectin receptors1/2,AdipoR1/2)的表达改变,探讨吡格列酮对高脂血症大鼠主动脉血管脂联素受体表达的影响。方法清洁级SD大鼠26只,随机分为正常饮食组(9只)和高脂饮食组(17只);高脂饮食组12周后检测空腹血脂,明确造模是否成功,随机分为模型组(8只)和吡格列酮组(9只),后者给予吡格列酮溶液(0.6mg/ml)连续灌胃4周,之后检测血脂水平及主动脉病理,ELISA法检测血清脂联素水平,荧光RT-PCR法检测主动脉脂联素受体AdipoR1和AdipoR2mRNA的表达,Western Bolt法检测脂联受体蛋白表达。结果高脂饲料喂养12周,高脂饮食组TG、TC、LDL水平明显升高(P0.01);给药四周后,吡格列酮组TG、TC水平明显降低(P0.01),模型组主动脉脂联素受体1/2mRNA和蛋白的表达明显下降(P0.01)。与模型组比较,吡格列酮组主动脉AdipoR(1P0.05)和AdipoR2(P0.01)mRNA的表达明显升高,主动脉脂联素受体蛋白的表达明显升高(P0.05),差异有统计学意义。结论脂联素及其受体下降可能介入高脂血症血管损伤,吡格列酮具有抗动脉粥样硬化作用,该作用可能与提高血清脂联素和主动脉血管脂联素受体表达有关。     

非诺贝特和吡格列酮对血管紧张素Ⅱ介导的心肌细胞肥大和凋亡的干预作用

目的 探讨过氧化物酶体增殖物激活型受体α和γ(PPARα和PPARγ)的配体非诺贝特、吡格列酮对血管紧张素Ⅱ(Ang Ⅱ)诱导的心肌细胞肥大、凋亡的干预作用,并观察其对凋亡相关基因Bcl-2/Bax表达变化的影响 .方法 分别以非诺贝特和/或吡格列酮预处理体外原代培养的新生大鼠心肌细胞24 h后,再加用Ang Ⅱ作用24 h.采用软件分析细胞表面积,用流式细胞仪检测细胞凋亡率,用Western-blot法观察凋亡相关基因Bcl-2/Bax的表达变化,逆转录聚合酶链反应检测PPARα和PPARγ的mRNA水平.结果 与Ang Ⅱ组比较,非诺贝特组、吡格列酮组及非诺贝特和吡格列酮组的心肌细胞表面积、细胞凋亡率及Bax蛋白的表达明显降低(P＜0.05),而 Bax蛋白的表达和Bcl-2/Bax蛋白水平比值显著增加(P＜0.05),非诺贝特组、吡格列酮组及非诺贝特和吡格列酮组间的上述指标差异无显著性(P＞0.05),非诺贝特组的PPARα mRNA和吡格列酮组的PPARγ mRNA表达增高.结论 PPARα和γ激活可逆转心肌细胞肥大,抑制心肌细胞凋亡,并能改变凋亡相关基因Bcl-2/Bax的表达,但PPARα、γ配体合用无叠加效应.     

吡格列酮对实验性动脉粥样硬化大鼠血脂水平的影响及临床意义

目的观察吡格列酮对高脂饮食诱导动脉粥样硬化模型大鼠血脂水平的影响,并探索其临床意义。方法设清洁型SD大鼠26只,随机分为对照组(n=9)、高脂饮食组(n=17),高脂饮食组喂养12周后再随机分为模型组(n=8)和吡格列酮组(n=9),分别给予蒸馏水、蒸馏水(1.5ml/100g)和吡格列酮10mg/(kg·d)灌胃,1次/d,同时继续高脂饮食,干预4周后,检测各组血脂水平并观察主动脉病理形态学改变。结果高脂饮食喂养12周后,与对照组相比,模型组和吡格列酮组三酰甘油(TG)、总胆固醇(TC)显著升高(P<0.01)。给药干预4周后,吡格列酮组干预后TG、TC、低密度脂蛋白胆固醇(LDL-C)较干预前明显降低(P<0.01),与模型组比较,吡格列酮组TG、TC水平明显降低(P<0.01)。且可减轻高脂饮食诱导的主动脉内膜增厚和平滑肌细胞增殖。结论吡格列酮可改善高脂血症大鼠血脂水平,延缓主动脉粥样硬化病理改变,提示吡格列酮的抗动脉粥样硬化作用可能部分归于血脂改善效应。     

