肠道菌群失衡诱发肠易激综合征的机制

肠易激综合征（irritable bowel syndrome,IBS）是一种常见的功能性胃肠道疾病,严重地威胁着人类的健康与生存质量。最近的研究发现IBS的发病机制是复杂多样的,尽管其确切的发病原因尚不完全清楚,但有证据显示IBS可能与肠道菌群失衡有关。本文就有关肠道菌群的功能、IBS患者肠道菌群的特点、肠道菌群失衡导致IBS发病的可能机制的研究进展作一综述,旨在为IBS的早期诊断与有效治疗提供有价值的理论依据。     

Current progress of China‘s free ART program

China‘s Free ART Program was initiated in 2002 as an emergency response to save and improve the lives of AIDS patients living mainly in impoverished rural regions of central China. With little experience in HIV/AIDS treatment and care and resource limitations, China‘s efforts to provide widespread access to free antiretroviral therapy has been a process fraught with difficulty. However, the Free ART Program is progressing from an emergency response to a standardized treatment and care system. The development of national guidelines, training programs, a laboratory support network, a national patient database, programs for special populations such as children and patients living with coinfections, and operational research has improved the scope and quality of the free treatment program. As of June 30,2005, a total of 19,456 patients in 28 provinces, autonomous regions, and special municipalities had received free ART.Challenges stemming from the nature of China‘s health system and patient population persist, but with strong government support and a diverse set of resources, China has the capacity to overcome these challenges and to provide nationwide access to high quality treatment and care.     

Current progress of China＇s free ART program

China＇s Free ART Program was initiated in 2002 as an emergency response to save and improve the lives of AIDS patients living mainly in impoverished rural regions of central China. With little experience in HIV/AIDS treatment and care and resource limitations, China＇s efforts to provide widespread access to free antiretroviral therapy has been a process fraught with difficulty. However, the Free ART Program is progressing from an emergency response to a standardized treatment and care system. The development of national guidelines, training programs, a laboratory support network, a national patient database, programs for special populations such as children and patients living with coinfections, and operational research has improved the scope and quality of the free treatment program. As of June 30, 2005, a total of 19,456 patients in 28 provinces, autonomous regions, and special municipalities had received free ART. Challenges stemming from the nature of China＇s health system and patient population persist, but with strong government support and a diverse set of resources, China has the capacity to overcome these challenges and to provide nationwide access to high quality treatment and care.     

Current progress of China’s free ART program

INTRODUCTION At the end of 2003, there were an estimated 840,000 people in China infected with HIV, among whom 80,000 were in need of antiretroviral therapy (ART) [1]. Since 1999, the annual rate of increase in reported HIV infec- tions has been around 30%, with growing numbers of females becoming infected [1]. The transmission of HIV/ AIDS in China has been through intravenous drug use (43. 2%) in the south, southwest, and western provinces; prior commercial blood and plasma selli…     

In Vitro Modification of Human Immunodeficiency Virus Type 1 (HIV-1) Infectivity by the U937 Cells

The effect of host cell factors on infectivity of human immunodeficiency virus type 1 (HIV-1) was studied by infecting a monoblastoid cell line (U937) or a T-cell line (MOLT-4) with a highly infective single clone of HIV-1 and comparing the infectivity of the produced viruses to different cell lines. Chronically infected U937 cells consistently produced viruses with minimal infectivity. This phenotypic change was host-dependent as the back-passage of the U937-produced low infective viruses into MOLT-4 cells resulted in regaining their original high infectivity. Southern and Northern blot analyses of the HIV-1 grown in U937 cells did not reveal any genomic difference between it and the virus grown it MOLT-4 cells. The radioimmunoprecipitation analysis of viral proteins showed that the HIV-1-infected U937 cells had a different pattern of envelope glycoproteins and core proteins, which well correlated with the low infectivity of the produced viruses. This experimental system using MOLT-4 and U937 cell lines would be useful to further explore host cell factor(s) which play an important role in the regulation of HIV-1 infectivity.     

