肠道菌群与脊髓损伤并发症

脊髓损伤是严重的致残性神经系统疾病,脊髓损伤后产生的水肿、炎症反应和代谢紊乱等并发症是致使脊髓损伤继发性加重的主要原因。近年来,随着对肠道微生物的研究越来越深入,肠道菌群对神经系统疾病的影响得到广泛关注。肠道菌群可以通过调节机体能量代谢、炎症反应及作用于神经内分泌和脑-肠轴的途径影响中枢神经系统疾病。最近研究发现,肠道菌群与脊髓损伤并发症的关系非常紧密。脊髓损伤后肠道菌群的变化可能影响脊髓损伤后并发症发生以及加重。本文主要就肠道菌群对脊髓损伤后并发症的影响和可能的作用机制进行综述,为临床研究和治疗脊髓损伤提供新思路。     

肠道菌群与孤独症发病关系的研究进展

肠道菌群与人体的健康或疾病状态息息相关,在营养摄取、免疫与内分泌调节、药物代谢中都起着重要的作用,并能通过微生物群-肠-脑轴影响中枢神经系统的发育与功能。流行病学数据显示,肠道菌群的组成变化与多种中枢系统疾病相关。其中,孤独症是一类以社交障碍、刻板行为、兴趣狭隘为主要临床特征的神经发育障碍性疾病。由于孤独症与胃肠道疾病之间联系紧密且其发病率正逐年上升,人们愈发关注肠道菌群在孤独症发病过程中的作用。研究发现,肠道菌群能够影响孤独症患者的中枢神经系统发育,导致异常的行为表现并诱发胃肠症状等。本文总结了影响肠道菌群组成的因素,并从微生物群-肠-脑轴的角度讨论了肠道菌群影响孤独症的方式,同时介绍了孤独症患者肠道菌群疗法的有效性与临床前景。     

肠道菌群影响脊髓损伤后焦虑情绪的研究进展

脊髓损伤作为一种严重的创伤性应激可以引发焦虑情绪,对患者心理健康造成极大影响。研究发现,脊髓损伤后肠道菌群失调与焦虑情绪的发生存在密切联系,因此本文从5-羟色胺系统失调、多巴胺系统失调、脑源性神经营养因子缺乏及炎症反应4个方面,探讨脊髓损伤后肠道菌群改变影响焦虑情绪发生的机制,为今后治疗脊髓损伤后焦虑情绪的深入研究和药物开发提供理论依据。     

肠道菌群-肠-脑-肌轴信号交流的研究进展

肠道菌群及其代谢产物在老年神经退行性疾病、胃肠道疾病以及肌肉骨骼系统性疾病的发病与康复中的作用越来越受到关注。肠道菌群及其代谢产物可通过免疫、内分泌和神经系统等多种途径调节大脑神经或肌肉骨骼系统功能;反之,肠道、大脑或肌肉骨骼系统也可通过炎症、代谢或线粒体通路作用于肠道系统,调节肠道菌群微生态,形成肠道菌群与肠-脑、肠-肌、 肠-脑-肌之间的双向信号交流机制,从而影响机体健康。因此,本综述总结了肠道菌群如何通过代谢产物、肠道通透性和免疫-神经通路建立起肠-脑-肌之间的相互联系,为促进大脑神经的可塑性和改善肌肉健康提供新思路。     

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。     

肠道菌群与神经系统疾病

人类肠道菌群是数以万亿的细菌组成的高度多样化的生态系统,菌群失调与多个系统疾病有关联。肠道菌群通过菌群-肠-脑轴与神经系统多途径双向互作,能引起神经免疫炎症反应、肠黏膜和血脑屏障功能改变、直接刺激迷走神经和肠道神经系统脊神经、神经内分泌-下丘脑-垂体-肾上腺轴,造成神经系统疾病。肠道菌群的代谢产物也有一定的作用。文中综述自闭症谱系障碍、多发性硬化、帕金森病、癫痫、吉兰巴雷综合征、阿尔茨海默病、视神经脊髓炎、肝性脑病、肌萎缩侧索硬化、精神分裂症、抑郁症、慢性疲劳综合征、亨廷顿病、脑卒中等肠道菌群改变特征及其干预措施的研究进展。目前肠道菌群的研究还处在初级阶段,因果关系和机制方面的研究比较少,这对精准实施菌群临床干预措施具有重要意义,期待将来有所突破成为一些神经系统疾病治疗的新路径。     