非诺贝特和吡格列酮对血管紧张素Ⅱ介导的心肌细胞肥大和凋亡的干预作用

目的探讨过氧化物酶体增殖物激活型受体α和γ(PPARα和PPARγ)的配体非诺贝特、吡格列酮对血管紧张素Ⅱ(AngⅡ)诱导的心肌细胞肥大、凋亡的干预作用,并观察其对凋亡相关基因Bcl-2/Bax表达变化的影响。方法分别以非诺贝特和/或吡格列酮预处理体外原代培养的新生大鼠心肌细胞24h后,再加用AngⅡ作用24h。采用软件分析细胞表面积,用流式细胞仪检测细胞凋亡率,用Western-blot法观察凋亡相关基因Bcl-2/Bax的表达变化,逆转录聚合酶链反应检测PPARα和PPARγ的mRNA水平。结果与AngⅡ组比较,非诺贝特组、吡格列酮组及非诺贝特和吡格列酮组的心肌细胞表面积、细胞凋亡率及Bax蛋白的表达明显降低(P<0.05),而Bax蛋白的表达和Bcl-2/Bax蛋白水平比值显著增加(P<0.05),非诺贝特组、吡格列酮组及非诺贝特和吡格列酮组间的上述指标差异无显著性(P>0.05),非诺贝特组的PPARαmRNA和吡格列酮组的PPARγmRNA表达增高。结论PPARα和γ激活可逆转心肌细胞肥大,抑制心肌细胞凋亡,并能改变凋亡相关基因Bcl-2/Bax的表达,但PPARα、γ配体合用无叠加效应。     

吡格列酮对高脂饮食兔主动脉CD40L表达的影响

目的探讨吡格列酮对高脂饮食兔主动脉CD40L表达的影响。方法设立正常饮食、高脂饮食及高脂饮食加吡格列酮干预三组,比较主动脉病理形态学改变、血脂变化,采用免疫组织化学检测兔主动脉CD40L的表达,采用逆转录聚合酶链反应检测兔主动脉凝血酶样氧化型低密度脂蛋白受体1 mRNA的表达。结果吡格列酮能减轻高脂饮食所致的内膜增厚和平滑肌细胞增殖,吡格列酮还能明显升高高密度脂蛋白胆固醇水平。高脂饮食刺激兔主动脉CD40L的表达,吡格列酮能显著减轻这种作用。高脂饮食能上调兔主动脉表达凝血酶样氧化型低密度脂蛋白受体1 mRNA的表达,而吡格列酮能显著抑制这种作用。结论吡格列酮能减轻高脂饮食兔主动脉CD40L的表达,其作用可能与抑制凝血酶样氧化型低密度脂蛋白受体1 mRNA表达有关,提示吡格列酮可通过抑制高脂血症患者炎症信号通路而达到抗动脉硬化的作用。     

