胰腺癌细胞株中Elastase 3B基因启动子异常甲基化研究

目的 探讨Elastase 3B(ELA3B)基因在胰腺癌中低表达的分子机制.方法 应用RT-PCR方法检测2例正常胰腺组织和BxPC、CFPAC、PaTu8988、PANC1、SW1990 5株胰腺癌细胞株ELA3B基因表达.利用去甲基化试剂5-氮-2'-脱氧胞嘧啶(DAC)处理细胞株,再检测ELA3B基因表达,并用甲基化特异性PCR检测和测序进行验证.结果 ELA3B在正常胰腺组织中表达,而在BxPC、CFPAC、PaTu8988、PANC1和SW1990 5株胰腺癌细胞株中均无表达.DAC处理后,BxPC、PaTu8988、PANC1和SW1990 4株胰腺癌细胞株表达ELA3B,而CFPAC仍不表达.正常胰腺组织和PANC1 ELA3B基因部分甲基化,而其他4株胰腺癌细胞株则高甲基化.结论 ELA3B基因启动子的高甲基化是导致该基因在胰腺癌中表达下降的主要原因之一.     

胰腺癌细胞株中Elastase 3B基因启动子异常甲基化研究

目的探讨Elastase 3B（ELA3B）基因在胰腺癌中低表达的分子机制。方法应用RT-PCR方法检测2例正常胰腺组织和BxPC、CFPAC、PaTu8988、PANC1、SW1990 5株胰腺癌细胞株ELA3B基因表达。利用去甲基化试剂5-氮-2′-脱氧胞嘧啶（DAC）处理细胞株,再检测ELA3B基因表达,并用甲基化特异性PCR检测和测序进行验证。结果ELA3B在正常胰腺组织中表达,而在BxPC、CFPAC、PaTu8988、PANC1和SW1990 5株胰腺癌细胞株中均无表达。DAC处理后,BxPC、PaTu8988、PANC1和SW1990 4株胰腺癌细胞株表达ELA3B,而CFPAC仍不表达。正常胰腺组织和PANC1 ELA3B基因部分甲基化,而其他4株胰腺癌细胞株则高甲基化。结论ELA3B基因启动子的高甲基化是导致该基因在胰腺癌中表达下降的主要原因之一。     

胰腺癌细胞株原钙黏附蛋白8基因的甲基化状态

目的 分析原钙黏附蛋白8(protocadherin 8,PCDH8)基因在胰腺癌细胞株的甲基化状态.方法 抽提6株胰腺癌细胞株PANC1、ASPC1、BxPC3、CFPAC、PaTu8988、SW1990和2例正常胰腺组织的总RNA,以甲基化特异性PCR(MSP)法检测PCDH8甲基化情况.应用DNA甲基化转移酶(DNMT)抑制剂5-氮杂2'-脱氧胞苷(5-Aza-dC)处理6株胰腺癌细胞株,采用实时定量PCR法检测处理前后细胞的PCDH8 mRNA表达.结果 2例正常胰腺组织PCDH8基因未发生甲基化,PANC1、BxPC3、CFPAC胰腺癌细胞株PCDH8基因部分甲基化,而PaTu8988、ASPC1、SW1990细胞完全甲基化.PCDH8mRNA在PANC1、SW1990、PaTu8988胰腺癌细胞株中有表达,表达的相对值(RQ)分别为1.576±0.648、0.013±0.008、0.002±0.001;BxPC3、CFPAC、ASPC1细胞株无PCDH8 mRNA表达.5-Aza-dC处理后,胰腺癌细胞株PANC1、ASPC1、BxPC3、CFPAC、PaTu8988、SW1990均有PCDH8 mRNA表达,表达量较处理前明显升高,相对表达量分别为7.463±2.628、10.696±1.539、7.852±2.762、421.815±1.493、118.595±4.089、6.690±1.884.结论 PCDH8基因启动子高甲基化是导致该基因在胰腺癌细胞株表达下降的主要原因之一.     

