肠道菌群在非甾体类抗炎药肠病中的作用及机制

非甾体类抗炎药(NSAIDs)是全球范围内广泛使用的解热镇痛抗炎药,但存在明显的胃肠道不良反应,可导致胃肠道溃疡、出血和穿孔等。目前,NSAIDs引起的肠病的发病率较高,且作用机制尚不明确。其中,肠黏膜屏障损伤在NSAIDs肠病发病机制中起着主要作用。近期研究表明肠道菌群与NSAIDs在机体内相互影响,且肠道微生物对肠黏膜屏障功能的维持有重要作用。肠道菌群失衡逐渐成为NSAIDs肠病的病理生理机制之一。本文综述了肠道菌群与NSAIDs药物作用的密切关系,并从肠黏膜屏障损伤和修复的角度阐述肠道菌群在NSAIDs肠病发生发展中的作用及机制,为以肠道菌群为靶标治疗NSAIDs肠病提供理论基础。     

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。     

肠道菌群和肠黏膜屏障在类风湿关节炎中的作用CSCD

类风湿关节炎（rheumatoid arthritis,RA）是一种自身免疫性疾病,致畸率与致残率较高,发病机制尚不清楚,目前尚未有特效药可完全治愈。近年来,国内外相关研究表明RA的发病机制与肠道菌群和肠黏膜屏障密切相关。积极调节肠道菌群和改善肠黏膜屏障可有效缓解RA的关节炎症状,这可能作为RA干预的新靶点。肠道菌群失调引起肠道微生态失衡,一系列有害物质侵入并诱发肠道炎症反应,导致肠道黏膜屏障功能障碍,可能参与RA的发病,但具体作用机制还需进一步明确。本文对肠道菌群和肠黏膜屏障在RA中的具体作用及影响进行总结归纳,以期为治疗RA提供新方向。     

防御素在肠黏膜屏障功能中的作用

肠黏膜不仅有消化和吸收功能,而且还具有重要的防御性屏障功能,它可以使机体的内环境保持相对稳定以维持机体的正常生命活动。当肠黏膜屏障受到损伤时,肠道中的微生物和毒素会突破肠黏膜屏障,进入门静脉和淋巴系统从而引起细菌移位,甚至发展为全身性的炎症反应综合征（systemic inflammatory response syndrome,SIRS）以及多器官功能衰竭综合征（multiple organs defic iency syndrome,MODS）。     

化疗对肠道菌群及血清5-羟色胺水平的影响

化疗不仅导致肠黏膜炎和5-羟色胺(5-HT)水平的异常,也会诱发肠道菌群失衡。平衡状态下的微生物是一道生物屏障,菌群失衡可加剧肠道炎症。近期研究发现,5-HT的水平受肠道菌群的调节。因此,化疗引起的5-HT水平改变可能与肠道菌群的异常有关。本研究主要探讨肠道菌群通过何种途径影响化疗后肠黏膜炎和5-HT水平,为临床上以益生菌调节肠道菌群来改善化疗后的胃肠道反应提供依据。     

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。     

急进高原缺氧环境下TLR4、HIF-1α对肠黏膜屏障的影响

机体急进高原时,随着海拔增高氧分压不断降低,出现低氧反应,导致机体各个器官出现严重的损伤和一系列病理生理改变。肠道是连接人体与外部环境之间最大的通道,也是最大的免疫器官,可以阻挡外界有害物质对人体的侵袭。在急进高原缺氧环境下肠道损伤尤为明显,可引起肠黏膜屏障功能不同程度的损伤,导致机体出现明显的胃肠道不适症状,如腹泻、恶心、呕吐、厌食等,严重者可引起全身炎症反应综合征,甚至多器官功能衰竭及死亡。急进高原缺氧环境下肠黏膜屏障损伤的具体机制仍未明确,越来越多的证据表明肠黏膜屏障损伤与固有免疫的重要组成部分Toll样受体及缺氧诱导因子相关,同时Toll样受体4与缺氧诱导因子-lα被认为是炎症和缺氧最主要的信号因子,两者在肠黏膜屏障功能损伤研究中的作用尤为重要,本文将急进高原缺氧环境下Toll样受体4与缺氧诱导因子-lα对肠黏膜屏障的影响作一简要概述。     

