肠道微生物代谢物在肝硬化中的作用CSCD

肝硬化是由多因素引起的终末期肝病,也是导致慢性肝病患者病死的主要原因之一。随着微生物相关多组学的发展和应用,越来越多的研究发现,肠道微生物及其代谢产物如短链脂肪酸、胆汁酸和内毒素等在肝硬化等肝脏疾病中发挥主要作用,但这些肠道微生物代谢产物影响肝硬化发展的机制依然不明确。因此,根据近年来关于肠道微生物及其代谢产物与肝硬化关系的研究,本文重点介绍几种研究比较深入的微生物代谢物以及其影响肝硬化发展的潜在的作用机制,并简要介绍微生物代谢物治疗肝硬化的方法,以期为肝硬化的病理生理学机制、诊断和治疗提供新的见解。     

肠道菌群与肝脏疾病相关性

肠道菌群是一个复杂的微生态系统,其种类、数量、比例、定位等要素的平衡对宿主健康产生重大影响,尤其与消化系统关系紧密。肝脏是身体内以代谢功能为主的器官,大量研究显示,肠道菌群可对酒精性肝病、非酒精性肝病、肝性脑病、肝硬化、肝癌以及自身自身免疫性肝炎等肝病的发生发展产生重要影响。本文从肠道菌群与肝脏疾病的相关性,肠道菌群影响肝脏疾病的可能机制等方面进行综述,为以肠道菌群为靶点的肝病临床治疗研究提供借鉴。     

维生素K2对心血管疾病作用的研究进展

摘要：心血管疾病（CVD）目前是人类面临的重大健康问题之一,也是全球人口死亡的首要原因。近年来,国内外研究发现维生素K2对于防治许多心血管疾病发挥着重要作用。维生素K2主要由人体肠道微生物代谢产生,人类也可以通过细菌发酵类食品如纳豆和奶酪等获得,这反映出细菌与人共生关系的重要性。大量临床试验和基础医学实验表明,维生素K2参与羧化维生素K依赖蛋白（VKDPs）,具有防治骨质疏松症、改善血管钙化、减少炎性因子释放和提高胰岛素敏感性等功能。本综述主要分析维生素K2在心血管疾病的研究进展和前景。     

常见肠道菌群代谢产物作为疾病诊断的指针的研究进展

人类肠道菌群能够产生多种代谢产物或与人体相互作用产生肠道菌群-宿主共代谢物,显著影响人体各大系统的生理功能。当人体健康状态以及肠道菌群发生变化时,肠道代谢物的种类和含量也会相应受到影响,因此肠道菌群代谢产物具有作为疾病诊断指针的巨大潜力。本文总结了常见的几类肠道微生物代谢产物,包括糖类、胆碱代谢物、脂质、氨基酸与肽类、维生素、胆汁酸、短链脂肪酸、酚、苯甲酰基和苯基衍生物等,及其在不同疾病状态下的作用机理,以期更好地理解肠道菌群、代谢产物和疾病之间的相关性,为疾病的预防、诊断和治疗提供新的靶点。     

肝硬化患者肠道菌群失衡的研究现状

肝硬化是我国的一种常见病,近年来越来越多的研究表明肝硬化及其并发症(如门静脉高压、自发性腹膜炎、肝性脑病及肝癌等)都与肠道菌群失衡有着密切的联系。肝脏和肠道通过"肠-肝轴"紧密联系在一起,肝硬化时因小肠细菌过度生长、肠黏膜屏障功能受损、机体免疫功能下降等因素,导致细菌移位、肠道微生态失衡。而肠道微生态失衡又会使肝功能障碍进一步发展,引起肝性脑病等并发症。本文就目前国内外对肝硬化及其并发症与肠道细菌及真菌菌群失衡的研究进行综述。     

后生元(postbiotics):调节肝硬化患者肠道菌群及疾病进程的新策略

肝硬化是慢性肝炎发展的终末阶段,患者出现有不同程度的肠道菌群失调,并伴有肠道屏障功能的缺失和菌群移位,是引发肝硬化并发症的重要原因。尽管益生菌能在多个层面保护肠道屏障功能,但其在肝硬化肠道菌群紊乱中的疗效并不明确。现在的研究发现一些益生菌的组分或代谢产物有着与益生活菌类似的益生功效,包括稳定肠道菌群、加强肠上皮屏障功能和调节肠黏膜免疫反应等,其重要的优点是具有明确的分子结构和显著的生物活性,可能是未来调节肝硬化肠道菌群及疾病进程的新方向。本文主要总结了肝硬化肠道菌群失调对于肝硬化并发症及疾病进程的影响,探讨了益生菌的作用及局限性,并重点讨论后生元在调控肝硬化肠道菌群及疾病进程中的应用前景。     

