益生菌防治特应性皮炎的研究进展

特应性皮炎(atopic dermatitis,AD)是会反复发作、具有明显遗传倾向性的慢性炎症性皮肤病,发病率逐年增高.AD的发病机制主要为遗传性或获得性皮肤屏障受损引起的皮肤微生态失衡和变应原渗漏,激活对应的炎症反应,造成"屏障受损-炎症反应"的恶性循环.AD的传统治疗方法多采用糖皮质激素和免疫抑制剂,但其副作用的...     

肠道益生菌在儿童特应性皮炎中的应用CSCD

特应性皮炎(atopic dermatitis,AD)是儿童常见的皮肤过敏性疾病,虽然临床表现多样,但基本特征是全身皮肤干燥、慢性湿疹样损害和剧烈瘙痒表现[1]。近十年余中国儿童的AD患病率显着提高,2002年顾恒等[2]对中国的10个城市进行学龄前儿童特应性皮炎现况调查,研究结果发现学龄前儿童AD患病率为2.78%,而在2014年一项对中国12个城市的流行病学调查中发现AD则已影响了30.48%的婴儿以及12.94%的幼儿与学龄前儿童[3-4]。     

益生菌对儿童中重度特应性皮炎的辅助治疗

目的探讨益生菌辅助治疗对儿童中重度特应性皮炎(AD)的临床疗效。方法选择于首都儿科研究所附属儿童医院皮肤科就诊的96例中重度AD患儿为研究对象。入选患儿随机分成两组,其中试验组(50例)患儿给予口服乳杆菌及我院皮肤科AD常规药(口服抗组胺药,外用糠酸莫米松乳膏、我院自制肤乐霜);对照组(46例)患儿仅给予我院皮肤科AD常规药。两组患儿均治疗3个月,治疗前后分别用SCORAD评分、CDLQI评分、DFIQ评分进行病情评估,同时检测两组患儿治疗前后的血清总IgE、IL2受体、IL4、嗜酸细胞阳离子蛋白(ECP)水平及Th1/Th2比值。结果治疗后,SCORAD评分显示实验组患儿总有效率为82.0%(41/50),对照组总有效率为52.2%(24/46),两者差异有统计学意义(χ²=6.448,P=0.011)。治疗后,试验组患儿SCORAD评分、CDLQI评分、DFIQ、总IgE水平低于对照组(t=4.656,4.189,3.097、2.278;P<0.001、<0.001、=0.003、=0.025),而IL2受体、IL4、ECP、Th1/Th2水平差异无统计学意义(均P>0.05)。结论中重度AD患儿在常规治疗上基础上补充益生菌,可显著降低血清IgE水平,减轻AD患儿的症状,提高疗效。     

益生菌对婴儿期特应性皮炎预防作用的系统评价

目的系统评价益生菌对婴儿期特应性皮炎的预防作用。方法计算机检索中英文数据库,检索时限从建库到2017年12月,收集益生菌对婴儿期特应性皮炎预防的临床随机对照试验的文献,由2名研究员筛选文献及质量评价,采用RevMan 5.3软件进行Meta分析。结果最终纳入质量较高的20个研究,共3 701例患儿。结果显示:益生菌组特应性皮炎发生率低于对照组,两组差异具有统计学意义(RR=0.74,95%CI:0.64~0.86,P0.01)。进一步亚组分析后发现仅产前母亲或产后婴儿口服益生菌对婴儿期特应性皮炎无预防作用(RR=0.91,95%CI:0.62~1.33,P=0.62;RR=0.91,95%CI:0.71~1.16,P=0.43),而在两者均服用益生菌的比较中发现单独服用乳酸菌类或与其他益生菌混合服用同安慰剂组比较均具有预防作用(RR=0.70,95%CI:0.52~0.94,P0.05;RR=0.65,95%CI:0.50~0.86,P0.01)。结论孕母及产后婴儿均补充益生菌对婴儿期特应性皮炎具有预防作用,单独服用临床常用的乳酸菌类或与其他益生菌混合服用同样具有保护作用,但由于国内外菌株、种群差异等诸多因素,其对婴儿期特应性皮炎的保护机制在国内尚需进一步研究。     