多联益生菌对5-氟尿嘧啶诱发大鼠肠道菌群紊乱及 肠黏膜损伤的保护作用研究

摘要：目的 研究多联益生菌对5-氟尿嘧啶（5-Fu）诱发大鼠肠道菌群紊乱、肠黏膜损伤以及脾脏损伤的保护作用。方法 28只SPF级SD大鼠随机分为正常组、5-Fu+生理盐水组、5-Fu+低剂量益生菌组和5-Fu+高剂量益生菌组,每组7只。所有大鼠于化疗结束后第3天处死,应用PCR-DGGE技术测定肠道菌群变化,鲎试剂测定血浆内毒素含量,HE染色观察肠黏膜变化和脾脏变化。结果 与5-Fu+生理盐水组相比,经益生菌干预后的大鼠其肠道菌群失调和体重减轻症状有明显改善,血浆内毒素含量显著降低,肠黏膜损伤也得到了显著改善,脾脏淋巴细胞明显增多,脾脏损伤程度降低。结论 该多联益生菌制剂能有效减轻5-Fu对大鼠肠黏膜及肠道菌群的破坏,同时减轻其对脾脏的损伤,并且改善大鼠在化疗后的生存质量。     

MicroRNA通过肠道菌群对绝经后骨质疏松症影响的机制探讨

胃肠道是营养和矿物质高效吸收的重要部位。研究显示胃肠道微生物群通过肠-骨轴对骨质量具有调节作用,其作用机制十分复杂,主要通过矿物质吸收、激素控制和免疫调节来实现。中药可以调节肠道菌群,起到治疗绝经后骨质疏松症的作用。近期研究发现,microRNA通过调节肠道微生物基因,改变肠道微生物的生理功能,从而调节骨代谢,影响绝经后骨质疏松症的发生与发展。本文就microRNA调节肠道菌群的研究现状作一综述,探讨绝经后骨质疏松症的调节机制,为绝经后骨质疏松症的肠道微生态研究提供一定的理论依据。     

肺部菌群和肠道菌群及其互作与肺癌发生发展的相关性研究进展

肺部菌群及肠道菌群与肺癌密切相关,研究发现与健康人群相比肺癌患者的肺部及肠道菌群发生失调,即菌群组成结构发生显著改变。随着“肠-肺轴”概念的提出,肺部及肠道菌群在人体内的紧密联系越发受到重视,因此关于肺部及肠道菌群的研究对于阐明肺癌的发生发展机制有重要的指引作用。文中综述了肺癌患者肺部及肠道菌群的组成特点及可能的互作机制,强调了肠-肺轴中免疫系统的重要性,最后总结了肺部及肠道菌群对肺癌临床治疗的影响,并对肺部及肠道菌群可作为肺癌早期诊断与治疗的新颖靶点进行了展望。     

肠道菌群与脑-肠轴相互作用关系研究进展

人体肠道内定植了大量的细菌,它们参与机体多种生理功能的维持。大脑与胃肠道之间通过脑-肠轴进行双向关联。近年研究发现肠道菌群与脑-肠轴可相互作用、相互影响。肠道菌群可影响机体神经内分泌系统及免疫系统的功能,脑-肠轴功能变化同样也会改变肠道的菌群结构。本研究就肠道菌群与脑-肠轴功能相互影响的研究进展作一综述,以期为深入了解肠道菌群对脑-肠轴功能的影响提供参考。     

血清pNF-H、NSE、ESR与老年脊柱手术患者病情和术后认知功能的相关性研究

摘要 目的：研究老年脊柱手术患者血清神经丝蛋白H磷酸化亚型（pNF-H）、神经元特异性烯醇化酶（NSE）以及红细胞沉降率（ESR）水平与患者病情以及术后认知功能障碍发生的相关性。方法：选取2017年6月到2021年6月在我院进行脊柱手术的老年患者82例,根据病情严重程度分为脊髓未损伤组（n=35）、脊髓不完全损伤组（n=27）和脊髓完全损伤组（n=20）,根据术后是否发生认知功能障碍（POCD）分为认知功能障碍组（POCD组,n=30）和无认知功能障碍组（No-POCD组,n=52）。比较各组患者术前和术后1天、3天、7天血清pNF-H、NSE和ESR水平。结果：（1）脊髓未完全损伤组患者血清pNF-H、NSE和ESR均显著高于脊髓未损伤组患者,而均显著低于脊髓完全损伤组患者（P<0.05）;（2）No-POCD组和POCD组在性别、年龄、体重、BMI、手术时间以及术中失血量均具有可比性（P>0.05）;（3）POCD组患者术前和术后1天、3天、7天血清pNF-H、NSE和ESR水平均显著高于No-POCD组患者（P<0.05）。结论：老年脊柱手术患者血清pNF-H、NSE和ESR水平与患者病情以及术后认知功能障碍发生有关,术前及术后血清pNF-H、NSE和ESR水平升高可能增加老年脊柱手术患者术后认知功能障碍风险,检测血清pNF-H、NSE和ESR水平有助于评估老年手术患者病情和术后认知功能障碍发生风险。     