肠道菌群与胆汁酸代谢的互相作用

肠道菌群是胃肠道的多种共生细菌和其他微生物的统称,是一个复杂而动态的微生物生态系统,有数十万亿个微生物。胆汁酸是胆汁的主要成分,由肝脏中的胆固醇合成并释放到肠道中以帮助消化吸收膳食脂肪。肠道菌群在胆汁酸代谢中发挥着重要作用,它借助胆盐水解酶和类固醇脱氢酶等通过脱氢、脱羟基和脱硫等作用改变胆汁酸池的组成;随后通过影响胆汁酸受体(如法尼醇X受体)再反馈调节胆汁酸代谢。此外胆汁酸可通过破坏细菌细胞膜和损伤DNA等抑制细菌的生长而直接改变肠道菌群结构,也可通过其受体间接改变肠道菌群结构。越来越多的研究揭示了肝脏胆汁酸和肠道菌群在调节宿主健康和疾病中的相互作用。因此,了解肠道菌群和胆汁酸代谢之间的相互作用对维持宿主健康具有重要意义。本文就胆汁酸的基本代谢过程以及其与肠道菌群的相互作用作一综述。     

椰心叶甲、椰子织蛾肠道菌群多样性分析

[目的] 椰心叶甲、椰子织蛾同属棕榈科食叶性入侵害虫,两者同时取食棕榈科植物却无明显竞争作用,本文通过分子生物学手段对两者的肠道菌群组成、肠道代谢通路进行比对,以此探讨两者食性之间相关性。[方法] 以16S rRNA菌群分析等预测手段对两者肠道微生物群落、代谢通路等进行差异分析。[结果] 椰心叶甲体内变形菌门群落丰度显著高于椰子织蛾,椰子织蛾体内蓝菌门、放线菌门、酸杆菌门、疣微菌门等菌群丰度显著高于椰心叶甲;椰心叶甲体内膦酸酯和亚膦酸盐代谢、N-聚糖合成等肠道代谢通路显著强于椰子织蛾,而椰子织蛾肠道中酮体的合成和降解、维生素B6代谢、核黄素代谢、黄酮和黄酮醇生物合成等代谢通路显著强于椰心叶甲。[结论] 椰子织蛾体内相对较高的酸杆菌门丰度可能导致了其偏好取食纤维素高的椰子老叶,而椰心叶甲则相反。同时,椰子织蛾肠道内显著较高的维生素B含量在其族群发展过程中起到了主要作用。两者细菌丰度以及代谢通路强度的差异可能影响了两者的食性。     

肠道菌群在慢性肝脏疾病中作用的研究进展

随着肠-肝轴机制研究的不断深入,肠道菌群与多种慢性肝脏疾病如非酒精性脂肪性肝病、酒精性肝病、肝硬化等相关性研究日益增多。肠道菌群通过肠道菌群失调、物质能量代谢改变及免疫反应激活等机制在多种肝脏疾病发生发展中发挥重要作用。本文对肠道菌群与慢性肝脏疾病关系的研究进展进行综述。     

肠道菌群在代谢手术改善肥胖代谢性疾病中的研究进展

肥胖不仅是体内脂肪细胞的增加,而且是机体代谢状态的异常改变,导致肥胖患者出现2型糖尿病、非酒精性脂肪性肝病、心血管疾病和多囊卵巢综合征等代谢紊乱性疾病。代谢手术在减重的同时,能够治疗和缓解由肥胖导致的相关疾病。对代谢手术改善肥胖及其合并症的机制研究发现,肠道微生物在术后显著改变,这促使肠道菌群及其代谢产物（短链脂肪酸和胆汁酸）等成为代谢手术改善代谢效应机制研究的热点。随着粪菌移植和口服益生菌治疗肥胖及其合并症的报道,进一步验证了肠道菌群在改善肥胖及其相关并发症中发挥有益作用。本综述将总结肠道菌群在代谢手术领域中的最新研究进展。     