Plasma cholesterol efflux capacity from human THP-1 macrophages is reduced in HIV-infected patients: impact of HAART

The capacity of HDL to remove cholesterol from macrophages is inversely associated with the severity of angiographic coronary artery disease. The effect of human immunodeficiency virus (HIV) infection or its treatment on the ability of HDL particles to stimulate cholesterol efflux from human macrophages has never been studied. We evaluated the capacity of whole plasma and isolated HDL particles from HIV-infected subjects (n = 231) and uninfected controls (n = 200), as well as in a subset of 41 HIV subjects receiving highly active antiretroviral therapy (HAART) to mediate cholesterol efflux from human macrophages. Plasma cholesterol efflux capacity was reduced (−12%; P = 0.001) in HIV patients as compared with controls. HIV infection reduced by 27% (P < 0.05) the capacity of HDL subfractions to promote cholesterol efflux from macrophages. We observed a reduced ABCA1-dependent efflux capacity of plasma (−27%; P < 0.0001) from HIV-infected subjects as a result of a reduction in the efflux capacity of HDL3 particles. HAART administration restored the capacity of plasma from HIV patients to stimulate cholesterol efflux from human macrophages (9.4%; P = 0.04). During HIV infection, the capacity of whole plasma to remove cholesterol from macrophages is reduced, thus potentially contributing to the increased coronary heart disease in the HIV population. HAART administration restored the removal of cholesterol from macrophages by increasing HDL functionality.     

Age-mediated gut microbiota dysbiosis promotes the loss of dendritic cells tolerance

The old age-related loss of immune tolerance inflicts a person with a wide range of autoimmune and inflammatory diseases. Dendritic cells (DCs) are the sentinels of the immune system that maintain immune tolerance through cytokines and regulatory T-cells generation. Aging disturbs the microbial composition of the gut, causing immune system dysregulation. However, the vis-à-vis role of gut dysbiosis on DCs tolerance remains highly elusive. Consequently, we studied the influence of aging on gut dysbiosis and its impact on the loss of DC tolerance. We show that DCs generated from either the aged (DC^Old) or gut-dysbiotic young (DC^Dysbiotic) but not young (DC^Young) mice exhibited loss of tolerance, as evidenced by their failure to optimally induce the generation of Tregs and control the overactivation of CD4⁺ T cells. The mechanism deciphered for the loss of DC^Old and DC^Dysbiotic tolerance was chiefly through the overactivation of NF-κB, impaired frequency of Tregs, upregulation in the level of pro-inflammatory molecules (IL-6, IL-1β, TNF-α, IL-12, IFN-γ), and decline in the anti-inflammatory moieties (IL-10, TGF-β, IL-4, IDO, arginase, NO, IRF-4, IRF-8, PDL1, BTLA4, ALDH2). Importantly, a significant decline in the frequency of the Lactobacillus genus was noticed in the gut. Replenishing the gut of old mice with the Lactobacillus plantarum reinvigorated the tolerogenic function of DCs through the rewiring of inflammatory and metabolic pathways. Thus, for the first time, we demonstrate the impact of age-related gut dysbiosis on the loss of DC tolerance. This finding may open avenues for therapeutic intervention for treating age-associated disorders with the Lactobacillus plantarum.     

肠道菌群参与宿主免疫应答的作用及机制研究进展

肠道菌群作为动物体内重要的组成部分,能够直接参与机体的免疫调控作用,促进机体免疫系统发育,维持正常免疫功能。同时,免疫系统对肠道菌群又有调控和制约作用。本文主要综述了肠道菌群的组成以及影响肠道菌群变化的因素,系统阐述了肠道菌群与疾病相互作用的机制,总结了肠道菌群在宿主感染与免疫应答中的作用,为开展肠道菌群参与机体免疫应答的机制方面的研究提供新的思路。     

Histoplasmosis as cause of penile ulcer in acquired immune deficiency syndrome (AIDS): three case reports

Background Histoplasma capsulatum is the causative agent of American histoplasmosis. The relationship between disseminated histoplasmosis and AIDS has been well established. Widespread hematogenous dissemination of Histoplasma capsulatum in HIV positive patients can cause a plethora of clinical manifestations; virtually any organic system can be affected. However, genital ulceration by H. capsulatum in patients with AIDS is a real challenge during investigation of the infection due to the great variety of differential diagnoses that are involved. Method The diagnosis was performed by histopathologic study; H. capsulatum was detected by silver staining (Grocott staining) and confirmed by immunocytochemistry. Results We report three cases of histoplasmosis in patients with AIDS, in which we observed genital ulcers, an unusual form of presentation of this disease. In one of these cases, the treatment resulted in total cure. Conclusion The cases reported herein are to illustrate the plurality of pathologies and clinical manifestations, which may affect immunocompromised patients. The correct diagnosis of fungal diseases in these patients following well established treatment will improve the prognosis.     