吡格列酮对人脐静脉内皮细胞血凝素样氧化低密度脂蛋白受体1表达的影响

目的探讨氧化型低密度脂蛋白(ox-LDL)作用下,吡格列酮对人脐静脉内皮细胞(HUVECs)血凝素样氧化低密度脂蛋白受体1(LOX-1)表达的影响。方法将培养的第4代HUVECs分5组:空白组(无干预);ox-LDL组(80 mg/L ox-LDL);低浓度组(1μmol/L吡格列酮+80 mg/L ox-LDL);高浓度组(10μmol/L吡格列酮+80 mg/Lox-LDL);对照组(10μmol/L吡格列酮),各组培养24 h后,采用流式细胞仪检测LOX-1的表达,采用RT-PCR检测LOX-1 mRNA的表达。结果与空白组比较,对照组LOX-1及LOX-1 mRNA表达均无明显改变(P0.05),ox-LDL组、低浓度组和高浓度组LOX-1及LOX-1 mRNA表达明显增多(P0.01);与ox-LDL组比较,低浓度组和高浓度组LOX-1及LOX-1 mRNA表达明显降低(P0.01);高浓度组较低浓度组降低更明显(P0.05)。结论吡格列酮能降低ox-LDL刺激下的HUVECs LOX-1及LOX-1 mRNA的表达,提示吡格列酮可能通过干预ox-LDL的病理生理过程起到抗动脉硬化的作用。     

吡格列酮对缺血再灌注心肌细胞凋亡影响的实验研究

目的观察吡格列酮对大鼠在体心肌缺血再灌注时心肌细胞凋亡的影响。方法实验动物随机分为2组,一为缺血30 min再灌注30 min组,进一步分为假手术组（n = 5）、模型组（即溶剂对照组,n = 6）和吡格列酮组（3mg／kg,n = 7）,测定心肌梗死面积;另一为缺血30 min再灌注2h组,然后进一步分为假手术组（n = 5）、模型组（n = 6）及吡格列酮0．3mg／kg组（n = 6）、1mg／kg组（n = 7）和3mg／kg组（n = 6）,各用药组于缺血前30 min静脉注射给药。然后,取心脏标本,石蜡包埋后切片,免疫组化检测凋亡蛋白Bax、Bcl-2、Caspase-3、PPARy蛋白质表达,原位杂交方法检测PPARymRNA表达。TUNEL法和DNA凝胶电泳观察心肌细胞凋亡。结果（1）与模型组比较,吡格列酮组梗死面积与缺血区面积之比减少28％（P 〈 0．01）,梗死面积与左室面积之比减少32％（P 〈 0．01）;（2）免疫组化和原位杂交结果示：吡格列酮0．3、1、3mg／kg可呈剂量依赖性减少Bax、Caspase-3,增加Bcl-2、PPARy蛋白质以及PPARymRNA表达;（3）TUNEL法检测吡格列酮可减少心肌细胞凋亡指数,3组作用均显著（P 〈 0．05）,但DNA凝胶电泳模型组、吡格列酮0．3、1mg／kg可见到DNA梯带,假手术组和吡格列酮3mg／kg则无DNA梯带。结论吡格列酮预处理可通过减少心肌细胞凋亡和梗死面积起到抗缺血再灌注损伤的作用。     

吡格列酮对动脉粥样硬化大鼠核因子-κB表达的影响

目的探讨吡格列酮对动脉粥样硬化大鼠核因子-κB(NF-κB)表达的影响。方法将30只健康雄性Wistar大鼠随机分为3组,正常饮食组、高脂饮食组、高脂饮食加吡格列酮干预组,比较3组大鼠主动脉病理形态学改变,测定大鼠的血脂变化,采用免疫组化技术测定NF-κB在血管内皮细胞的表达。结果吡格列酮能减轻动脉粥样硬化所致的内膜和肌层增厚。吡格列酮能降低胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白(LDL-C),升高高密度脂蛋白胆固醇(HDL-C)。高脂饮食能刺激大鼠主动脉NF-κB的表达,吡格列酮能显著减轻这种作用。结论吡格列酮能减轻动脉粥样硬化大鼠NF-κB的表达,从而可能会有效防治动脉粥样硬化。     