The interrelationship between bile acid and vitamin A homeostasis

Vitamin A is a fat-soluble vitamin important for vision, reproduction, embryonic development, cell differentiation, epithelial barrier function and adequate immune responses. Efficient absorption of dietary vitamin A depends on the fat-solubilizing properties of bile acids. Bile acids are synthesized in the liver and maintained in an enterohepatic circulation. The liver is also the main storage site for vitamin A in the mammalian body, where an intimate collaboration between hepatocytes and hepatic stellate cells leads to the accumulation of retinyl esters in large cytoplasmic lipid droplet hepatic stellate cells. Chronic liver diseases are often characterized by disturbed bile acid and vitamin A homeostasis, where bile production is impaired and hepatic stellate cells lose their vitamin A in a transdifferentiation process to myofibroblasts, cells that produce excessive extracellular matrix proteins leading to fibrosis. Chronic liver diseases thus may lead to vitamin A deficiency. Recent data reveal an intricate crosstalk between vitamin A metabolites and bile acids, in part via the Retinoic Acid Receptor (RAR), Retinoid X Receptor (RXR) and the Farnesoid X Receptor (FXR), in maintaining vitamin A and bile acid homeostasis. Here, we provide an overview of the various levels of “communication” between vitamin A metabolites and bile acids and its relevance for the treatment of chronic liver diseases.     

Viability and plasma vitamin K levels in the common bile duct-ligated rats.

The common bile duct-ligated (CBDL) rat, which is widely used as a model of human cirrhosis, rapidly develops secondary biliary cirrhosis (SBC) within 4 weeks. The CBDL rat shows poor viability, however, a detailed examination of the causes of its death has not been made. In this study, we investigated the outcome of bile duct ligation in detail and attempted to extend the life span of this model by feeding the animals a diet supplemented with nutrients. Survival rate, blood chemistry, blood cell counts, plasma levels of K vitamins and liver histology were compared among CBDL rats fed a standard diet and an enriched diet. Sham-operated rats were used as a control. Six out of 18 CBDL rats fed the standard diet died within 32 days of operation. The cause of death was massive internal hemorrhage in various organs or body cavities. All CBDL rats fed the enriched diet survived more than 31 days, but the viability of CBDL rats was not significant between those fed the standard diet and the enriched diet. The degree of anemia correlated significantly with the prolongation of prothrombin time. Plasma vitamin K1 levels in CBDL rats were significantly lower than those in sham-operated rats, but vitamin K2 levels were similar. We suggest that massive hemorrhage, which was the direct cause of death, is caused by the impairment of hemostasis resulting from vitamin K deficiency. The enriched diet with vitamin K nutritional supplements seemed to contribute to the prolongation of the life span of CBDL rats.     

Vitamin K1 as a modulator of benzo(a)pyrene metabolism as measured by in vitro metabolite formation and in vivo DNA-adduct formation

Vitamin K1 (2-methyl-3-phytyl-1,4-napthoquinone) increases the microsomal metabolism of benzo(a)pyrene in rat liver microsomes in vitro. The increase is most marked in the 9,10 diol, 4,5 diol and 3-OH metabolites. The effect is seen at an in vitro concentration of 25 microM and disappears at higher concentrations of K1. The production of BP metabolite-DNA adducts in liver in vivo in ICR/Ha mice is reduced in dietary induced vitamin K deficient mice and this effect is reversed by vitamin K1. These findings indicate a role for vitamin K1 in the regulation of the microsomal mixed function oxidase system and suggest a reason for the low intracellular content and minimal body stores of this vitamin.     

Role of cytochrome P450-dependent arachidonic acid metabolites in liver physiology and pathophysiology