基于人体微生物群的特应性皮炎研究进展

皮肤和人体微生物群相互作用,关系复杂。特应性皮炎（atopic dermatitis,AD）是一种常见的慢性和易复发性疾病,与机体的内部和外部环境相关,发病率呈上升趋势。AD的发生往往会改变人体微生物群的组成和数量,微生物群的定植在AD的发生和发展中起着主要作用。本文就人体微生物群与AD的关系、基于皮肤微生物群的AD研究及基于肠道微生物群的AD研究三方面进行综述,主要阐述了皮肤微生物群和肠道微生物群与AD的关系,重点讨论金黄色葡萄球菌在AD发生中的作用以及益生菌等微生物在AD治疗中的重要作用,以期为AD的防治提供新的思路。     

马拉色菌在特应性皮炎免疫学发病机制中的研究进展

近年来,对马拉色菌与免疫系统之间关联的研究明显增加,其重要内容是马拉色菌在特应性皮炎发病中的作用。本文主要概述近期一些研究中对马拉色菌与树突状细胞、角质形成细胞间的关联性及其在特应性皮炎发病的免疫学机制中的作用所获得的进展。     

婴幼儿皮肤微生态特点及其在特应性皮炎发病中的作用

特应性皮炎(atopic dermatitis, AD)是一种常见的慢性炎症性皮肤病, 可发生于各个年龄段, 婴幼儿尤为高发。AD病因复杂, 既往认为遗传背景、皮肤屏障功能障碍和免疫紊乱是其主要发病机制。近年来皮肤微生态在AD发病中的作用被逐渐揭示, 成人AD常伴有以金黄色葡萄球菌定植增加和菌群多样性下降为主要特征的皮肤菌群失调。婴幼儿皮肤屏障功能与免疫功能随着年龄增长发生显著变化, 其皮肤菌群特点也不同于成人, 国内对此领域关注较少, 因此本文就婴幼儿皮肤微生态的特点及其在AD发病中的作用作一综述。

     

益生菌与肠黏膜互作的分子机制研究进展

益生菌是一类定植于动物肠道,可辅助动物消化功能,维护肠道菌群平衡并可影响肠道免疫系统,有益于动物健康的重要调节性菌群。该类菌群与动物肠上皮细胞间互作的分子机制包括菌体表面分子如磷脂壁酸（phosphatidicacid,LTA）、表面层蛋白（Slayerprotein）等与宿主的粘附相关蛋白分子结合,通过占位效应抑制有害菌群在肠道内的定植;益生菌还可刺激肠道细胞分泌B防御素2、细菌素和有机酸等可抑制甚至杀灭有害菌群;在益生菌作用下,肠道上皮细胞可增强粘液糖蛋白、紧密连接蛋白occludin和ZO-1等分子的表达,加厚并加固肠道黏膜屏障;益生菌相关抗原可通过与抗原递呈细胞表面模式识别受体（TLRs等）分子结合,激活递呈细胞,启动各免疫细胞的交互作用,调节肠道免疫状态。     

应激对肠道菌群的影响及机制研究进展

应激是机体受到各种因素刺激时所出现的全身非特异性反应,可对全身各个系统产生影响。肠道菌群是肠道微生态的重要组成部分,对维持机体健康发挥重要作用。应激通过影响肠道黏膜屏障功能、肠道免疫功能、胃肠道运动功能等引起肠道菌群紊乱。本文就应激对肠道菌群的影响及机制的研究进展进行综述。     

益生菌的免疫调节作用及其相关应用研究进展

益生菌的定义来自希腊语,益生菌是指:当摄入足够的剂量时可以对宿主产生有益影响的活的微生物。目前,全球对益生菌及其相关制剂的研究日益受到重视,益生菌在食品、营养品及医药领域的研究也不断深入,益生菌的免疫调节机制主要包括黏膜屏障作用、增强单核—巨噬细胞的吞噬作用、促进sIgA生成等。此外,益生菌还应用于临床相关疾病的治疗,改善受损肝脏的功能,缓解肠易激综合征的临床症状,通过调节脂肪代谢及胰岛素敏感性预防2型糖尿病的发生,预防结直肠肿瘤细胞生长及减轻肠道炎症等。本文主要就益生菌的上述相关研究进展进行综述,为益生菌的研究及相关应用提供参考。     

