四君子汤及其纳米制剂对微生态失调小鼠的调整作用

目的研究四君子汤水提液及纳米制剂对肠道微生态失调小鼠的调整作用。方法应用林可霉素灌胃建立小鼠肠道微生态失调模型,然后应用四君子汤水提液(常态中药)及其纳米制剂进行治疗,同时设正常、阳性对照及自然恢复组,于给药6 d后处死小鼠,进行肠道菌群检测、肠组织电镜检查及肝脏细菌易位检测。结果林可霉素灌胃3 d后,小鼠肠道菌群失调,肠黏膜损伤严重,肝脏有大量细菌易位。持续6 d治疗后,肠道双歧杆菌和乳酸杆菌菌量明显上升,损伤的肠黏膜基本修复,肝脏细菌易位数量大幅度下降。各治疗组间比较纳米中药组的效果要好于常态中药和丽珠肠乐组(P<0.001,P<0.01,P<0.05)。结论2种不同粒径的中药均能扶植肠道正常菌群生长,促进肠黏膜损伤修复,控制细菌易位。但纳米中药效果优于常态中药,且用药量小。     

异麦芽低聚糖对衰老模型小鼠肠黏膜免疫功能调节作用的研究

目的探讨异麦芽低聚糖（Isomalto oligosaccharide,IMO）对衰老模型小鼠肠黏膜免疫功能的调节作用及可能机制。方法昆明纯系小鼠随机分为Young组、Aging组、IMO组和IMOLCM组。采用D-半乳糖造成衰老模型后,给予相应药物干预。采用细菌定量测定法检测肠道菌群、放射免疫法检测肠黏膜sIgA、免疫组化法检测肠黏膜IgA^＋浆细胞的表达。结果与Young组相比,Aging组小鼠存在肠道菌群失调、肠黏膜sIgA含量降低、IgA^＋浆细胞表达减少（P〈0．05）;与Aging组相比,IMO组肠道菌群失调状况有所改善,肠黏膜sIgA含量增加、IgA^＋浆细胞的表达增加（P〈0．05）;与IMO组相比,IMOLCM组肠道菌群失调再次出现,肠黏膜sIgA降低、IgA^＋浆细胞的表达降低（P〈0．05）。结论异麦芽低聚糖可改善衰老模型小鼠肠道菌群失调状态和提高肠黏膜免疫功能;异麦芽低聚糖提高肠黏膜免疫功能可能主要由增加益生菌数量间接实现的。     

小鼠肠道优势菌群失衡肠黏液sIgA、黏液素的变化

目的研究肠道菌群失衡对小鼠肠黏膜机械屏障的影响,探讨优势菌群与肠道黏膜屏障的相互作用机制。方法利用ELISA法检测肠黏膜sIgA含量变化,RT-PCR技术及免疫组化法检测肠黏膜上皮细胞Mucin2、Mucin3和防御素mRNA转录产物的变化。结果菌群失衡小鼠小肠段肠黏膜sIgA水平下降,重度菌群失衡组与正常组比较下降显著（P〈0.05）,与轻度菌群失衡组相比下降明显。菌群失衡小鼠上皮细胞中的Mucin2、Mucin3和防御素mRNA转录产物与正常小鼠相比明显增高,在杯状细胞胞浆内Mucin2蛋白阳性表达增强,且重度菌群失衡组与轻度菌群失衡组小鼠比较,Mucin2、Mucin3和防御素增高明显。结论菌群失衡可导致肠黏膜sIgA分泌量随菌群失衡程度呈下降趋势,同时引起黏液层中黏液素和防御素分泌量增加。     

肠道菌群变化对实验小鼠肠黏膜免疫的影响

目的探讨肠道菌群变化对肠黏膜相关淋巴组织的影响。方法通过变性梯度凝胶电泳（Denatu-ring gradient gel electrophoresis,DGGE）法研究了三种不同级别实验小鼠即清洁级小鼠、SPF小鼠和普通小鼠肠道菌群的组成,并用免疫组织化学（immunohistochemistry,IHC）方法研究了此三种不同级别的实验小鼠肠黏膜相关淋巴组织sIgA阳性细胞分布情况。结果普通小鼠肠道细菌种类最多,其sIgA阳性细胞分布最多,肠道不同部位之间sIgA分布情况差异有显著性（P〈0.05）,小肠和大肠之间的阳性细胞分布差异极显著（P〈0.01）;其次是清洁级小鼠,其肠道不同部位之间菌种组成差异无显著性,小肠和大肠之间的阳性细胞分布差异有显著性（P〈0.05）;SPF小鼠肠道细菌种类最少,故其sIgA阳性细胞分布最少,且其肠道不同部位之间菌种组成差异无显著性,小肠和大肠之间的阳性细胞分布差异无显著性（P〉0.05）。结论随着动物微生物控制级别的增高,肠道微生物多样性递减;sIgA阳性细胞与肠道细菌种类正相关。     

