过敏性鼻炎患儿肠道菌群变化 及双歧杆菌三联活菌散对其辅助治疗效果

摘要：目的 观察过敏性鼻炎患儿肠道菌群变化及双歧杆菌三联活菌散对其辅助治疗的效果。方法 选取我院就诊的过敏性鼻炎患儿60例,从中随机抽取10例为疾病组,并以10例体检的健康儿童为健康对照组,采集两组对象粪便标本,用高通量测序法对比过敏性鼻炎患儿与健康对照组肠道菌结构的差异。另一方面,将入选的60例过敏性鼻炎患儿分为对照组（30例,采用常规治疗）和治疗组（30例,常规治疗联合双歧杆菌三联活菌治疗）。两组患儿连续治疗8周后,观察其治疗前后临床症状评分及血清IL-4、IL-12、IgE水平变化。结果 过敏性鼻炎患儿肠道菌群多样性低于健康对照组。患儿肠道菌群以拟杆菌门为主,健康对照组以厚壁菌门为主（P＜0.05)。患儿肠道双歧杆菌属数量低于健康对照组,而毛螺菌属,瘤胃菌属,红蝽菌属和普雷沃菌属有所增多（均P＜0.05)。治疗8周后,治疗组患儿临床症状评分明显降低,治疗的总有效率高于对照组（P<0.05）。治疗组患儿血清IL-4、IgE水平明显降低,IL-12水平明显升高,且治疗组患儿以上指标的改善程度均优于对照组（均P<0.05）。结论 过敏性鼻炎患儿与健康儿童相比肠道菌群存在差异,肠道菌群失衡可能是促进过敏性鼻炎发生发展的一个因素。双歧杆菌三联活菌散对过敏性鼻炎有辅助治疗的作用,能显著改善患儿临床症状,调节机体的免疫能力,具有一定临床应用价值。     

肠道菌群对代谢相关性脂肪肝的影响及运动干预研究进展

大量研究表明,肠道菌群与神经退行性疾病和代谢性疾病等多种疾病的发生和发展息息相关,菌群的种类和数量会受到遗传、饮食习惯、运动等因素的影响。在代谢相关脂肪性肝病中,肠道菌群的部分代谢物通过增加肝脏脂肪变性、改变肠道黏膜通透性等方式对疾病的发展起到促进作用,菌群的种类和数量变化与病情进展的关系也被广泛研究,但是两者发生的先后顺序仍不十分明确。运动可以增加肠道有益菌群的种类和数量,同时改善高脂饮食导致的肠道菌群紊乱,并有效缓解代谢相关脂肪性肝病的病情,肠道菌群也能对机体的运动能力产生影响,但运动是如何通过肠道菌群来改善代谢相关脂肪性肝病的机制尚不十分明确。本文通过综述三者的相互关系来阐述肠道菌群和运动在代谢相关脂肪性肝病中发挥的重要作用。     

母乳性黄疸患儿肠道菌群宏基因组学研究

目的探讨母乳性黄疸(BMJ)患儿的肠道菌群情况。方法采用鸟枪法宏基因组测序方法,对16例BMJ患儿及16例正常婴儿的肠道菌群进行研究。结果 BMJ组与对照组中样品菌种丰度及菌群种类总的水平上差异无统计学意义(P0.05);在部分菌种上有差异,双歧杆菌、脆弱拟杆菌及多形拟杆菌在BMJ组中较对照组少(P0.05);在菌群基因的功能通路上差异也有统计学意义(P≤0.05),尤其是在糖合成和代谢基因功能通路中,BMJ组比对照组表达较少些,差异有统计学意义(P0.05)。结论 BMJ患儿肠道菌群的种类、丰度与正常同龄婴儿总体上差异不大,在菌种上有部分差异,双歧杆菌、脆弱拟杆菌及多形拟杆菌在BMJ患儿肠道中含量较少,可补充双歧杆菌、拟杆菌制剂使BMJ患儿的肠道菌群平衡。同时,在基因功能通路表达上,BMJ患儿与正常同龄婴儿有显著差别,特别是糖合成和代谢通路,可深入研究。     

