2型糖尿病肠道菌群研究进展

2型糖尿病是一种常见的慢性消耗性疾病,其发病机制十分复杂,流行病学研究表明,肥胖、高热量饮食、体力活动不足及年龄增大是2型糖尿病最主要的环境因素。它是一种以胰岛素抵抗和胰岛素分泌不足为特征的代谢性疾病。肠道菌群作为进入人体的一个重要环境因素,肠道微生物的菌群变化影响宿主能量物质的吸收,调节肠道的分泌功能和非特异性免疫功能,从营养、代谢、疾病等各方面与我们生命活动相关。肠道菌群已成为我们身体的一部分,影响宿主的免疫,在肥胖、糖尿病、代谢综合征等疾病中都具有非常重要的作用。     

肠道菌群影响宿主肥胖的研究进展

越来越多的研究结果表明,肠道菌群与宿主消化、呼吸、内分泌、心血管、神经等系统发生的疾病密切相关。目前,全世界患肥胖和Ⅱ型糖尿病的人逐渐增多。肠道菌群的平衡有利于维持宿主正常的能量代谢过程,而肠道菌群失调使机体产生慢性炎症反应及胰岛素抵抗,从而导致肥胖和Ⅱ型糖尿病等代谢性疾病的发生。本文综述了肠道菌群影响肥胖的机制,以及通过调控肠道菌群改善肥胖的方法。     

基于调节肠道菌群的功能性低聚糖改善肥胖的研究进展

肥胖是机体脂肪积聚过多的一种典型的能量过剩疾病,是导致2型糖尿病和心血管疾病等一系列代谢性疾病的主要原因之一,已成为威胁全球健康的重大公共卫生问题。肠道菌群作为机体能量代谢调控的重要参与者,在肥胖及相关代谢性疾病的发生发展中起着关键作用,通过饮食干预调节肠道菌群,进而改善机体健康状况将是未来的研究热点之一。已有研究表明,功能性低聚糖作为一类典型的新型益生元,可调节肠道菌群结构及其代谢产物的水平,影响机体能量代谢过程,改善肥胖及相关代谢性疾病。本文主要对肠道菌群在肥胖中的潜在作用机制,以及常见功能性低聚糖调节肠道菌群改善肥胖的作用效果进行综述,以期为通过靶向肠道菌群精准干预肥胖及相关代谢性疾病提供一些新的潜在防治策略。     

膳食营养与肠道微生物组

膳食营养是影响肠道菌群结构和功能最为重要,也较为迅速的因素,并由此影响宿主的代谢状况。高脂等不健康饮食习惯会引起肠道菌群的失调,使肠道通透性增加,形成全身的慢性、低水平炎症,进一步破坏胰岛素的信号转导通路,最终导致包括胰岛素抵抗、肥胖、糖尿病等在内的代谢综合征的发生。高纤维饮食可能通过富集短链脂肪酸(SCFAs)产生菌,增加肠道内SCFAs浓度,降低内毒素产生菌水平,进而减少脂多糖(LPS)入血引起的组织器官炎症。这类饮食还能抑制某些能产生有害物质,如三甲胺(TMA)和吲哚的有害菌,从而改善宿主的代谢状况。益生元能减少宿主的脂肪积累,降低宿主的炎症水平并增加胰岛素敏感性,同时还伴随着食欲因子、胃肠肽水平和肠道中某些益生菌丰度的增加。此外,蔬菜、水果、奶制品等食物也能通过调节肠道菌群进而改善宿主的代谢状况。虽然越来越多的研究表明,肠道菌群可能在调节宿主的代谢状况中存在着因果关系,但是在食物-肠道菌群-代谢这条通路中到底存在着一种怎样的机制,有待进一步研究。     

二甲双胍对T2D患者肠道菌群的影响

2型糖尿病是一种由环境和遗传因素共同导致的以高血糖为主的慢性代谢性疾病,其主要的特点是胰岛素分泌不足和胰岛素抵抗。目前2型糖尿病发病率正在快速上升,给我们的未来带来了严峻的挑战。宿主肠道内正常的肠道菌群参与宿主的营养代谢、生长发育等重要生理功能,而研究表明肠道菌群失调与2型糖尿病密切相关。二甲双胍由于廉价、安全、有效成为了目前应用最广泛的降糖药之一,它不仅可以通过依赖及非依赖AMPK途径降糖,越来越多的研究表明它还可以通过改善T2D患者失调的肠道菌群发挥降糖作用。明确二甲双胍对肠道菌群的影响,有助于全面了解二甲双胍的作用机制。     