低聚果糖对溃疡性结肠炎模型小鼠肠黏膜屏障影响的研究

目的探讨低聚果糖对溃疡性结肠炎(UC)模型小鼠肠黏膜屏障的调节作用及可能机制。方法小鼠随机分成3组:正常对照(NC)组、模型(MD)组和低聚果糖(FOS)组,采用葡聚糖硫酸钠制作UC小鼠模型。造模7d同时给予干预治疗,停用造模药物并后续治疗7d。采用细菌定量测定法检测肠道菌群,放射免疫法检测肠黏膜sIgA,ELISA法检测小鼠肠黏膜IL-10、TNF-α和IL-6水平。结果模型组小鼠存在肠道菌群失调(t=2.088,2.036,2.203,2.109,P0.05),其TNF-α、IL-6水平高于正常对照组(t=1.734,1.801,P0.05),肠黏膜sIgA、IL-10低于正常对照组(t=1.820,1.806,P0.05);低聚果糖组肠道菌群失调状况较模型组有所改善,其TNF-α、IL-6水平低于正常对照组(t=1.980,1.816,1.936,1.920,1.969,1.893,P0.05),肠黏膜sIgA、IL-10高于正常对照组(t=1.801,1.796,P0.05)。结论低聚果糖可改善溃疡性结肠炎模型小鼠肠道菌群屏障功能,可以提高肠黏膜sIgA和抗炎细胞因子IL-10的水平并降低致炎细胞因子TNF-α和IL-6的水平,通过调节肠道过度的免疫反应,使免疫屏障功能得到一定恢复。     

异麦芽低聚糖对D-半乳糖致衰老大鼠肠道菌群、血清IgG和肠黏膜sIgA的影响

目的探讨异麦芽低聚糖对D-半乳糖致衰老大鼠肠黏膜功能的影响。方法Wistar大鼠随机分为3组：（1）青年对照组,（2）衰老对照组,（3）衰老观察组（衰老＋异麦芽低聚糖）。采用D-半乳糖造成衰老模型后,应用异麦芽低聚糖灌胃,检测各组肠道菌群、血清IgG和肠黏膜sIgA。结果D-半乳糖致衰老大鼠肠道菌群失调;灌胃异麦芽低聚糖后,衰老大鼠肠道双歧杆菌增加（P〈0．05）,肠杆菌和肠球菌数量减少（P〈0．05）;血清IgG、肠黏膜sIgA含量增加（P〈0．05）。结论异麦芽低聚糖可改善衰老机体肠黏膜功能。     

双歧杆菌三联活菌肠溶胶囊 对重症肺炎患者肠黏膜屏障功能的保护作用

目的探讨双歧杆菌三联活菌肠溶胶囊对重症肺炎患者肠黏膜屏障功能的保护作用。方法选取重症肺炎患者66例,随机分为观察组（n=33例）和对照组（n=33例）。两组患者均予以吸氧、抗感染、抗休克和营养支持等常规治疗,必要时行机械通气或血管活性药物。观察组患者加用双歧杆菌三联活菌肠溶胶囊420 mg,3次/d,温水服用或水化后自鼻饲注入。观察两组患者治疗前和治疗14 d后内毒素、二胺氧化酶（DAO）和D-乳酸水平的变化,并比较其临床疗效。结果治疗14 d后,两组患者血清内毒素、DAO和D-乳酸水平均较前明显下降（P〈0.01或P〈0.05）,且观察组下降值明显大于对照组（P〈0.05）;同时观察组患者的临床总有效率明显高于对照组（χ2=3.88,P〈0.05）。结论双歧杆菌三联活菌肠溶胶囊辅助治疗重症肺炎患者具有较好的疗效,能明显降低血清内毒素、DAO和D-乳酸水平,减轻患者内毒素血症和肠黏膜通透性,保护患者肠黏膜屏障功能。     

加味四君子汤改善小鼠肠黏膜屏障作用的研究

目的 观察加味四君子汤和思密达改善小鼠肠黏膜屏障的作用.方法 盐酸林可霉素灌胃建立小鼠肠黏膜破损及肠道菌群失调模型.昆明种鼠随机分5组,进行肠道菌群检测、细菌易位分析及通透性(血浆二胺氧化酶)的检测.结果 盐酸林可霉素灌服小鼠3 d,肠道菌群失调、细菌平均易位率从正常对照组的12.5%增加到59%,血浆二胺氧化酶从正常对照组的2.08 mg/ml增加到7.18 mg/ml,肠黏膜屏障功能受损.分组分别给加味四君子汤、思密达后,肠道菌群得以调整,细菌平均易位率降低到9.35%以下,血浆二胺氧化酶减低到3.88 mg/ml以下.结论 加味四君子汤和思密达均能调整失调的菌群、降低肠道通透性和细菌易位率,改善小鼠肠黏膜屏障功能.     