基于16S rDNA高通量测序技术对克罗恩病患儿肠道菌群变化的研究

目的研究克罗恩病(Crohn′s disease, CD)儿童和正常人群肠道菌群的分布,寻找与CD发生发展显著相关的菌属结构。方法纳入CD患儿36例和健康儿童21例,CD患儿分为活动期22例、缓解期14例,采用16S rDNA高通量测序技术,分析各组肠道菌群的生物多样性与结构组成。结果 CD组患儿(活动期与缓解期)肠道菌群丰富度指数、香浓多样性指数较健康儿童组有明显下降,差异有统计学意义(F=8.829 0,P=0.001 0,P=0.004 5;F=8.890 0,P=0.000 3,P=0.035 6)。在门类水平,所有CD患儿肠道菌群的放线菌门数量减少,变形菌门数量增多。在菌属水平,与健康儿童组相比,所有CD组患儿Faecalibacterium相对丰度显著减低,Klebsiella(克雷伯菌属)、Enterococcus(肠球菌属)相对丰度显著升高。活动期CD组Blautia(布劳特菌属)、Bifidobacterium(双歧杆菌属)、Subdoligranulum、Lachnospira(毛螺旋菌属)、Anaerostipes(丁酸弧菌属)、Eubacterium_rectale_group(直肠杆菌属)的相对丰度明显下降。结论 CD患儿肠道菌群结构及相对丰度较健康儿童存在显著差异。肠道菌群结构的异常与儿童CD的发生发展存在相关性。     

小鼠肠道菌群代谢产物与糖尿病的相关性研究

目的研究糖尿病小鼠粪便中肠道菌群代谢产物与血糖之间的相关性,探讨肠道菌群与糖尿病之间的关系。方法采用高脂饮料喂养加腹腔注射链脲佐菌素(STZ)的方法建立糖尿病小鼠模型;将实验动物随机分为正常组、高脂组、糖尿病组及模型给药组,连续给药5周后,采血测血糖血脂,同步收集动物粪便,测粪便中短链脂肪酸(Short-chain fatty acids,SCFA)及D-乳酸。SCFA的检测使用气相色谱法,D-乳酸的检测使用紫外酶促法。结果糖尿病组小鼠粪便中乙酸、丙酸和正丁酸含量明显低于正常组及高脂组(P<0.01),D-乳酸含量明显高于正常组及高脂组(P<0.01);给药组乙酸、丙酸和正丁酸含量明显高于糖尿病组(P<0.01),D-乳酸含量明显低于糖尿病组(P<0.01)。给药组丙酸、正丁酸的含量与正常组间差异无统计学意义(P>0.05),但乙酸的含量仍低于正常组(P<0.01),D-乳酸的含量仍高于正常组(P<0.01)。结论糖尿病小鼠粪便中的肠道菌群代谢产物与血糖之间存在着密切的关系,代谢产物的差异性,提示肠道菌群的差异性,反映出糖尿病小鼠存在肠道菌群紊乱。     

肠道菌群及其代谢产物与高血压的相关性研究进展

高血压是一种常见的慢性疾病,是世界上最严重的公共卫生问题之一,其发病机制尚未完全阐明.人体肠道菌群与疾病的发生相关,高血压患者或高血压动物模型肠道中均存在菌群失调,肠道菌群及其代谢产物被证明与高血压的发生密切相关.本文综述了国内外的相关研究进展,从与高血压相关的肠道菌群种类、代谢产物及作用机制等多方面讨论了肠道菌群及其...     

脑瘫伴癫痫儿童肠道菌群变化

目的探讨脑瘫伴癫痫儿童肠道菌群的变化。方法选择龙岗区社会福利中心诊断为脑瘫伴癫痫的31例患儿作为疾病组;另外选取同龄健康儿童30例作为健康组。留取受试者的粪便标本,提取总DNA,并对16S rRNA基因的V3-V4可变区进行扩增,并在Illumina MiSeq平台进行高通量测序。结果与健康儿童相比,疾病组儿童肠道内微生物多样性出现明显差异。在门水平优势菌群中,疾病组儿童放线菌的相对丰度明显高于健康组(32.87%vs 3.56%),而拟杆菌的相对丰度明显低于健康组(22.66%vs 53.59%)。在属水平优势菌群中,疾病组儿童双歧杆菌属、副拟杆菌属的相对丰度均明显高于健康组(26.94%vs 2.61%,5.72%vs 1.90%),其中肠杆菌属的相对丰度达6.00%,而拟杆菌属、粪杆菌属的相对丰度明显低于健康组(11.38%vs 45.16%,0.63%vs 12.78%),普雷沃菌属的相对丰度也低于健康组(3.11%vs 5.30%)。结论与同龄健康儿童相比,脑瘫伴癫痫儿童肠道菌群改变明显,菌群门水平和属水平均有明显差异。     