Arachidonic acid (AA) can undergo monooxygenation or epoxidation by enzymes in the cytochrome P450 (CYP) family in the brain, kidney, lung, vasculature, and the liver. CYP-AA metabolites, 19- and 20-hydroxyeicosatetraenoic acids (HETEs), epoxyeicosatrienoic acids (EETs) and diHETEs have different biological properties based on sites of production and can be stored in tissue lipids and released in response to hormonal stimuli. 20-HETE is a vasoconstrictor, causing blockade of Ca(++)-activated K(+) (KCa) channels. Inhibition of the formation of nitric oxide (NO) by 20-HETE mediates most of the cGMP-independent component of the vasodilator response to NO. 20-HETE elicits a potent dilator response in human and rabbit pulmonary vascular and bronchiole rings that is dependent on an intact endothelium and COX. 20-HETE is also a vascular oxygen sensor, inhibits Na(+)/K(+)-ATPase activity, is an endogenous inhibitor of the Na(+)-K(+)-2Cl(-)cotransporter, mediates the mitogenic actions of vasoactive agents and growth factors in many tissues and plays a significant role in angiogenesis. EETs, produced by the vascular endothelium, are potent dilators. EETs hyperpolarize VSM cells by activating KCa channels. Several investigators have proposed that one or more EETs may serve as endothelial-derived hyperpolarizing factors (EDHF). EETs constrict human and rabbit bronchioles, are potent mediators of insulin and glucagon release in isolated rat pancreatic islets, and have anti-inflammatory activity. Compared with other organs, the liver has the highest total CYP content and contains the highest levels of individual CYP enzymes involved in the metabolism of fatty acids. In humans, 50-75% of CYP-dependent AA metabolites formed by liver microsomes are omega/omega-OH-AA, mainly w-OH-AA, i.e. 20HETE, and 13-28% are EETs. Very little information is available on the role of 19- and 20-HETE and EETs in liver function. EETs are involved in vasopressin-induced glycogenolysis, probably via the activation of phosphorylase. In the portal vein, inhibition of EETs exerts profound effects on a variety of K-channel activities in smooth muscles of this vessel. 20-HETE is a weak, COX-dependent, vasoconstrictor of the portal circulation. EETs, particularly 11,12-EET, cause vasoconstriction of the porto-sinusoidal circulation. Increased synthesis of EETs in portal vessels and/or sinusoids or increased levels in blood from the meseneric circulation may participate in the pathophysiology of portal hypertension of cirrhosis. CYP-dependent AA metabolites are involved in the pathophysiology of portal hypertension, not only by increasing resistance in the porto-sinusoidal circulation, but also by increasing portal inflow through mesenteric vasodilatation. In patients with cirrhosis, urinary 20-HETE is several-fold higher than PGs and TxB2, whereas in normal subjects, 20-HETE and PGs are excreted at similar rates. Thus, 20-HETE is probably produced in increased amounts in the preglomerular microcirculation accounting for the functional decrease of flow and increase in sodium reabsorption. In conclusion, CYP-AA metabolites represent a group of compounds that participate in the regulation of liver metabolic activity and hemodynamics. They appear to be deeply involved in abnormalities related to liver diseases, particularly cirrhosis, and play a key role in the pathophysiology of portal hypertension and renal failure.     

Profiling of human serum glycans associated with liver cancer and cirrhosis by IMS-MS

Aberrant glycosylation of human glycoproteins is related to various physiological states, including the onset of diseases such as cancer. Consequently, the search for glycans that could be markers of diseases or targets of therapeutic drugs has been intensive. Here, we describe a high-throughput ion mobility spectrometry/mass spectrometry analysis of N-linked glycans from human serum. Distributions of glycans are assigned according to their m/z values, while ion mobility distributions provide information about glycan conformational and isomeric composition. Statistical analysis of data from 22 apparently healthy control patients and 39 individuals with known diseases (20 with cirrhosis of the liver and 19 with liver cancer) shows that ion mobility distributions for individual m/z ions appear to be sufficient to distinguish patients with liver cancer or cirrhosis. Measurements of glycan conformational and isomeric distributions by IMS-MS may provide insight that is valuable for detecting and characterizing disease states.     

Metabolism of retinol and retinoic acid by human liver cytochrome P450IIC8

Liver microsomes obtained from nine subjects were found to metabolize retinol to polar metabolites, including 4-hydroxyretinol. In a reconstituted monooxygenase system containing human liver P450IIC8, retinol was converted to 4-hydroxyretinol and other polar metabolites, with a Km of 0.071 mM and a Vmax of 1.73 nmol/min/nmol P450. Neither P450IIC9 nor P450IIE1, two other purified human P450s, displayed significant retinol hydroxylase activity. Immunoblots performed with a monospecific antibody directed against human P450IIC8 revealed that appreciable amounts of this enzyme were present in human liver microsomes. The same antibody significantly inhibited retinol metabolism in liver microsomes and in the system reconstituted with P450IIC8. The system reconstituted with P450IIC8 also converted retinoic acid to polar metabolites. Thus, this study shows, for the first time, metabolism of two physiologic substrates by a human liver cytochrome P450 related to a group of "constitutive" rodent P450s believed to participate in the metabolism of endogenous compounds. Through its involvement in vitamin A metabolism, P450IIC8 may participate in maintaining the balance between those vitamin A concentrations that promote cellular integrity (and oppose the development of cancer) and those concentrations that cause cellular toxicity.     