女性艾滋病患者的抗反转录病毒治疗与人类免疫缺陷病毒母婴阻断

自从对感染人类免疫缺陷病毒(HIV)的妊娠妇女实施抗反转录病毒治疗(ART)以预防母婴垂直传播以来,HIV母婴阻断成功率明显上升。而部分抗病毒药物,如依非韦伦和替诺福韦,也逐渐被证实用于妊娠期妇女对胎儿是安全的,这增加了HIV母婴阻断药物的选择范围。     

43 例HIV/AIDS 患者抗病毒治疗情况分析

目的:研究来第四军医大学唐都医院传染科就诊的人类免疫缺陷病毒/艾滋病(Human immunodeficiency virus/Acquired immuno deficiency syndrome,HIV/AIDS)患者感染状况及抗病毒治疗效果。方法:采用前瞻性随访研究的方法,收集来我院就诊的HIV/AIDS患者的基本信息,并对其实验室检查结果、治疗方案及后续随访结果进行分析。结果:随访观察的43例HIV/AIDS患者治疗前平均基线CD4+T淋巴细胞计数为(330.74±176.35)cells/μL,CD8+T淋巴细胞计数为(1177.80±321.49)cells/μL,CD4+,CD8+T淋巴细胞比值为0.30±0.19;治疗一年后平均CD4+T淋巴细胞计数为(482.74±217.77)cells/μL,CD8+T淋巴细胞计数为(861.53±282.85)cells/μL,CD4+,CD8+T淋巴细胞比值为0.59±0.28。所有患者治疗一年后血浆HIV-RNA载量均达到检测限以下(500copies/m L)。结论:规范的抗病毒治疗对于改善HIV/AIDS患者预后至关重要;基线CD4+T淋巴细胞计数越低,抗病毒治疗效果越差。     

Disseminated dermatophytosis caused by Microsporum gypseum in two patients with the acquired immunodeficiency syndrome

Microsporum gypseum is not a common agent of human dermatophytosis. To the best of our knowledge, this fungus has not been described in human immunodeficiency virus (HIV)-infected patients. We report a tinea corporis infection with atypical presentation caused by M. gypseum in two patients with the acquired immunodeficiency syndrome (AIDS) studied at the São Paulo Hospital (São Paulo, Brazil).This revised version was published online in October 2005 with corrections to the Cover Date.     

藤三七类黄酮组分对小鼠代谢综合征模型及其肠道菌群的调节作用

目的 探究类黄酮组分对小鼠代谢综合征模型及肠道菌群的调节作用。方法 SPF级雄性BALB/c小鼠分为对照组（NFD）、模型组（HFD）、类黄酮组（HFD+fla）,每组6只。采用高脂饲料和高果糖建立代谢综合征模型,处理8周。类黄酮组用100 mg/(kg•d)藤三七类黄酮灌胃。记录动物进食量和饮水量,测空腹血糖和体重。第8周处死动物,解剖获取肝脏和附睾脂肪组织。测定总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TG）和高密度脂蛋白胆固醇（HDL-C）含量。小鼠肝脏组织切片进行HE染色观察。取小鼠粪便,应用PCR-DGGE技术分析肠道菌群。结果 模型组小鼠TC明显高于对照组（P=0.000）,类黄酮组TC显著低于模型组（P=0.007）。模型组LDL-C显著高于对照组（P=0.031）,类黄酮组LDL与模型组差异无统计学意义（P=0.072）,但有降低趋势。肝脏脏器系数与脂肪系数组间比较差异无统计学意义（F=1.891,P=0.185）,但类黄酮组与模型组相比,有降低趋势;模型组小鼠血清TG较对照组降低,组间比较差异有统计学意义（F=7.738,P=0.005）。模型组小鼠HDL较对照组升高,组间比较差异无统计学意义（F=3.621,P=0.052）;肝脏病理学结果显示,类黄酮组肝细胞水肿得到了明显改善。模型组小鼠肠道菌群多样性和拟杆菌属细菌低于对照组;类黄酮组相比于模型组,肠道菌群多样性和拟杆菌属细菌有所恢复,嗜胆菌属细菌增加。结论 藤三七类黄酮组分能促进肠道主要益生菌的生长,可以显著降低BALB/c小鼠TC水平,并有降低血清LDL-C的趋势。类黄酮明显改善小鼠肝细胞水肿,促进肠道菌群的恢复。     

1225例HIV/AIDS患者流行病学特征分析

目的:了解来陕西地区就诊的人类免疫缺陷病毒/艾滋病(Human immunodeficiency virus/Acquired immuno deficiency syndrome,HIV/AIDS)患者感染状况、流行特征。方法:收集来我院就诊的HIV/AIDS患者的基本信息,对其流行病学资料统计分析。结果:在调查的1225例HIV/AIDS患者中,男性占83.51%,平均年龄为(35.55±11.61)岁,50.98%为农民,小学及以下学历占33.55%,经血液途径感染250例,经性传播途径感染916例,其中同性性传播337例,经母婴垂直传播16例,就诊时CD4+T淋巴细胞计数平均值为(222.82±190.49)个/μL,56%的HIV/AIDS患者采用的抗病毒方案为齐多夫定(Zidovudine,AZT)/替诺福韦(Tenofovir Disoproxil Fumarate,TDF)+拉米夫定(Lamivudine,3TC)+依非韦伦(Efavirenz,EFV)方案。结论:陕西地区HIV/AIDS感染人数呈上升趋势,且年轻化加剧,同性性传播比例大幅增加。虽然治疗较为及时,应进一步在高危人群中积极宣传防艾知识与措施。     