A future perspective on neurodegenerative diseases: nasopharyngeal and gut microbiota

Neurodegenerative diseases are considered a serious life‐threatening issue regardless of age. Resulting nerve damage progressively affects important activities, such as movement, coordination, balance, breathing, speech and the functioning of vital organs. Reports on the subject have concluded that neurodegenerative disease can be caused by mutations of susceptible genes, alcohol consumption, toxins, chemicals and other unknown environmental factors. Although several diagnostic techniques can be used to determine aetiologies, the process is difficult and often fails. Research shows that nasopharyngeal and gut microbiota play important roles in brain to spinal cord coordination. However, no conclusive epidemiologic evidence is available on the roles played by respiratory and gut microbiota in the development of neurodegenerative diseases. Thus, understanding the connection between respiratory and gut microbiota and the nervous system could provide information on causal links. The present review describes future perspectives on the role played by nasopharyngeal and gut microbiota in the development of neurodegenerative diseases.     

Visceral pain: gut microbiota,a new hope?

Background

Visceral pain is a complex and heterogeneous disorder, which can range from the mild discomfort of indigestion to the agonizing pain of renal colic. Regulation of visceral pain involves the spinal cord as well as higher order brain structures. Recent findings have linked the microbiota to gastrointestinal disorders characterized by abdominal pain suggesting the ability of microbes to modulate visceral hypersensitivity and nociception to pain.

Main body

In this review we describe the neuroanatomical basis of visceral pain signaling and the existing evidence of its manipulation exerted by the gut microbiota. We included an updated overview of the potential therapeutic effects of dietary intervention, specifically probiotics and prebiotics, in alleviating hypersensitivity to visceral pain stimuli.

Conclusions

The gut microbiota dramatically impacts normal visceral pain sensation and affects the mechanisms mediating visceral nociception. Furthermore, manipulation of the gut microbiota using prebiotics and probiotics plays a potential role in the regulation of visceral pain disorders.

     

Neuropathy in COVID-19 associated with dysbiosis-related inflammation

Although COVID-19 affects mainly lungs with a hyperactive and imbalanced immune response, gastrointestinal and neurological symptoms such as diarrhea and neuropathic pains have been described as well in patients with COVID-19. Studies indicate that gut–lung axis maintains host homeostasis and disease development with the association of immune system, and gut microbiota is involved in the COVID-19 severity in patients with extrapulmonary conditions. Gut microbiota dysbiosis impairs the gut permeability resulting in translocation of gut microbes and their metabolites into the circulatory system and induce systemic inflammation which, in turn, can affect distal organs such as the brain. Moreover, gut microbiota maintains the availability of tryptophan for kynurenine pathway, which is important for both central nervous and gastrointestinal system in regulating inflammation. SARS-CoV-2 infection disturbs the gut microbiota and leads to immune dysfunction with generalized inflammation. It has been known that cytokines and microbial products crossing the blood-brain barrier induce the neuroinflammation, which contributes to the pathophysiology of neurodegenerative diseases including neuropathies. Therefore, we believe that both gut–lung and gut–brain axes are involved in COVID-19 severity and extrapulmonary complications. Furthermore, gut microbial dysbiosis could be the reason of the neurologic complications seen in severe COVID-19 patients with the association of dysbiosis-related neuroinflammation. This review will provide valuable insights into the role of gut microbiota dysbiosis and dysbiosis-related inflammation on the neuropathy in COVID-19 patients and the disease severity.     

Intestinal Pathology and Gut Microbiota Alterations in a Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) Mouse Model of Parkinson’s Disease

Patients with Parkinson’s disease (PD) often have non-motor symptoms related to gastrointestinal (GI) dysfunction, such as constipation and delayed gastric emptying, which manifest prior to the motor symptoms of PD. Increasing evidence indicates that changes in the composition of the gut microbiota may be related to the pathogenesis of PD. However, it is unclear how GI dysfunction occurs and how gut microbial dysbiosis is caused. We investigated whether a neurotoxin model of PD induced by chronic low doses of MPTP is capable of reproducing the clinical intestinal pathology of PD, as well as whether gut microbial dysbiosis accompanies this pathology. C57BL/6 male mice were administered 18 mg/kg MPTP twice per week for 5 weeks via intraperitoneal injection. GI function was assessed by measuring the 1-h stool frequency and fecal water content; motor function was assessed by pole tests; and tyrosine hydroxylase and alpha-synuclein expression were analyzed. Furthermore, the inflammation, intestinal barrier and composition of the gut microbiota were measured. We found that MPTP caused GI dysfunction and intestinal pathology prior to motor dysfunction. The composition of the gut microbiota was changed; in particular, the change in the abundance of Lachnospiraceae, Erysipelotrichaceae, Prevotellaceae, Clostridiales, Erysipelotrichales and Proteobacteria was significant. These results indicate that a chronic low-dose MPTP model can be used to evaluate the progression of intestinal pathology and gut microbiota dysbiosis in the early stage of PD, which may provide new insights into the pathogenesis of PD.     