运动与肠道菌群的相关性

肠道菌群与人体互相依存,与机体的感染、营养、免疫及代谢密不可分,在某些疾病的预防和治疗中有着非常重要的作用。肠道菌群具有易变性,它的种类和数量是由遗传和环境因素共同决定的,环境因素主要包括宿主健康状态和生活方式等。近来发现,生活方式与代谢性疾病的发生发展密切相关,而这些代谢性疾病的发生发展都与肠道菌群的改变有关。本研究就机体不同代谢状态下肠道菌群的变化以及运动这种生活方式直接对肠道菌群的影响进行综述。     

人肠道菌群与肺癌关系的研究进展

肠道菌群是由不同种类微生物组成的一个大群体,对宿主的代谢、内分泌系统和免疫系统有着较大的影响。近年来大量的研究发现肠道微生物群落结构变化与消化系统疾病、精神疾病、呼吸系统疾病等多种疾病的发生密切相关,其中关于肠道菌群与肺癌的研究发展迅速。在这篇综述中,我们系统地回顾了肠道常见菌群及肠道菌群与肺癌的关系,并探讨了调节肠道菌群在疾病预防和治疗方面的作用,以期能更加全面地了解肠道菌群在肺癌发生发展中的作用,从而为肺癌的预防、诊断及治疗提供新的方向。     

哺乳动物生物钟与肠道菌群关系的研究进展

为适应昼夜交替所带来的外界环境的变化,大多数生物的生理活动会表现出以24 h为周期的节律性变化,这种现象称为生物节律(又称生物钟)。生物钟紊乱会增加相关代谢性疾病的风险,这些疾病的发展与肠道菌群失调密切相关。肠道菌群即为人体胃肠道内寄生的一定数量和种类的微生物群落。正常情况下,肠道菌群处于平衡状态;但当宿主生物节律受到外界环境干扰时,其肠道菌群稳态也会发生失衡。越来越多的研究显示,肠道菌群的紊乱导致了代谢性疾病的发生。现对生物钟、肠道菌群以及代谢性疾病的关系进行论述,从而为治疗代谢性疾病提供新的策略。     

On the origin of the Hirudinea and the demise of the Oligochaeta

The phylogenetic relationships of the Clitellata were investigated with a data set of published and new complete 18S rRNA gene sequences of 51 species representing 41 families. Sequences were aligned on the basis of a secondary structure model and analysed with maximum parsimony and maximum likelihood. In contrast to the latter method, parsimony did not recover the monophyly of Clitellata. However, a close scrutiny of the data suggested a spurious attraction between some polychaetes and clitellates. As a rule, molecular trees are closely aligned with morphology-based phylogenies. Acanthobdellida and Euhirudinea were reconciled in their traditional Hirudinea clade and were included in the Oligochaeta with the Branchiobdellida via the Lumbriculidae as a possible link between the two assemblages. While the 18S gene yielded a meaningful historical signal for determining relationships within clitellates, the exact position of Hirudinea and Branchiobdellida within oligochaetes remained unresolved. The lack of phylogenetic signal is interpreted as evidence for a rapid radiation of these taxa. The placement of Clitellata within the Polychaeta remained unresolved. The biological reality of polytomies within annelids is suggested and supports the hypothesis of an extremely ancient radiation of polychaetes and emergence of clitellates.     