参麦注射液对严重烫伤大鼠肠道屏障功能的保护作用

目的:探索参麦注射液对30% Ⅲ°烫伤早期肠道屏障功能的保护作用,为参麦注射液防治肠源性感染提供实验依据。方法:Wistar大鼠60只,随机分为正常对照组、模型对照组,地塞米松5 mg/kg组、参麦注射液5、10、15 mg/kg组,每组10只,使用烫伤仪建立30% Ⅲ°烫伤动物模型,立即腹腔注射相应的药物,每天1次。烫伤72 h后,检测肝脏、脾脏、肠系膜淋巴结细菌移位量、血浆内毒素、二胺氧化酶(DAO)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)水平和肠粘膜分泌型免疫球蛋白A(sIgA)的水平。结果:与正常对照组比较,模型组肝脏、脾脏、肠系膜淋巴结细菌移位量,血浆内毒素、DAO、TNF-α及 IL-6和肠黏膜sIgA水平明显升高(P＜0.01);与模型组比较,地塞米松组和参麦注射液5、10、15 mg/kg组肝脏、脾脏、肠系膜淋巴结细菌移位量,血浆内毒素、DAO、TNF-α及 IL-6和肠黏膜sIgA水平明显降低(P＜0.05或P＜0.01)。结论:参麦注射液可减轻严重烫伤引起的肠粘膜损伤,效果与地塞米松相当,高剂量组效果更好。     

GLP-2对小鼠小肠黏膜的作用及不同脏器分布的影响

目的：观察胰高血糖素样肽-2对小鼠小肠黏膜的作用效果及其受体在不同脏器的分布和表达。方法：选用5-6周龄的雄性健康BALB/C小鼠,体重17～20g。随机分为3组。对照组8只;脑内注射GLP-2组9只,每天按25μg/kg脑内注射GLP-2液2次,连续3天;腹腔注射GLP-2组9只,每天按250μg/kg腹腔注射GLP-2液2次,连续3天。3天后,处死小鼠,做组织切片进行HE染色,观察小鼠小肠黏膜的组织学变化,用免疫组化方法检测GLP-2R在不同脏器的表达和分布。结果：小鼠经腹腔注射GLP-2后,小肠不同肠段黏膜的绒毛高度较对照组明显增加（P〈0.05）,脑内注射组的肠黏膜无明显形态学变化;GLP-2R在小鼠胃、空肠与结肠部位均有表达,而食管与肝显阴性;腹腔注射组的GLP-2R表达较对照组显著下调（P〈0.05）。结论：GLP-2能刺激小肠黏膜上皮增厚,增加小肠不同肠段黏膜的绒毛高度;小鼠的胃、空肠与结肠经GLP-2（腹腔注射）处理后其受体表达下调。     

急进高原大鼠肠黏膜机械屏障损伤后细胞自噬变化的初步研究

目的探讨急进高原大鼠肠黏膜机械屏障损伤后细胞自噬的变化情况。方法50只Wistar大鼠随机分为5组：平原组,急进高原6h组、12h组、24h组、48h组,每组各10只。通过低压低氧动物实验舱模拟急进海拔4767m建立急进高原大鼠模型。观察各组大鼠肠黏膜机械屏障损伤情况,用透射电镜观察肠上皮细胞中自噬体;用免疫组织化学法检测肠上皮细胞中自噬相关蛋白Beclinl及LC3B表达。结果与平原组比较,急进高原组可使其肠黏膜机械屏障发生损伤,并且在急进高原肠黏膜损伤6h后可观测到自噬体,24h后检测到自噬相关蛋白Beclinl及LC3B表达显著增高（P〈0．01）。结论急进高原组大鼠肠黏膜机械屏障损伤后自噬相关蛋白Beclinl及LC3B表达明显增加,表明急进高原大鼠肠黏膜机械屏障损伤后细胞自噬活性上调。     