胰岛素瘤的解剖分布特点分析

目的胰岛素瘤是最常见的胰腺神经内分泌肿瘤，因其临床表现多样，导致诊断困难。影像学诊断尤其是超声内镜(EUS)在胰岛素瘤的诊断中起着重要作用，拥有较高的敏感性和特异性。本研究拟通过明确胰岛素瘤的解剖分布特点，以期有助于提高影像学的诊断准确率和降低漏诊率，尤其是在教育和培训实践中对于EUS的学习者更具有指导价值。 方法回顾性分析解放军总医院第一医学中心病案资料数据库1993年1月至2019年11月经外科手术、病理确诊为胰岛素瘤的患者的临床资料，检索方法采取搜索术后病理诊断为"胰岛素瘤"的病例，通过查阅病例的方法，提取出胰岛素瘤的大小和解剖分布等数据，进一步分析其特点。 结果共检索到确诊为胰岛素瘤的患者116例，其中，男45例、女71例，年龄13～76岁，平均年龄(44.4±14.85)岁。胰岛素瘤单发110例(94.8%)、多发6例(5.2%)。位置分布：头颈部46例(39.7%)，单发45例、多发1例；体尾部68例(58.6%)，单发65例、多发3例；全胰腺多发2例(1.7%)。病变大小特点：最大径0.4～3.4 cm，平均大小(1.53±0.58)cm。≤1 cm 29例、>1 cm而≤1.5 cm41例、>1.5 cm而≤2.0 cm28例，≤3 cm 15例，>3 cm 3例。年龄与肿瘤的大小相关，≤44岁患者肿瘤平均大小为(1.36±0.51)cm、>44岁患者肿瘤平均大小为(1.70±0.60)cm，P<0.05。头颈部的肿瘤大于体尾部的肿瘤，头颈部肿瘤平均大小(1.66±0.63)cm，体尾部(1.42±0.52)cm，P<0.05。 结论胰岛素瘤在胰腺体尾部较头颈部更好发；绝大多数单发，但可以全胰腺多发；多数小于1.5 cm，肿瘤的大小与患者年龄和肿瘤的解剖分布相关。     

Pathogenesis of carcinoma of the papilla of Vater

Most adenomas and carcinomas of the small intestine and extrahepatic bile ducts arise in the region of the papilla of Vater. In familial adenomatous polyposis (FAP) it is the main location for carcinomas after proctocolectomy. In many cases symptoms due to stenosis lead to diagnosis at an early tumor stage. In about 80%, curative intended resection is possible. Operability is the most relevant prognostic factor. Most ampullary carcinomas resp. carcinomas of the papilla of Vater develop from adenomatous or flat dysplastic precursor lesions. They can be sited in the ampulloduodenal part of the papilla of Vater, which is lined by intestinal mucosa. They also can develop in deeper parts of the ampulla, which are lined by pancreaticobiliary duct mucosa. Intestinal-type adenocarcinoma and pancreaticobiliary-type adenocarcinoma represent the main histological types of ampullary carcinoma. Furthermore, there exist unusual types and undifferentiated carcinomas. Many carcinomas of intestinal type express the immunohistochemical marker profile of intestinal mucosa (keratin 7?, keratin 20+, MUC2+). Carcinomas of pancreaticobiliary type usually show the immunohistochemical profile of pancreaticobiliary duct mucosa (keratin 7+, keratin 20?, MUC2?). Even poorly differentiated carcinomas, as well as unusual histological types, may conserve the marker profile of the mucosa they developed from. These findings underline the concept of histogenetically different carcinomas of the papilla of Vater which develop either from intestinal- or from pancreaticobiliary-type mucosa of the papilla of Vater. Molecular alterations in ampullary carcinomas are similar to those of colorectal as well as pancreatic carcinomas, although they appear at different frequencies. In future studies, molecular alterations in ampullary carcinomas should be correlated closely with the different histologic tumor types. Consequently, the histologic classification should reflect the histogenesis of ampullary tumors from the two different types of papillary mucosa.     