肠道菌群在肥胖发病中的作用

近十年来,肠道菌群在人类许多疾病发病机制中的潜在作用引起了人们的广泛关注。已被证实肠道菌群与肥胖和肥胖相关的代谢性疾病的发生发展密切相关。与肥胖相关的肠道微生物可调控宿主的能量代谢、胰岛素抵抗和脂肪组织堆积,这些在肥胖发生中都起着至关重要的作用。本综述重点介绍了代谢紊乱中肠道菌群组成的变化以及肠道菌群在肥胖发病机制中的作用,包括能量代谢、中枢食欲、免疫系统和宿主昼夜节律。在不久的将来,该领域的研究将为治疗肥胖及其并发症开辟新的途径。     

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。     

固有淋巴细胞在脂质代谢中的研究进展

由于世界范围内营养条件和生活方式的变化,肥胖及其相关的代谢性疾病已成为当前威胁人类健康的重要因素之一.在能量摄取和消耗以及体内脂肪储存、分解和脂肪组织重塑的研究中,人们逐渐认识到脂质过量及异位堆积将导致代谢组织处于慢性炎症状态,这开启了肥胖相关组织炎症研究的新方向.固有淋巴细胞(innate lymphoid cell...     

褐藻膳食纤维对机体代谢及其肠道菌群调节作用的研究进展

褐藻膳食纤维（海藻酸盐,Alg）是存在于海洋食用藻类中的一种酸性多糖,具有多种生物活性作用。研究表明,褐藻膳食纤维可有效地改善肠道菌群的组成结构,通过菌群代谢膳食纤维发酵产物调节宿主机体的代谢水平,从而改善肥胖、糖尿病等代谢相关性疾病。从作为食品添加剂的角度出发,对褐藻膳食纤维作用于人和动物模型体重、血糖、脂代谢以及肠道菌群的效果加以综述,并探讨其潜在机制,为海洋功能性产品的开发和应用提供科学依据。     

肠道菌群与肥胖关系的研究进展

西方化的高脂饮食方式造成了越来越多的肥胖人群。高脂饮食在一定程度上可以改变肠道菌群的结构组成和功能,促进宿主对食物营养的吸收,从而增加体重形成肥胖。高脂饮食诱导的肥胖者肠道菌群的改变会导致宿主能量吸收增加,肠道通透性和炎症增加,而有减肥功能的短链脂肪酸合成能力下降。最近研究发现肠道菌群也可以通过影响中枢神经系统,尤其是下丘脑相关基因的表达来控制食欲,从而调控肥胖的形成。本文系统介绍了最近几年高脂饮食诱导肥胖的研究,总结了一些与肥胖形成有密切关系的肠道菌群以及其在肥胖形成中的作用机制,为进一步研究肠道菌群与肥胖之间的调控作用奠定了基础。最后总结了肠道菌群可以作为一个预防和治疗肥胖的有效靶点,可以通过在食物中添加有益菌或者通过菌群移植来治疗肥胖。     

动物宿主——肠道微生物代谢轴研究进展

肠道中栖息着数量庞大且复杂多样的微生物菌群,在维持宿主肠道微环境稳态中发挥重要作用。微生物菌群可以利用宿主肠道的营养素,发酵产生代谢产物,与宿主机体形成宿主—微生物代谢轴(host-microbe metabolic axis)。该代谢轴既能影响营养素吸收和能量代谢,又可调控宿主各项生理过程。本文主要阐述宿主-肠道微生物代谢轴的概念、肠-肝轴、肠-脑轴、肠道微生物与宿主肠道代谢轴的互作以及对机体健康的影响。     

Amino acid supplements and metabolic health: a potential interplay between intestinal microbiota and systems control