益生菌缓解新型冠状病毒感染症状的研究进展

由急性呼吸道综合征冠状病毒2(severeacuterespiratorysyndromecoronavirus2,SARS-CoV-2)引起的新型冠状病毒感染(coronavirusdisease2019,COVID-19)从2020年初迅速扩展至全球,成为人类历史上最严重的大流行之一。已有证据证明当SARS-CoV-2的刺突蛋白(S蛋白)与细胞表面受体血管紧张素转化酶2 (angiotensin converting enzyme 2, ACE2)结合时,可感染宿主细胞,引起肠道菌群失调,并引发不同的并发症。益生菌是活的微生物,已被证明对人体健康有益。因其在调节肠道菌群、治疗多种疾病和抗病毒方面的功效而被考虑用来改善COVID-19。本文基于目前公开的临床前和临床试验结果,总结了益生菌在缓解COVID-19临床症状及胃肠道不良反应的效果,并讨论了益生菌在改善COVID-19后遗症方面的潜力,从而为后续管理COVID-19提供新的方向,进一步为呼吸系统疾病提供理论依据。     

Characterization of the skin fungal microbiota in patients with atopic dermatitis and in healthy subjects

Patients with atopic dermatitis (AD) are highly susceptible to viral, bacterial, and fungal skin infections because their skin is dry and this compromises the barrier function of the skin. Therefore, the skin microbiota of patients with AD is believed to be different from that of healthy individuals. In the present study, the skin fungal microbiota of nine patients with mild, moderate, or severe AD and ten healthy subjects were compared using an rRNA clone library. Fungal D1/D2 large subunit analysis of 3647 clones identified 58 species and seven unknown phylotypes in face scale samples from patients with AD and healthy subjects. Malassezia species were predominant, accounting for 63%-86% of the clones identified from each subject. Overall, the non-Malassezia yeast microbiota of the patients was more diverse than that of the healthy individuals. In the AD samples 13.0 ± 3.0 species per case were detected, as compared to 8.0 ± 1.9 species per case in the samples taken from healthy individuals. Notably, Candida albicans, Cryptococcus diffluens, and Cryptococcus liquefaciens were detected in the samples from the patients with AD. Of the filamentous fungal microbiota, Cladosporium spp. and Toxicocladosporium irritans were the predominant species in these patients. Many pathogenic fungi, including Meyerozyma guilliermondii (anamorphic name, Candida guilliermondii), and Trichosporon asahii, and allergenic microorganisms such as Alternaria alternata and Aureobasidium pullulans were found on the skin of the healthy subjects. When the fungal microbiota of the samples from patients with mild/moderate to severe AD and healthy individuals were clustered together by principal coordinates analysis they were found to be clustered according to health status.     

益生菌及益生元调节骨代谢的研究进展

骨质疏松症已成为威胁中老年人健康的主要疾病之一,越来越多的人受到该病症的危害.肠道菌群是定殖在机体肠道内,与宿主形成共生关系的微生物,对宿主的免疫及代谢等产生重要影响,研究发现,肠道菌群与骨代谢之间存在密切关系,本文从肠道菌群与免疫、骨代谢与免疫、肠道菌群与骨代谢、益生菌及益生元调节骨代谢等几个方面阐述,肠道菌群有望成为骨质疏松症治疗的一个新靶点,通过益生菌或益生元来干预肠道菌群组成,进而调节免疫系统状态,抑制促炎因子的生成,从而降低骨吸收作用,达到预防和治疗骨质疏松症的目的.     