骶神经电刺激对脊髓损伤大鼠肠黏膜机械屏障的保护作用

目的：观察骶神经电刺激对脊髓损伤大鼠肠黏膜机械屏障的保护作用。方法：56只Wistar大鼠分7组（n=8）：正常组、急性完全性脊髓损伤（SCI）组和骶神经电刺激组（按24、48、72h各8只）。进行内毒素测定;肠系膜淋巴结、肝脏、脾脏菌培养;肠道形态学观察;紧密连接蛋白zo-1的蛋白表达测定。结果：对照组肠黏膜不同程度损伤;肠道上皮细胞及细胞间连接破坏;内毒素血症和细菌移位明显。实验组肠黏膜得到改善,内毒素水平下降且细菌移位减少。ZO-1蛋白表达无统计学差异。对照组ZO-1的分布出现不同程度的散乱、排列不规则,实验组分布得到改善。结论：骶神经电刺激可促肠蠕动、排肠内容物、减少肠道菌群数量,保护肠黏膜上皮细胞及紧密连接的机械屏障,减少细菌移位和内毒素血症。     

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。     

葛根芩连汤对泄泻肠道湿热证小鼠肠道双糖酶活性的影响

目的探究葛根芩连汤对泄泻肠道湿热证小鼠肠道双糖酶活性的影响。方法采用“高糖高脂+高温高湿+白酒复合灌胃冰水”的方法制备泄泻肠道湿热证小鼠模型,并运用葛根芩连汤进行干预治疗。分别在干预的第0、2、4、6天无菌采集各组小鼠肠黏膜,运用DNS法测定蔗糖酶活性,ONPG法测定乳糖酶活性,观察葛根芩连汤对泄泻肠道湿热证小鼠肠道双糖酶活性的影响。结果经肠道湿热泄泻造模后,小鼠肠道前段和后段黏膜的乳糖酶和蔗糖酶活性均显著下降,与正常组小鼠相比差异有统计学意义(均P<0.01)。随着治疗时间的延长,治疗组小鼠肠道乳糖酶和蔗糖酶活性与正常组相比有显著的提高(均P<0.05),治疗6 d后,肠道前段黏膜蔗糖酶和乳糖酶活性恢复至正常组水平(P>0.05)。肠道后段乳糖酶活性在第4天时最高,后段黏膜蔗糖酶活性在第6天时最高,与正常组和自愈组相比差异有统计学意义(均P<0.05)。结论泄泻肠道湿热证造模使小鼠肠道黏膜蔗糖酶、乳糖酶等双糖酶的活性显著下降,葛根芩连汤能调节泄泻肠道湿热证小鼠肠道黏膜乳糖酶和蔗糖酶的活性,从而发挥治疗泄泻肠道湿热证的疗效。     

Influence of Microcystin-LR on the activity of membrane enzymes in rat intestinal mucosa

The objective of the present study was to evaluate the effects of microcystin-LR (MCLR) on the activity of membrane enzymes from intestinal mucosa. In addition, serum chemistry and peroxidative status of both serum and intestinal homogenate were evaluated after treatment with MCLR. Wistar rats were treated with intraperitoneal injection of either 100 microg pure MCLR/Kg body weight or saline solution. A significant increase in liver weight and altered serum enzyme activities were found in MCLR-treated rats, indicating damage to the liver in these rats, as previously suggested. A higher specific activity of sucrase (1.5-fold) was observed after the administration of MCLR, whereas other intestinal apical membrane enzymes, such as lactase, maltase and alkaline phosphatase were not modified by the treatment. The specific activities of acid phosphatase and succinate dehydrogenase, markers for lysosomal and mitochondrial membranes, respectively, were also increased (32% and 60%, respectively) in treated rats. The analysis of lipid peroxidation showed that the peroxidative status was increased in both serum and intestinal mucosa from MCLR-treated rats, reflecting an excess production of oxygen free radicals induced by this cyanobacterial toxin. In conclusion, this study shows that acute exposure to MCLR affects the intestinal physiology by modifying the intestinal peroxidation status as well as the activity of membrane enzymes.     