Dietary supplementation of essential amino acids (EAAs) has been shown to promote healthspan. EAAs regulate, in fact, glucose and lipid metabolism and energy balance, increase mitochondrial biogenesis, and maintain immune homeostasis. Basic science and epidemiological results indicate that dietary macronutrient composition affects healthspan through multiple and integrated mechanisms, and their effects are closely related to the metabolic status to which they act. In particular, EAA supplementation can trigger different and even opposite effects depending on the catabolic and anabolic states of the organisms. Among others, gut-associated microbial communities (referred to as gut microbiota) emerged as a major regulator of the host metabolism. Diet and host health influence gut microbiota, and composition of gut microbiota, in turn, controls many aspects of host health, including nutrient metabolism, resistance to infection, and immune signals. Altered communication between the innate immune system and the gut microbiota might contribute to complex diseases. Furthermore, gut microbiota and its impact to host health change largely during different life phases such as lactation, weaning, and aging. Here we will review the accumulating body of knowledge on the impact of dietary EAA supplementation on the host metabolic health and healthspan from a holistic perspective. Moreover, we will focus on the current efforts to establish causal relationships among dietary EAAs, gut microbiota, and health during human development.     

Deletion of the Toll-Like Receptor 5 Gene Per Se Does Not Determine the Gut Microbiome Profile That Induces Metabolic Syndrome: Environment Trumps Genotype

Over the past decade, emerging evidence has linked alterations in the gut microbial composition to a wide range of diseases including obesity, type 2 diabetes, and cardiovascular disease. Toll-like receptors (TLRs) are the major mediators for the interactions between gut microbiota and host innate immune system, which is involved in the localization and structuring of host gut microbiota. A previous study found that TLR5 deficient mice (TLR5KO1) had altered gut microbial composition which led to the development of metabolic syndrome including hyperlipidemia, hypertension, insulin resistance and increased adiposity. In the current study, a second TLR5-deficient mouse model was studied (TLR5KO2). TLR5 deficient mice did not manifest metabolic abnormalities related to the metabolic syndrome compared with littermate controls maintained on normal chow or after feeding a high fat diet. Analysis of the gut microbial composition of littermate TLR5KO2 and wild type mice revealed no significant difference in the overall microbiota structure between genotypes. However, the TLR5KO2 microbiota was distinctly different from that previously reported for TLR5KO1 mice with metabolic syndrome. We conclude that an altered composition of the microbiota in a given environment can result in metabolic syndrome, but it is not a consequence of TLR5 deficiency per se.     

Gut microbiota and immunity relevance in eubiosis and dysbiosis

Human gut is colonized by numerous microorganisms, in which bacteria present the highest proportion of this colonization that live in a symbiotic relationship with the host. This microbial collection is commonly known as the microbiota. The gut microbiota can mediate gut epithelial and immune cells interaction through vitamins synthesis or metabolic products. The microbiota plays a vital role in growth and development of the main components of human’s adaptive and innate immune system, while the immune system regulates host-microbe symbiosis. On the other hand, negative alteration in gut microbiota composition or gut dysbiosis, can disturb immune responses. This review highlights the gut microbiota-immune system cross-talk in both eubiosis and dysbiosis.     

Gut microbiota–bile acid–skeletal muscle axis

The gut microbiota represents a ‘metabolic organ’ that can regulate human metabolism. Intact gut microbiota contributes to host homeostasis, whereas compositional perturbations, termed dysbiosis, are associated with a wide range of diseases. Recent evidence demonstrates that dysbiosis, and the accompanying loss of microbiota-derived metabolites, results in a substantial alteration of skeletal muscle metabolism. As an example, bile acids, produced in the liver and further metabolized by intestinal microbiota, are of considerable interest since they regulate several host metabolic pathways by activating nuclear receptors, including the farnesoid X receptor (FXR). Indeed, alteration of gut microbiota may lead to skeletal muscle atrophy via a bile acid–FXR pathway. This Review aims to suggest a new pathway that connects different mechanisms, involving the gut–muscle axis, that are often seen as unrelated, and, starting from preclinical studies, we hypothesize new strategies aimed at optimizing skeletal muscle functionality.     