On the ontogeny of the haptor and the evolution of the Monogenea

Data on the ontogeny of the posterior haptor of monogeneans were obtained from more than 150 publications and summarised. These data were plotted into diagrams showing evolutionary capacity levels based on the theory of a progressive evolution of marginal hooks, anchors and other attachment components of the posterior haptor in the Monogenea (Malmberg, 1986). 5 + 5 unhinged marginal hooks are assumed to be the most primitive monogenean haptoral condition. Thus the diagrams were founded on a 5 + 5 unhinged marginal hook evolutionary capacity level, and the evolutionary capacity levels of anchors and other haptoral attachement components were arranged according to haptoral ontogenetical sequences. In the final plotting diagram data on hosts, type of spermatozoa, oncomiracidial ciliation, sensilla pattern and protonephridial systems were also included. In this way a number of correlations were revealed. Thus, for example, the number of 5 + 5 marginal hooks correlates with the most primitive monogenean type of spermatozoon and with few sensillae, many ciliated cells and a simple protonephridial system in the oncomiracidium. On the basis of the reviewed data it is concluded that the ancient monogeneans with 5 + 5 unhinged marginal hooks were divided into two main lines, one retaining unhinged marginal hooks and the other evolving hinged marginal hooks. Both main lines have recent representatives at different marginal hook evolutionary capacity levels, i.e. monogeneans retaining a haptor with only marginal hooks. For the main line with hinged marginal hooks the name Articulon-choinea n. subclass is proposed. Members with 8 + 8 hinged marginal hooks only are here called Proanchorea n. superord. Monogeneans with unhinged marginal hooks only are here called Ananchorea n. superord. and three new families are erected for its recent members: Anonchohapteridae n. fam., Acolpentronidae n. fam. and Anacanthoridae n. fam. (with 7 + 7, 8 + 8 and 9 + 9 unhinged marginal hooks, respectively). Except for the families of Articulonchoinea (e.g. Acanthocotylidae, Gyrodactylidae, Tetraonchoididae) Bychowsky's (1957) division of the Monogenea into the Oligonchoinea and Polyonchoinea fits the proposed scheme, i.e. monogeneans with unhinged marginal hooks form one old group, the Oligonchoinea, which have 5 + 5 unhinged marginal hooks, and the other group form the Polyonchoinea, which (with the exception of the Hexabothriidae) has a greater number (7 + 7, 8 + 8 or 9 + 9) of unhinged marginal hooks. It is proposed that both these names, Oligonchoinea (sensu mihi) and Polyonchoinea (sensu mihi), will be retained on one side and Articulonchoinea placed on the other side, which reflects the early monogenean evolution. Except for the members of Ananchorea [Polyonchoinea], all members of the Oligonchoinea and Polyonchoinea have anchors, which imply that they are further evolved, i.e. have passed the 5 + 5 marginal hook evolutionary capacity level (Malmberg, 1986). There are two main types of anchors in the Monogenea: haptoral anchors, with anlages appearing in the haptor, and peduncular anchors, with anlages in the peduncle. There are two types of haptoral anchors: peripheral haptoral anchors, ontogenetically the oldest, and central haptoral anchors. Peduncular anchors, in turn, are ontogenetically younger than peripheral haptoral anchors. There may be two pairs of peduncular anchors: medial peduncular anchors, ontogentically the oldest, and lateral peduncular anchors. Only peduncular (not haptoral) anchors have anchor bars. Monogeneans with haptoral anchors are here called Mediohaptanchorea n. superord. and Laterohaptanchorea n. superord. or haptanchoreans. All oligonchoineans and the oldest polyonchoineans are haptanchoreans. Certain members of Calceostomatidae [Polyonchoinea] are the only monogeneans with both (peripheral) haptoral and peduncular anchors (one pair). These monogeneans are here called Mixanchorea n. superord. Polyonchoineans with peduncular anchors and unhinged marginal hooks are here called the Pedunculanchorea n. superord. The most primitive pedunculanchoreans have only one pair of peduncular anchors with an anchor bar, while the most advanced have both medial and lateral peduncular anchors; each pair having an anchor bar. Certain families of the Articulonchoinea, the Anchorea n. superord., also have peduncular anchors (parallel evolution): only one family, the Sundanonchidae n. fam., has both medial and lateral peduncular anchors, each anchor pair with an anchor bar. Evolutionary lines from different monogenean evolutionary capacity levels are discussed and a new system of classification for the Monogenea is proposed.In agreeing to publish this article, I recognise that its contents are controversial and contrary to generally accepted views on monogenean systematics and evolution. I have anticipated a reaction to the article by inviting senior workers in the field to comment upon it: their views will be reported in a future issue of this journal. EditorIn agreeing to publish this article, I recognise that its contents are controversial and contrary to generally accepted views on monogenean systematics and evolution. I have anticipated a reaction to the article by inviting senior workers in the field to comment upon it: their views will be reported in a future issue of this journal. Editor