Demonstration of the mechanism of action of biguanides

Summary Palmitic acid oxidation in rat diaphragm homogenate is depressed by biguanide concentrations that are still incapable of inhibiting oxidative phosphorylation. Glucose oxidation is not directly effected by the same biguanide concentrations: however, the inhibitory effect of palmitic acid on glucose oxidation is partly removed by biguanides. Inhibition of fatty acid oxidation, which accounts for most of the metabolic effects caused by these drugs, can be regarded as the fundamental mechanism of action of biguanides. There is some evidence suggesting that these drugs might interact with carnitine, thus preventing long-chain fatty acids from being transported across the mitochondrial membrane to the site of oxidation. Traduzione a cura degli AA.     

Lack of correlation of degree of villous atrophy with severity of clinical presentation of coeliac disease

BACKGROUND AND AIM: Both the clinical presentation and the degree of mucosal damage in coeliac disease vary greatly. In view of conflicting information as to whether the mode of presentation correlates with the degree of villous atrophy, we reviewed a large cohort of patients with coeliac disease. PATIENTS AND METHODS: We correlated mode of presentation (classical, diarrhoea predominant or atypical/silent) with histology of duodenal biopsies and examined their trends over time. RESULTS: The cohort consisted of 499 adults, mean age 44.1 years, 68% females. The majority had silent coeliac disease (56%) and total villous atrophy (65%). There was no correlation of mode of presentation with the degree of villous atrophy (p=0.25). Sixty-eight percent of females and 58% of males had a severe villous atrophy (p=0.052). There was a significant trend over time for a greater proportion of patients presenting as atypical/silent coeliac disease and having partial villous atrophy, though the majority still had total villous atrophy. CONCLUSIONS: Among our patients the degree of villous atrophy in duodenal biopsies did not correlate with the mode of presentation, indicating that factors other than the degree of villous atrophy must account for diarrhoea in coeliac disease.     

血吸虫童虫生长发育及其机制的研究进展

血吸虫童虫是宿主免疫系统攻击的重要靶标,包括皮肤型、肺型和肝门型童虫。宿主分子对童虫生长发育具有重要作用。童虫生长发育机制包括免疫调节、信号转导、性别发育及凋亡等。肌动蛋白、组织蛋白酶、烯醇化酶和葡萄糖基转移酶等分子为血吸虫童虫生长发育的重要分子。本文对血吸虫童虫生长发育及其机制的研究进展做一综述。     

氯硝柳胺悬浮剂的毒性评价

目的评价氯硝柳胺悬浮剂的毒性，为现场大规模应用灭螺提供依据。方法按照中华人民共和国国家标准GB 15670-1995《农药登记毒理学试验方法》和鱼类毒性试验方法进行。结果经口、经皮肤的LDso雌、雄性大鼠均>5 000 mg/kg，经呼吸道的LCso雌、雄性大鼠均>5 000mg/m3，该药经口、经皮肤、经呼吸道毒性均属微毒类药物；兔眼用药后，观察期内无不良反应，对眼无刺激性；皮肤用药后对皮肤无刺激性。与氯硝柳胺原药、氯硝柳胺乙醇胺盐原药和氯硝柳胺乙醇胺盐可湿性粉剂相比，氯硝柳胺悬浮剂对鱼急性毒性最低。结论氯硝柳胺悬浮剂属微毒类药物，对鱼的毒性低于其乙醇胺盐可湿性粉剂，适合于现场应用。     

124例耐多药结核分枝杆菌基因突变特征分析

目的对临床分离的耐多药结核分枝杆菌相关基因的突变特征进行分析。方法对124例耐多药结核分枝杆菌以及50株敏感株的耐药相关基因(包括异烟肼inh A、kat G、oxyR-ahp C间隔区以及利福平rpo B)进行序列测定,分析其基因突变情况。结果异烟肼耐药inh A基因突变率为14.5%;kat G基因突变率为70.2%(87/124),主要位于315位;oxyR-ahp C间隔区突变率为15.3%;inh A、kat G两种基因同时突变率75.0%,三种基因同时突变率为89.5%。利福平rpo B基因突变的检出率高达95.2%,突变主要发生在531、526、516位点。结论我省耐多药菌异烟肼耐药相关基因最常见突变为kat G 315、inh A C-T(-15)、axyR-ahp C间隔区(-10)C-T,利福平为rpo B531、526、516。结合MDR-TB耐药相关基因的特征分析,可以建立一种快速、准确、特异的适合于我省的检测结核菌耐多药性的新方法。     