Molecular Paths Linking Metabolic Diseases,Gut Microbiota Dysbiosis and Enterobacteria Infections

Alterations of both ecology and functions of gut microbiota are conspicuous traits of several inflammatory pathologies, notably metabolic diseases such as obesity and type 2 diabetes. Moreover, the proliferation of enterobacteria, subdominant members of the intestinal microbial ecosystem, has been shown to be favored by Western diet, the strongest inducer of both metabolic diseases and gut microbiota dysbiosis. The inner interdependence between the host and the gut microbiota is based on a plethora of molecular mechanisms by which host and intestinal microbes modify each other. Among these mechanisms are as follows: (i) the well-known metabolic impact of short chain fatty acids, produced by microbial fermentation of complex carbohydrates from plants; (ii) a mutual modulation of miRNAs expression, both on the eukaryotic (host) and prokaryotic (gut microbes) side; (iii) the production by enterobacteria of virulence factors such as the genotoxin colibactin, shown to alter the integrity of host genome and induce a senescence-like phenotype in vitro; (iv) the microbial excretion of outer-membrane vesicles, which, in addition to other functions, may act as a carrier for multiple molecules such as toxins to be delivered to target cells. In this review, I describe the major molecular mechanisms by which gut microbes exert their metabolic impact at a multi-organ level (the gut barrier being in the front line) and support the emerging triad of metabolic diseases, gut microbiota dysbiosis and enterobacteria infections.     

The gut microbiota and its interactions with cardiovascular disease

The intestine is colonized by a considerable community of microorganisms that cohabits within the host and plays a critical role in maintaining host homeostasis. Recently, accumulating evidence has revealed that the gut microbial ecology plays a pivotal role in the occurrence and development of cardiovascular disease (CVD). Moreover, the effects of imbalances in microbe–host interactions on homeostasis can lead to the progression of CVD. Alterations in the composition of gut flora and disruptions in gut microbial metabolism are implicated in the pathogenesis of CVD. Furthermore, the gut microbiota functions like an endocrine organ that produces bioactive metabolites, including trimethylamine/trimethylamine N-oxide, short-chain fatty acids and bile acids, which are also involved in host health and disease via numerous pathways. Thus, the gut microbiota and its metabolic pathways have attracted growing attention as a therapeutic target for CVD treatment. The fundamental purpose of this review was to summarize recent studies that have illustrated the complex interactions between the gut microbiota, their metabolites and the development of common CVD, as well as the effects of gut dysbiosis on CVD risk factors. Moreover, we systematically discuss the normal physiology of gut microbiota and potential therapeutic strategies targeting gut microbiota to prevent and treat CVD.     

The Gut Microbiota Modulates Glycaemic Control and Serum Metabolite Profiles in Non-Obese Diabetic Mice

Islet autoimmunity in children who later progress to type 1 diabetes is preceded by dysregulated serum metabolite profiles, but the origin of these metabolic changes is unknown. The gut microbiota affects host metabolism and changes in its composition contribute to several immune-mediated diseases; however, it is not known whether the gut microbiota is involved in the early metabolic disturbances in progression to type 1 diabetes. We rederived non-obese diabetic (NOD) mice as germ free to explore the potential role of the gut microbiota in the development of diabetic autoimmunity and to directly investigate whether the metabolic profiles associated with the development of type 1 diabetes can be modulated by the gut microbiota. The absence of a gut microbiota in NOD mice did not affect the overall diabetes incidence but resulted in increased insulitis and levels of interferon gamma and interleukin 12; these changes were counterbalanced by improved peripheral glucose metabolism. Furthermore, we observed a markedly increased variation in blood glucose levels in the absence of a microbiota in NOD mice that did not progress to diabetes. Additionally, germ-free NOD mice had a metabolite profile similar to that of pre-diabetic children. Our data suggest that germ-free NOD mice have reduced glycaemic control and dysregulated immunologic and metabolic responses.     

膳食脂肪、肠道微生物与宿主健康的研究进展

作为三大主要营养物质之一,膳食脂肪为人体提供能量和营养。膳食脂肪摄入不当会破坏肠道微生物的稳态,影响宿主的代谢状况,增加慢性疾病发生的风险。建立疾病动物模型是研究肠道微生物与宿主健康的重要手段。文中综述了膳食脂质的数量和种类、肠道微生物和宿主代谢之间的相互作用及其可能的作用机制,阐述了基于不同的疾病动物模型,膳食脂质影响肠道微生物的结构和功能,以及对宿主代谢的调节,为深入了解膳食脂质、肠道微生态和宿主健康三者之间的关系提供了依据。