Vascular and lymphatic regulation of gastrointestinal function and disease risk

The vascular and lymphatic systems in the gut regulate lipid transport while restricting transfer of commensal gut microbiota and directing immune cell trafficking. Increased permeability of the endothelial systems in the intestine associates with passage of antigens and microbiota from the gut into the bloodstream leading to tissue inflammation, the release of pro-inflammatory mediators and ultimately to abnormalities of systemic metabolism. Recent studies show that lipid metabolism maintains homeostasis and function of intestinal blood and lymphatic endothelial cells, BECs and LECs, respectively. This review highlights recent progress in this area, and information related to the contribution of the lipid transporter CD36, abundant in BECs and LECs, to gastrointestinal barrier integrity, inflammation, and to gut regulation of whole body metabolism. The potential role of endothelial lipid delivery in epithelial tissue renewal after injury and consequently in the risk of gastric and intestinal diseases is also discussed.     

脊髓损伤的病理变化及治疗进展

脊髓损伤是中枢神经系统严重的创伤,多为脊柱损伤的最严重并发症之一,常造成损伤平面以下的肢体运动、感觉及植物神经功能紊乱,不仅给患者本人带来常人难以想象的心理痛苦及生活障碍,给家庭及社会同样带来高额的负担。近年来,脊髓损伤呈现出高发病率、高耗费、高致残率及低龄化的"三高一低"的发病趋势,逐渐成为学术界急需攻克的重大医疗问题。随着脊髓损伤病理生理机制的深入研究,针对发病机制不同阶段进行阻断的新药研究成为热点,加上干细胞技术及生物工程的发展,均为脊髓损伤后的治疗提供了新的方向。     

Better living through microbial action: the benefits of the mammalian gastrointestinal microbiota on the host

Mammals live in a homeostatic symbiosis with their gastrointestinal microbiota. The mammalian host provides the microbiota with nutrients and a stable environment; whereas the microbiota helps shaping the host's gut mucosa and provides nutritional contributions. Microorganisms start colonizing the gut immediately after birth followed by a succession of populations until a stable, adult microbiota has been established. However, physiological conditions differ substantially among locations in the gut and determine bacterial density and diversity. While Firmicutes and Bacteroidetes dominate the gut microbiota in all mammals, the bacterial genera and species diversity is huge and reflects mammalian phylogeny. The main function of the gastrointestinal epithelium is to absorb nutrients and to retain water and electrolytes, yet at the same time it is an efficient barrier against harmful compounds and microorganisms, and is able to neutralize antagonists coincidentally breaching the barrier. These processes are influenced by the microbiota, which modify epithelial expression of genes involved in nutrient uptake and metabolism, mucosal barrier function, xenobiotic metabolism, enteric nervous system and motility, hormonal and maturational responses, angiogenesis, cytoskeleton and extracellular matrix, signal transduction, and general cellular functions. Whereas such effects are local at the gut epithelium they may eventually have systemic consequences, e.g. on body weight and composition.     

Vitamin A and vitamin D regulate the microbial complexity,barrier function,and the mucosal immune responses to ensure intestinal homeostasis

Diet is an important regulator of the gastrointestinal microbiota. Vitamin A and vitamin D deficiencies result in less diverse, dysbiotic microbial communities and increased susceptibility to infection or injury of the gastrointestinal tract. The vitamin A and vitamin D receptors are nuclear receptors expressed by the host, but not the microbiota. Vitamin A- and vitamin D-mediated regulation of the intestinal epithelium and mucosal immune cells underlies the effects of these nutrients on the microbiota. Vitamin A and vitamin D regulate the expression of tight junction proteins on intestinal epithelial cells that are critical for barrier function in the gut. Other shared functions of vitamin A and vitamin D include the support of innate lymphoid cells that produce IL-22, suppression of IFN-γ and IL-17 by T cells, and induction of regulatory T cells in the mucosal tissues. There are some unique functions of vitamin A and D; for example, vitamin A induces gut homing receptors on T cells, while vitamin D suppresses gut homing receptors on T cells. Together, vitamin A- and vitamin D-mediated regulation of the intestinal epithelium and mucosal immune system shape the microbial communities in the gut to maintain homeostasis.