Chronic liver and renal diseases differently affect structure of human serum albumin

Human serum albumin (HSA) binding with endogenous metabolites and drugs is substantially decreased in chronic renal and liver diseases. To test the hypothesis that the decreased binding ability is caused by conformational changes of the protein, we analyzed infrared and Raman spectra of HSA isolated from healthy donors and patients with chronic uremia and liver cirrhosis. Uremia did not affect the secondary structure of HSA but modified the environment of its Asp/Glu residues. Liver cirrhosis increased the amount of extended and beta-structures, modified the environment of Asp/Glu and Tyr side chains, and changed the configuration of disulfide bridges in albumin molecules. The conformational changes of "cirrhotic" albumin were not caused by reversibly bound ligands and resembled a partial unfolding of the protein induced by adsorption on the charcoal surface. The dramatic structural alterations of HSA in liver cirrhosis may be caused by its oxidative modification and might underlie the decreased binding ability and changed body distribution of albumin.     

Retinoid metabolism during development of liver cirrhosis

The changes in retinoid metabolism have been documented in liver cirrhosis. However, the dynamic alterations in levels of this vitamin between circulation and liver during development of the liver cirrhosis are not well understood. The aim of this study was to measure retinoids in the liver and circulation in parallel, during and after development of cirrhosis induced by carbon tetrachloride and thioacetamide. Retinoid levels were measured by HPLC. A decrease in retinaldehyde and total retinol, together with an increase in retinoic acid was evident in liver from both carbon tetrachloride or thioacetamide treated rats within a month after initiation of treatment. Activity of enzymes involved in retinoid metabolism such as retinaldehyde oxidase, retinaldehyde dehydrogenase, and retinaldehyde reductase were decreased in the liver. In parallel, levels of retinol and retinaldehyde in the serum were increased while retinoic acid was decreased. This study indicates that during development of cirrhosis, there is reciprocal transfer of retinoid metabolites between the circulation and the liver.     

Beyond vitamin E supplementation: an alternative strategy to improve vitamin E status

Vitamin E has many reported health effects and is recognized as the most important lipid-soluble, chain-breaking antioxidant in the body. Vitamin E has also been reported to play a regulatory role in cell signalling and gene expression. Epidemiological studies show that high blood concentrations of vitamin E are associated with a decreased risk of cardiovascular diseases and certain cancers. Yet, high doses of supplemental vitamin E have been associated with an elevated risk of heart failure and all-cause mortality. Therefore, establishing alternative strategies to improve vitamin E status without potentially increasing mortality risk may prove important for optimal nutrition. To identify dietary phenolic compounds capable of increasing blood and tissue concentrations of vitamin E, selected polyphenols were incorporated into standardized, semi-synthetic diets and fed to male Sprague-Dawley rats for 4 weeks. Blood plasma and liver tissue concentrations of alpha-T and gamma-Twere determined. The flavanols (+)-catechin and (-)-epicatechin, the flavonol quercetin, and the synthetic preservative butylated hydroxytoluene (BHT) markedly elevated the amount of alpha-T in plasma and liver. The sesame lignan sesamin and cereal alkylresorcinols substantially increased the concentrations of gamma-T, but not alpha-T, in the liver. Sesamin also increased gamma-T concentrations in plasma. In order to study the impact of selected polyphenols on the enzymatic degradation of vitamin E, HepG2 cells were incubated together with phenolic compounds in the presence of tocopherols and the formation of metabolites was determined. Sesamin, at concentrations as low as 2 microM, almost completely inhibited tocopherol side-chain degradation and cereal alkylresorcinols inhibited it, dose-dependently (5-20 microM), by 20-80%. BHT, quercetin, (-)-epicatechin, and (+)-catechin had no effect on tocopherol-omega-hydroxylase activity in HepG2 cells. In order to confirm the inhibition of gamma-T metabolism by sesame lignans in humans, sesame oil or corn oil muffins together with deuterium-labelled d6-alpha-Tand d2-gamma-Twere given to volunteers. Urine samples were collected for 72 h and analysed for deuterated and non-deuterated tocopherol metabolites. Consumption of sesame oil muffins significantly reduced the urinary excretion of d2-gamma-CEHC and total (sum of labelled and unlabelled) gamma-CEHC. Overall, the findings from these studies show that the tested dietary phenolic compounds increase vitamin E concentrations through different mechanisms and, thus, have the potential to improve vitamin E status without the use of vitamin E supplements.