Microcystin-LR induced DNA damage in human peripheral blood lymphocytes

Human exposure to microcystins, which are produced by freshwater cyanobacterial species, is of growing concern due to increasing appearance of cyanobacterial blooms as a consequence of global warming and increasing water eutrophication. Although microcystins are considered to be liver-specific, there is evidence that they may also affect other tissues. These substances have been shown to induce DNA damage in vitro and in vivo, but the mechanisms of their genotoxic activity remain unclear. In human peripheral blood lymphocytes (HPBLs) exposure to non-cytotoxic concentrations (0, 0.1, 1 and 10μg/ml) of microcystin-LR (MCLR) induced a dose- and time-dependent increase in DNA damage, as measured with the comet assay. Digestion of DNA from MCLR-treated HPBLs with purified formamidopyrimidine-DNA glycosylase (Fpg) displayed a greater number of DNA strand-breaks than non-digested DNA, confirming the evidence that MCLR induces oxidative DNA damage. With the cytokinesis-block micronucleus assay no statistically significant induction of micronuclei, nucleoplasmic bridges and nuclear buds was observed after a 24-h exposure to MCLR. At the molecular level, no changes in the expression of selected genes involved in the cellular response to DNA damage and oxidative stress were observed after a 4-h exposure to MCLR (1μg/ml). After 24h, DNA damage-responsive genes (p53, mdm2, gadd45a, cdkn1a), a gene involved in apoptosis (bax) and oxidative stress-responsive genes (cat, gpx1, sod1, gsr, gclc) were up-regulated. These results provide strong support that MCLR is an indirectly genotoxic agent, acting via induction of oxidative stress, and that lymphocytes are also the target of microcystin-induced toxicity.     

优势菌群失衡对肠黏膜上皮结构的损害

目的通过观察小鼠肠道优势菌群失衡肠黏膜上皮结构的变化以探讨肠道优势菌群失衡对黏膜机械屏障的影响。方法利用光镜及电镜技术观察轻度、重度菌群失衡小鼠肠道黏膜绒毛形态变化及上皮细胞超微结构的变化。结果菌群失衡小鼠肠黏膜绒毛出现肿胀、断裂,绒毛顶端肠上皮细胞坏死、脱落,重度菌群失衡与轻度菌群失衡小鼠比较绒毛结构受损加重。超微结构观察发现上皮细胞间隙增宽,胞浆内出现空泡结构,黏膜及黏膜下层有淋巴细胞浸润。结论抗生素干扰肠道优势菌群,可导致肠道机械屏障黏膜绒毛及超微结构受损且重度优势菌群失衡的损害大于轻度优势菌群失衡的损害。     

Establishment of Human Epithelial Enteroids and Colonoids from Whole Tissue and Biopsy