肠道菌群影响黏膜屏障结构与功能的研究进展

肠道黏膜屏障具有防止致病性抗原侵入、维护肠道健康的功能。而肠道菌群是肠道黏膜屏障的重要构成部分,肠道菌群失调会导致肠道黏膜屏障的损伤,引起炎性肠病、肠易激综合征及肝、肾等多种疾病的发生发展。因此,本文从肠道黏膜的结构与功能及肠道菌群对其的影响等方面归纳总结肠道菌群对屏障系统的调控作用,从调节肠道微生态平衡、促进黏液分泌、影响紧密连接和肠道上皮通透性、激发肠黏膜免疫、调控肠上皮凋亡、影响肠上皮DNA稳定性及产生特殊代谢产物等方面阐述其作用机制,为临床胃肠道疾病及其并发症的治疗提供新的思路和方法。     

Gut-derived endotoxin translocation is the main aggravating mechanism of acute severe pancreatitis

Severe acute pancreatitis (SAP) is a serious systemic disease. It exacerbates when complicated with multiple organ dysfunction syndrome or failure (MODS or MOF). However, the aggravating mechanism of SAP is still unknown up to now. Study showed that maintaining integrity of intestinal mucosal barrier function by given effective antibiotics, selective digestive decontamination (SDD) and enteral nutrition therapy to the patients with SAP could significantly reduce infection of pancreatic necrotic tissue and improve the patient's outcome. Combining the findings of gut-derived bacteria in animals' pancreas, liver, spleen, mesenteric lymph nodes with increasing concentration of inflammatory cytokines and endotoxin in plasma with SAP, we hypothesize that gut-derived endotoxin translocation is the main aggravating mechanism of SAP. The hypothesis holds potential as a target for therapeutic intervention.     

Intestinal and hepatic expression of BNIP3 in necrotizing enterocolitis: regulation by nitric oxide and peroxynitrite

Necrotizing enterocolitis (NEC) is characterized by the upregulation of proinflammatory proteins, nitrosative stress, and increased enterocyte apoptosis. We examined the expression and regulation of the Bcl-2/adenovirus EIB 19-kDa-interacting protein 3 (BNIP3), a pro-apoptotic gene regulated by nitric oxide (NO) in hepatocytes, in NEC. Newborn rats subjected to hypoxia and fed a conventional formula by gavage (FFH) developed NEC and demonstrated elevated expression of BNIP3 mRNA and protein in mucosal scrapings of the ileal samples and in the liver. In contrast, control rats [breast-fed (BF) without hypoxia] did not develop NEC or elevated BNIP3 expression in these tissues. BNIP3 expression paralleled the histological manifestation of NEC. Supplementation of the formula with L-Nomega-(1-iminoethyl)lysine, an inducible NO synthase inhibitor, reduced BNIP3 expression in FFH animals to the levels found in BF animals. Both hypoxia and peroxynitrite upregulated BNIP3 protein expression in human intestinal cells. Finally, ileal samples obtained from infants undergoing surgical resection for acute NEC demonstrated higher levels of BNIP3 protein. Because hypoxia and formation of reactive nitrogen species may promote gut barrier failure, we propose that upregulation of the cell death-related protein BNIP3 is one possible mechanism associated with enterocyte cell death observed in the intestine with NEC.     

非酒精性脂肪性肝病与肠粘膜屏障关系的研究进展

近年来,非酒精性脂肪性肝病的发病率正呈逐年升高趋势,且可进一步发展为非酒精性肝炎、肝硬化甚至肝癌,但其具体的发病机制目前尚未完全阐明。迄今为止,关于非酒精性脂肪性肝病较为人们所接受的是"两次打击学说",即肝脏的脂肪变性及脂质的过氧化反应。自"肠-肝轴"被提出后,关于肠道粘膜屏障功能与非酒精性脂肪性肝病的发生和发展的关系备受研究人员的关注。近些年来,关于非酒精性脂肪性肝病与肠道粘膜的机械屏障、生物屏障、化学屏障、免疫屏障方面的研究越来越多,肠粘膜的四个屏障功能与非酒精性脂肪性肝病密切相关,相互影响共同促进疾病的发生发展。本文就非酒精性脂肪性肝病与肠粘膜屏障关系的研究进展进行了综述。     

Hyperammonemia induces transport of taurine and creatine and suppresses claudin-12 gene expression in brain capillary endothelial cells in vitro