Comparison of fecal microbiota and polyamine concentration in adult patients with intractable atopic dermatitis and healthy adults

Fecal microbiota and polyamine concentration obtained from eleven intractable adult-type atopic dermatitis (AD) patients and thirteen healthy adults were compared. Fecal microbiota were analyzed using terminal-restriction fragment length polymorphism. The fecal microbiota of volunteers were divided into two clusters, A (n=16) and B (n=8), and the number of AD patients was found to be higher in Cluster B than Cluster A, suggesting that there are relationships between the obstinacy of intractable adult-type AD and intestinal microbiota in Cluster B. Fecal spermidine concentration in Cluster B were lower than that in Cluster A significantly (P<0.05). Fecal putrescine concentration in Cluster B also tended to be lower than that in Cluster A. Terminal-restriction fragment (T-RF) of 122 bp generated by digestion with Hha I, which were predicted as unknown bacteria, were detected characteristically in Cluster A. In contrast, T-RFs of 368/9 bp generated by digestion with Hha I, which were predicted as Enterobacteriaceae, were detected characteristically in Cluster B. These bacteria are closely associated with intestinal polyamine concentration. These findings raise the possibility that a low concentration of intestinal polyamines produced by intestinal microbiota is one of the important factors in the onset of intractable adult-type AD.     

益生菌产生的细菌素及其功能机制

细菌素是细菌核糖体合成的具有抑菌活性的小肽.细菌素的产生是益生菌重要的益生特性,它们天然无毒,不仅对食品腐败菌和人体致病菌有很好的抑菌活性,还具有有助益生菌定殖和调节肠道菌群等益生特性.本文综述了益生菌产生的细菌素的种类、条件性合成、益生功能及其作用机理等,以期为深入认识益生菌的益生功能及其作用方式,研究开发对人体有益...     

儿童肠道菌群与食物过敏关系的研究进展

食物过敏(food allergy, FA)在儿童中的发生率逐年升高,严重影响其生活质量,已经成为全球面临的公共卫生问题之一。近年来,人们发现FA儿童的肠道菌群组成与健康儿童有显著差异。深入研究发现,肠道菌群可通过调节树突状细胞、辅助性T细胞、调节性T细胞、肥大细胞和粒细胞等免疫细胞维持免疫平衡,也可通过多种方式增强肠道屏障功能,抑制FA的发生。在已有研究基础上,益生菌和益生元在治疗儿童FA方面也得到了一定应用,但目前的应用效果并不明确。本文以婴幼儿FA在全球范围内患者规模日益扩大为背景,综述了肠道菌群影响FA的部分机制,总结了近年部分益生菌和益生元在治疗和预防婴幼儿FA方面的应用,并为肠道菌群在FA发生和发展中的作用机制研究和益生菌及其相关代谢产物在儿童FA治疗和预防中的应用提出了新思路,对促进婴幼儿FA治疗方法和策略的研究有重要意义。     

Inflammatory cytokine‐mediated induction of serine racemase in atopic dermatitis

Serine racemase (SR) is an enzyme that catalyses the synthesis of d ‐serine, an endogenous coagonist for N‐methyl‐D‐aspartate (NMDA)‐type glutamate receptor in the central nervous system. Our previous study demonstrated that SR was expressed in the epidermis of wild‐type (WT) mice but not in SR knockout (KO) mice. In addition, SR immune‐reactivity was only found in the granular and cornified layers of the epidermis in WT mice. These findings suggested that SR is involved in the differentiation of epidermal keratinocytes and the formation of the skin barrier. However, its role in skin barrier dysfunction such as atopic dermatitis (AD) remains elusive. AD is a chronic inflammatory disease of skin, and the clinical presentation of AD has been reported to be occasionally associated with psychological factors. Therefore, this study examined the content of d ‐serine in stratum corneum in AD patients and healthy controls using a tape‐stripping method. Skin samples were collected from the cheek and upper arm skin of AD patient's lesion and healthy individuals. The d ‐serine content was significantly increased in the involved skin of AD in comparison with healthy individuals. An immunohistochemical analysis also revealed an increased SR expression in the epidermis of AD patients. Furthermore, the SR expression in cultured human keratinocytes was significantly increased by the stimulation with tumour necrosis factor ‐α or macrophage migration inhibitory factor. Taken together, these findings suggest that d ‐serine expressed particularly strongly in AD lesional skin and that the SR expression in the keratinocytes is linked to inflammatory cytokines.