The epithelium of the gastrointestinal tract is constantly renewed as it turns over. This process is triggered by the proliferation of intestinal stem cells (ISCs) and progeny that progressively migrate and differentiate toward the tip of the villi. These processes, essential for gastrointestinal homeostasis, have been extensively studied using multiple approaches. Ex vivo technologies, especially primary cell cultures have proven to be promising for understanding intestinal epithelial functions. A long-term primary culture system for mouse intestinal crypts has been established to generate 3-dimensional epithelial organoids. These epithelial structures contain crypt- and villus-like domains reminiscent of normal gut epithelium. Commonly, termed “enteroids” when derived from small intestine and “colonoids” when derived from colon, they are different from organoids that also contain mesenchyme tissue. Additionally, these enteroids/colonoids continuously produce all cell types found normally within the intestinal epithelium. This in vitro organ-like culture system is rapidly becoming the new gold standard for investigation of intestinal stem cell biology and epithelial cell physiology. This technology has been recently transferred to the study of human gut. The establishment of human derived epithelial enteroids and colonoids from small intestine and colon has been possible through the utilization of specific culture media that allow their growth and maintenance over time. Here, we describe a method to establish a small intestinal and colon crypt-derived system from human whole tissue or biopsies. We emphasize the culture modalities that are essential for the successful growth and maintenance of human enteroids and colonoids.     

Gastrointestinal phenotype of GAD67lacZ transgenic mice with early postnatal lethality

It has been proposed that gamma-aminobutyric acid (GABA) in the gut may function as a neurotransmitter, hormone and/or paracrine agent. Our aim was to examine transgenic mice of the GAD67-lacZ line with impaired postnatal growth and early postnatal lethality for gastrointestinal abnormalities. The gastrointestinal tract was dissected and processed for histology, immunohistochemistry, electron microscopy, western blotting and measurement of GAD activity. Homozygous mice of both sexes displayed an intestinal phenotype characterized by a fragile and haemorrhagic intestinal wall, a reduced number of villi, epithelial lesions and the occasional appearance of pseudostratified epithelium. The number of GABA-immunoreactive enteroendocrine cells and mucin-secreting goblet cells increased significantly relative to wild-type epithelium. The appearance of GABA-immunopositive neuronal perikarya and the lack of GABA-immunoreactive varicose fibres were observed in the enteric plexuses of transgenic mice. Tissue homogenates of transgenic mice showed higher levels of expression of GAD67 and GAD65 as compared with wild-type mice. Our results suggest that the possible reason underlying the growth impairment and postnatal lethality observed in GAD67 transgenic mice is a functional impairment of GABAergic enteric neurons and disintegration of intestinal epithelium.     

Consumption of transgenic cows’ milk containing human lactoferrin results in beneficial changes in the gastrointestinal tract and systemic health of young pigs

Lactoferrin is an antimicrobial and immunomodulatory protein that is produced in high quantities in human milk and aids in the gastrointestinal (GI) maturation of infants. Beneficial health effects have been observed when supplementing human and animal diets with lactoferrin. A herd of genetically engineered cattle that secrete recombinant human lactoferrin in their milk (rhLF-milk) have been generated which provide an efficient production system and ideal medium for rhLF consumption. The effects of consumption of rhLF-milk were tested on young pigs as an animal model for the GI tract of children. When comparing rhLF-milk fed pigs to non-transgenic milk fed pigs (control), we observed that rhLF-milk fed pigs had beneficial changes in circulating leukocyte populations. There was a significant decrease in neutrophils (p = 0.0036) and increase in lymphocytes (p = 0.0017), leading to a decreased neutrophil to lymphocyte ratio (NLR) (p = 0.0153), which is an indicator of decreased systemic inflammation. We also observed changes in intestinal villi architecture. In the duodenum, rhLF-milk fed pigs tended to have taller villi (p = 0.0914) with significantly deeper crypts (p < 0.0001). In the ileum, pigs consuming rhLF-milk had villi that were significantly taller (p = 0.0002), with deeper crypts (p < 0.0001), and a thinner lamina propria (p = 0.0056). We observed no differences in cytokine expression between rhLF-milk and control-milk fed pigs, indicating that consumption of rhLF-milk did not change cytokine signaling in the intestines. Overall favorable changes in systemic health and GI villi architecture were observed; indicating that consumption of rhLF-milk has the potential to induce positive changes in the GI tract.