胰腺癌细胞株HOXA7基因表达及其启动子区甲基化状态

目的 检测HOXA7 mRNA在胰腺癌细胞株中的表达及其启动子区的甲基化状态,探讨两者的相关性.方法 采用RT-PCR法检测人胰腺癌细胞株BxPC3、CFPAC1、PANC1和SW1990细胞的HOXA7 mRNA的表达水平.采用重亚硫酸盐测序PCR(bisulfite sequencing PCR,BSP)和结合重亚硫酸盐的限制性内切酶法(combined bisulfite restriction analysis,COBRA)检测启动子区域甲基化状态.应用去甲基化药物5-氮杂-2'-脱氧胞苷(5-aza-2-deoxycytidine,5-aza-dC)处理各细胞株,检测处理前后细胞HOXA7 mRNA表达和甲基化状态的变化.结果 胰腺癌细胞株BxPC3、CFPAC1和SW1990细胞均表达HOXA7 mRNA,而PANC1细胞不表达HOXA7 mRNA.CFPAC1、BxPC3、PANC1和SW1990中HOXA7启动子甲基化率分别为93.16%、90.65%、90.09%、52.30%,SW1990细胞的HOXA7甲基化率较其他三株细胞均明显降低(P值均＜0.01).经5-aza-dC处理后,PANC1细胞的HOXA7 mRNA重新表达,BxPC3的HOXA7 mRNA表达增强;而CFPAC1和SW1990细胞的HOXA7 mRNA在5-aza-dC处理前后无明显变化.结论 胰腺癌细胞株BxPC3和PANC1细胞的HOXA7mRNA表达与启动子区甲基化状态密切相关,而CFPAC 1和SW1990细胞两者无明显相关性.     

五株胰腺癌细胞株的 PTCH 和 SMO mRNA 表达

目的 研究胰腺癌细胞株SW1990、PaTu8988s、PANC-1、BxPC3、CFPAC中PTCH和SMO mRNA表达及相关关系.方法 用RT-PCR法测定5株胰腺癌细胞株和正常胰腺组织的PTCH和 SMO mRNA表达.结果 正常胰腺组织无PTCH和SMO mRNA表达;胰腺癌细胞株SW1990、PaTu8988s、PANC-1、BxPC3有PTCH mRNA的表达;胰腺癌细胞株PaTu8988s、PANC-1、BxPC3有SMO mRNA表达,而SW1990无SMO mRNA表达;胰腺癌细胞株CFPAC无PTCH及SMO mRNA表达.结论 正常胰腺组织无PTCH和 SMO mRNA表达;胰腺癌细胞株PTCH和SMO mRNA表达有差异,这可能与其生物学特性不同有关.     

环氧化酶抑制剂吲哚美辛对胰腺癌新生血管生成的抑制作用

目的 通过观察环氧化酶(COX)抑制剂吲哚美辛对胰腺癌血管内皮生长因子(VEGF)表达及对体内外血管生成的的影响,探讨其对胰腺癌生长抑制的作用机制.方法 用RT-PCR方法检测不同浓度吲哚美辛对BxPC3细胞VEGF mRNA表达的调节作用;应用小管形成实验研究吲哚美辛对ECV304细胞体外血管生成的影响;建立裸鼠胰腺癌BxPC3细胞种植瘤模型,应用吲哚美辛给荷瘤裸鼠灌胃(3 mg·kg-1·d-1体重,共4周),观察其对种植瘤生长曲线、瘤重及种植瘤组织VEGF mRNA表达的影响;采用Ⅷ因子免疫组化染色评估瘤组织中微血管密度(MVD).结果 (1)小管形成实验中,吲哚美辛组ECV304细胞数较少,细胞排列差,偶可见条索状细胞链,中空闭合管状结构缺如.(2)吲哚美辛呈剂量依赖性抑制BxPC3细胞VEGF mRNA表达.(3)应用吲哚美辛给荷瘤裸鼠灌胃4周后,平均瘤重(0.495±0.31)g,显著小于对照组瘤重(1.57±1.06)g,抑瘤率为67%.吲哚美辛显著下调种植瘤VEGF mRNA表达.(4)对照组MVD为5.98±1.27,吲哚美辛组为2.02±0.28,差异有显著性(P＜0.01).结论 COX抑制剂吲哚美辛可下调VEGF mRNA的表达,抑制胰腺癌体内、体外血管的生成,抑制裸鼠种植瘤新生血管的生成,这可能是其抑制胰腺癌裸鼠种植瘤生长的重要原因.     

五株胰腺癌细胞株的PTCH和SMO mRNA表达

目的 研究胰腺癌细胞株SW1990、PaTu8988s、PANC-1、BxPC3、CFPAC中PTCH和SMOmRNA表达及相关关系。方法用 RT—PCR法测定5株胰腺癌细胞株和正常胰腺组织的PTCH和SMOmRNA表达。结果 正常胰腺组织无PTCH和SMOmRNA表达；胰腺癌细胞株SW1990、PaTu8988s、PANC-1、BxPC3有PTCHmRNA的表达；胰腺癌细胞株PaTu8988s、PANC-1、BxPC3有SMOmRNA表达，而SW1990无SMOmRNA表达；胰腺癌细胞株CFPAC无PTCH及SMOmRNA表达。结论 正常胰腺组织无PTCH和SMOmRNA表达；胰腺癌细胞株PTCH和SMOmRNA表达有差异，这可能与其生物学特性不同有关。     