Assessment of quality of life of parents of children with juvenile chronic arthritis

The aim of the study was to assess the quality of life (QOL) and the psychological status of parents of children with juvenile chronic arthritis (JCA). The QOL, anxiety and depression of the parents of 28 children with JCA were evaluated and compared to those of the parents of 28 healthy children. Mothers of JCA children and mothers of healthy children reported similar QOL. The reported anxiety and depression levels were similar for mothers and fathers in both groups. The parents of children with pauciarticular-type JCA reported lower QOL and higher levels of anxiety and depression than the parents of children with other types, namely polyarticular and systemic JCA. These findings may be explained by the fact that the pauciarticular patients had shorter disease duration and were less frequently seen in the outpatient clinic. The QOL of mothers of children with JCA was found to be slightly impaired in the group of children with pauciarticular JCA. Future larger studies are needed to confirm these results, as the number of subjects in the three groups was rather low. Received: 26 September 2001 / Accepted: 8 February 2002     

Numerical Simulation of the Effect of Rate of Change of Glucose on Measurement Error of Continuous Glucose Monitors

Background

A 5-day in-patient study designed to assess the accuracy of the FreeStyle Navigator® Continuous Glucose Monitoring System revealed that the level of accuracy of the continuous sensor measurements was dependent on the rate of glucose change. When the absolute rate of change was less than 1 mg•dl⁻¹•min⁻¹ (75% of the time), the median absolute relative difference (ARD) was 8.5%, with 85% of all points falling within the A zone of the Clarke error grid. When the absolute rate of change was greater than 2 mg•dl⁻¹•min⁻¹ (8% of the time), the median ARD was 17.5%, with 59% of all points falling within the Clarke A zone.

Method

Numerical simulations were performed to investigate effects of the rate of change of glucose on sensor measurement error. This approach enabled physiologically relevant distributions of glucose values to be reordered to explore the effect of different glucose rate-of-change distributions on apparent sensor accuracy.

Results

The physiological lag between blood and interstitial fluid glucose levels is sufficient to account for the observed difference in sensor accuracy between periods of stable glucose and periods of rapidly changing glucose.

Conclusions

The role of physiological lag on the apparent decrease in sensor accuracy at high glucose rates of change has implications for clinical study design, regulatory review of continuous glucose sensors, and development of performance standards for this new technology. This work demonstrates the difficulty in comparing accuracy measures between different clinical studies and highlights the need for studies to include both relevant glucose distributions and relevant glucose rate-of-change distributions.     

Study of constancy of hydrogen-consuming flora of human colon

The constancy of the hydrogen consuming flora of the human colon was studied in 15 healthy subjects via two measurements obtained 18 to 36 months apart. Hydrogen disappearance rate and the major products of H₂-consuming bacteria, methane and sulfide, were measured during incubation of fecal homogenates with excess hydrogen and sulfate. In 11/15, the hydrogen consumption rate and the predominant hydrogen-consuming pathway (methanogenesis, sulfate reduction, or neither) remained constant. However, major shifts in these pathways were observed in four subjects, with two losing and two gaining the ability to produce methane. Methanogenesis was associated with the highest hydrogen consumption rate. This study demonstrates that clinically unrecognizable, major alterations of the colonic flora occur in healthy subjects. Understanding of the factors responsible for these alterations might allow for therapeutic manipulation of the colonic flora.Supported in part by the Department of Veterans Affairs and NIDDKD RO1 DK 13309-25.