Ammonia is a key neurotoxin involved in the neurological complications of acute liver failure. The present study was undertaken to study the effects of exposure to pathophysiologically relevant concentrations of ammonium chloride on cultured brain capillary endothelial cells in order to identify mechanisms by which ammonia may alter blood-brain barrier function. Conditionally immortalized mouse brain capillary endothelial cells (TM-BBB) were used as an in vitro model of the blood-brain barrier. Gene expression of a series of blood-brain barrier transporters and tight junction proteins was assessed by quantitative real time PCR analysis. Exposure to ammonia (5mM for 72h) resulted in significant increases in mRNA levels of taurine transporter (TAUT; 2.0-fold increase) as well as creatine transporter (CRT; 1.9-fold increase) whereas claudin-12 mRNA expression was significantly reduced to 67.7% of control levels. Furthermore, [(3)H]taurine and [(14)C]creatine uptake were concomitantly increased following exposure to ammonia, suggesting that up-regulation of both TAUT and CRT under hyperammonemic conditions results in an increased function of these two transporters in TM-BBB cells. TAUT and CRT are respectively involved in osmoregulation and energy buffering in the brain, two systems that are thought to be affected in acute liver failure. Furthermore, claudin-12 down-regulation suggests that hyperammonemia may also affect tight junction integrity. Our results provide evidence that ammonia can alter brain capillary endothelial cell gene expression and transporter function. These findings may be relevant to pathological situations involving hyperammonemia, such as liver disease.     

Statin pleiotropy prevents rho kinase-mediated intestinal epithelial barrier compromise induced by Blastocystis cysteine proteases

Blastocystis is an enteric parasite that causes acute and chronic intestinal infections, often non-responsive to conventional antibiotics. The effects of Blastocystis infections on human epithelial permeability are not known, and molecular mechanisms of Blastocystis-induced intestinal pathology remain unclear. This study was conducted to determine whether Blastocystis species alters human intestinal epithelial permeability, to assess whether these abnormalities are rho kinase (ROCK)-dependent, and to investigate the therapeutic potential of the HMG-CoA reductase inhibitor Simvastatin in altered intestinal epithelial barrier function. The effect of metronidazole resistant (Mz(r) ) Blastocystis isolated from a symptomatic patient on human colonic epithelial monolayers (Caco-2) was assessed. Modulation of enterocyte myosin light chain phosphorylation, transepithelial fluorescein isothiocyanate-dextran fluxes, transepithelial resistance, cytoskeletal F-actin and tight junctional zonula occludens-1 (ZO-1) by parasite cysteine proteases were measured in the presence or absence of HMG-CoA reductase and ROCK inhibition. Blastocystis significantly decreased transepithelial resistance, increased epithelial permeability, phosphorylated myosin light chain and reorganized epithelial actin cytoskeleton andZO-1. Thesealterations were abolished byinhibition of enterocyte ROCK, HMG-CoA reductase and parasite cysteine protease. Our findings suggest that cysteine proteases of Mz(r) Blastocystis induce ROCK-dependent disruption of intestinal epithelial barrier function and correlates with reorganization of cytoskeletal F-actin and tight junctional ZO-1. Simvastatin prevented parasite-induced barriercompromise, suggesting a therapeutic potential of statins in intestinal infections.     

益生菌对肝硬化患者肠道菌群和肠道屏障功能的影响

目的 探讨益生菌对肝硬化患者肠道菌群、肠道屏障功能及肝脏功能的影响,为肝硬化患者的治疗提供参考.方法 选取2017年1月至2019年6月我院收治的60例乙肝肝硬化患者为研究对象.入选患者随机分为观察组和对照组,各30例.对照组患者采用常规治疗,观察组患者在此基础上加用地衣芽孢杆菌胶囊进行治疗.两组患者疗程均为1个月.比...     

肠道菌群失衡与急性胰腺炎易位感染的关系

目的探讨急性胰腺炎患者肠道菌群与胰腺炎易位感染的关系。方法前瞻性地募集重症急性胰腺炎患者171名,根据是否发生易位感染,分为急性胰腺炎非感染组(131名)和急性胰腺炎易位感染组(40名),所有入选者入院时收集粪便标本和血清,分别采用实时荧光定量PCR和分光光度法测定肠道菌群组成及肠道屏障功能,探讨肠道菌群与胰腺炎肠道屏障以及易位感染的关系。结果急性胰腺炎易位感染组患者入院时肠道菌群中的肠杆菌以及肠球菌含量较非感染组显著增加,实时荧光定量PCR结果发现感染组患者潜在致病菌如肠球菌、肠杆菌显著高于非感染组,与肠道黏膜屏障功能的内毒素水平、二胺氧化酶活性以及D-乳酸含量显著正相关,而双歧杆菌显著低于非感染组,与内毒素水平、二胺氧化酶活性以及D-乳酸含量显著负相关,结果提示肠道菌群失衡可能是急性胰腺炎易位感染发生的主要原因之一。结论肠道菌群失衡是急性胰腺炎易位感染发生的高危因素,与急性胰腺炎易位感染发生相关。