胰腺癌伴神经浸润动物模型的建立

目的 建立胰腺癌伴神经浸润的动物模型.方法 32只裸鼠分为4组,每组8只.将人胰腺癌细胞SW1990、CAPAN-2、PANC1分别注射于裸鼠的坐骨神经周围,以不做任何处理的裸鼠作为对照组.观察术后裸鼠体质量变化、成瘤情况、成瘤时间、造模成功率等指标.结果 对照组裸鼠体质量增加,各癌细胞注射组裸鼠成瘤后体质量明显下降,甚至呈现恶液质,成瘤侧肢体活动受限.CAPAN-2注射组及SW1990注射组的8只裸鼠最终均成瘤,PANC1注射组只有5只成瘤.以肿瘤最长径长至约0.8 cm为时间截点,CAPAN-2注射组、PANC1注射组、SW1990注射组裸鼠的成瘤时间分别为（49.8±5.0）、（56.6±2.4）、（25.4±3.0）d.SW1990注射组成瘤时间最短,PANC1注射组成瘤时间最长,3组间成瘤时间的差异具有统计学意义（F=73.51,P＜0.01）.CAPAN-2注射组、PANC1注射组、SW1990注射组裸鼠神经浸润造模成功率分别为87.5％ （7/8）、20.0％（1/5）、50.0％ （4/8）.结论 成功建立了胰腺癌伴神经浸润动物模型,但不同的胰腺癌细胞系建立的动物模型具有不同的特点.     

磷酸化转录激活因子5在胰腺癌细胞的表达及生长激素的干预作用

目的 检测磷酸化转录激活因子5(pSTAT5)在7株胰腺癌细胞株中的表达,观察生长激素(GH)处理SW1990细胞及其移植瘤后pSTAT5表达的变化,探讨GH的分子作用机制.方法 体外培养人胰腺癌细胞株SW1990、Cap-1、Colo、Mia、Aspc、P3、PANC1,Western blotting检测各株细胞的pSTAT5表达;收集指数生长期的SW1990细胞接种于BALB/C裸鼠,成瘤后随机分为GH组(瘤内注入GH 4 mg·kg-1·d-1,连续2周)和对照组(NS组),最后一次注射GH后1、2、24 h分批处死裸鼠,Western blotting检测SW1990细胞和移植瘤pSTAT5蛋白表达的变化.结果 所有胰腺癌细胞(SW1990、Cap-1、Colo、Mia、Aspc、P3、PANC1)均有pSTAT5表达.GH(50 ng/ml)刺激后5 min,SW1990细胞pSTAT5的表达量为0.57±0.05,较刺激前显著增高,10 min达到0.64±0.04,15 min很快下降至0.39±0.03,但直至1 h仍高于对照组(0.33±0.02对0.25±0.06),2 h后表达量为0.26±0.03,回落到基础水平.移植瘤pSTAT5表达无明显变化.结论 GH可迅速上调SW1990细胞的pSTAT5表达,但维持时间较短,而对胰腺癌移植瘤pSTAT5的表达无显著影响.     

人胰腺癌细胞株PANC1裸鼠原位模型的建立及磁共振监测

目的 建立一种稳定的人胰腺癌裸小鼠原位移植瘤模型,并探讨无创的磁共振(MRI)对其监测的应用价值.方法 人胰腺癌细胞株PANC1体外常规传代后建立裸鼠皮下种植瘤模型,将皮下种植瘤制成细胞悬液,植入20只BALB/C-nn裸鼠的胰腺包膜下构建人胰腺癌原位移植模型;通过MRI检查监测模型的成瘤率、成瘤时间、肿瘤生长速度、肿瘤形态、信号变化等特征,于第7周末取肿瘤组织行病理学检查.结果 接种后15 d,7只(35%)荷瘤鼠在MRI上显示成瘤,至接种后27 d,成瘤率为100%.肿瘤信号与邻近组织相比,90%(18/20)病灶T1WI呈均匀稍低信号,10%(2/20)呈等信号;75%(15/20)在T2WI呈均匀高信号.移植后2、3、4、5、6、7周经MRI测量的移植瘤体积分别为(12.6±2.4)mm3、(94.3±11.2)mm3、(175.9±82.5)mm3、(395.8±126.6)mm3、(1290.2±167.2)mm3、(1583.4±87.4)mm3.病理学检查确诊为胰腺低分化腺癌,并保持原发瘤的生物学特征.结论 人胰腺癌细胞株PANC1移植瘤制成的细胞悬液种植裸小鼠胰腺包膜下制备胰腺癌模型符合人胰腺癌的特征,且易于无创监测,为临床研究提供了一个有效、稳定的体内实验体系.     

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.