便秘型肠易激综合征患者肠道菌群变化特点及双歧杆菌四联活菌片的疗效观察

研究便秘型肠易激综合征（IBS-C）患者肠道菌群变化特点,并进一步分析双歧杆菌四联活菌片对其的干预效果。

选取2020年2月至2021年11月于我院消化内科就诊的162例IBS-C患者为研究组;选择同期113例健康体检者作为对照组。采用16S rDNA高通量测序法检测受试者肠道菌群的构成,分析菌群多样性,比较双歧杆菌四联活菌片干预前后IBS-C患者肠道菌群变化特点及便秘症状相关指标变化情况。

研究组患者肠道菌群Ace指数（P=0.001）、Chao指数（P＜0.001）、Shannon指数（P=0.020）、Sobs指数（P＜0.001）均显著低于对照组。在门水平上,研究组患者肠道厚壁菌门和变形菌门的丰度均显著高于对照组,而拟杆菌门丰度均显著低于对照组。双歧杆菌四联活菌片干预后,患者肠道厚壁菌门和变形菌门丰度均显著下降,拟杆菌门丰度显著提高。在属水平上,研究组患者肠道乳杆菌属和双歧杆菌属丰度均显著低于对照组。双歧杆菌四联活菌片干预后,患者肠道乳杆菌属、双歧杆菌属、粪杆菌属丰度均显著上升。干预后IBS-C患者的便秘症状积分（P＜0.001）、GIQLI评分（P＜0.001）、WC评分（P＜0.001）、PAC-QOL评分（P=0.005）均较干预前差异显著,排便次数也显著增加（P＜0.001）。

IBS-C患者肠道菌群显著紊乱,双歧杆菌四联活菌片能在一定程度上调节患者肠道菌群失衡,同时能够改善胃肠道功能,缓解便秘。

     

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。     

Advance in treatment strategy and immune reconstruction against HIV-1 infection

HIV-1 can be considered an infection of the immune system, resulting in progressive and ultimately profound immune suppression. The availability of highly active antiretroviral therapy (HAART) has resulted in dramatic changes in the disease course in persons fortunate enough to have access to these medications, but long-term therapy is limited by the development of resistance as well as toxicities of the potent medication regimens. Emerging data indicate that individuals who have non-progressive clinical course control HIV-1 immunologically. This has bolstered hope that the immune response might be effectively augmented in persons with HIV infection. Recent data indicating that immediate treatment of acute infection leads to augmentation of antiviral immune responses have provided evidence that the immune system might be enhanced in certain situations. Therefore, investigation in the reconstitution of anti-HIV immune response in patients under HAART should provide encouragement for continuing to explore methods to obtain meaningful and durable immune enhancement as an adjunct to HAART in HIV-1 infection.     

Characterization of the acquired immune deficiency syndrome at the cellular and molecular level

Summary The acquired immunodeficiency syndrome (AIDS) is a new disease characterized by severe dysfunction of both the T cell and B cell systems, occurring in previously healthy individuals. Affected individuals may have recurrent and chronic opportunistic infections and/ or Kaposi's sarcoma or other malignancy. Analysis of the cellular and subcellular components of immunity demonstrates a profound depression in the number and function of helper/ inducer T cells bearing the OKT4 (Leu 3) differentiation antigen and a concomitant defect in the synthesis of the immuno-enhancing soluble growth factor, interleukin 2 (IL-2). Hypotheses to explain the etiology of the immunological dysfunction and implications for future therapy of AIDS are discussed.     

艾滋病合并侵袭性肺真菌病的诊治

近年来,侵袭性真菌感染的发病率不断增加,其中肺真菌感染居首位,己成为免疫功能下降或缺陷宿主常见的死亡原因。艾滋病是经典免疫功能缺陷性疾病,合并真菌感染时需及时识别、治疗,以降低其病死率。国内、外各种有关侵袭性真菌感染诊治指南的不断问世,极大地提高了临床医生对侵袭性真菌病的认识和诊治水平。该文就艾滋病常见侵袭性肺真菌病:肺念珠菌病、肺孢子菌肺炎、肺马内菲青霉病、肺隐球菌病、肺曲霉病的诊断及治疗进展进行综述。     

Diet leaves a genetic signature in a keystone member of the gut microbiota

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