益生菌在儿童炎症性肠病中的应用

炎症性肠病(inflammatory bowel disease,IBD)是一种原因不明的慢性非特异性肠道炎性疾病,主要包括溃疡性结肠炎(ulcerative colitis,UC)、克罗恩病(Crohn′s disease,CD)和未定型的炎症性肠病(IBD-unclassified,IBDU)。随着对肠道微生物与IBD关系认识的不断加深,许多研究发现肠道菌群的生态失调在IBD的发病中起着重要作用。益生菌在儿童IBD治疗中具有良好前景,但仍缺乏有效的证据来确证益生菌疗效,并指导临床对益生菌的种类和剂量等进行选择。现有研究表明,益生菌对儿童IBD的治疗具有特异性,在诱导和维持UC缓解效果明显,但在诱导CD缓解、维持CD缓解和预防术后并发症及复发方面效果并不理想。     

肠道微生物群落与炎症性肠病关系研究进展

目的炎症性肠病（IBD）包括克罗恩病（CD）和溃疡性结肠炎（UC）,以持续性肠道非特异性炎症为特征,通常反复发作、迁延不愈,临床上仍无特效性的治疗手段。IBD确切的发病机制尚不清楚,涉及免疫、环境及遗传等因素,这些因素共同诱导肠道炎症、黏膜损伤和修复。肠道微生物群落及其代谢产物、宿主基因易感性及肠道黏膜免疫三方面共同参与了IBD的发病机制。本文从消化道微生态角度出发,对目前IBD相关的肠道微生物群落研究现状、宿主-微生物间免疫应答及益生菌治疗等内容进行探讨。     

细胞因子在炎症性肠病中的作用

炎症性肠病(inflammatory bowel disease,IBD)是一组病因未明的以慢性胃肠道炎症为特征的疾病,包括克罗恩病(Crohn's disease,CD)和溃疡性结肠炎(ulcerative colitis,UC)。细胞因子在IBD肠道炎症反应和黏膜免疫反应中起重要作用,目前已成为研究IBD发病机制的热点,本文就其在IBD中的作用作一综述。     

真菌菌群在炎症性肠病中的作用研究进展CSCD

炎症性肠病(inflammatory bowel disease,IBD)包括溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(Crohn's disease,CD),是消化道的慢性复发性炎症性疾病,多年来IBD与肠道菌群的关系备受关注[1-2],其发病率在全球范围内呈上升趋势[3]。IBD的发病机制是遗传易感性、环境影响和肠道屏障受损等多因素之间相互作用的结果[4-5]。     

益生菌治疗炎症性肠病的研究进展

炎症性肠病（inflammatory bowel disease,IBD）主要包括溃疡性结肠炎（ulcerative olitis,UC）和Crohn＇s病（Crohn＇s disease,CD）,近年来随着人们生活水平的提高以及饮食结构的变化,该病在我国的发病率逐年上升.目前研究认为IBD是由基因的易感性,环境因素激发和肠道免疫系统失调等多种因素交互作用引起的消化系统自身免疫性慢性炎症疾病.应用免疫抑制剂作为临床上治疗该病的主要手段已经有了很大的发展,却仍然存在着价格昂贵,毒副作用强,而且并不是对所有患者都有效等问题.长期使用抗生素则因容易引起肠道细菌耐药而导致菌群失调,往往使得IBD的病情更加复杂.临床研究表明IBD患者肠道内存在着严重的菌群失调,通过给予益生菌对局部的微生态环境进行调节,可使病情缓解.本文从炎症性肠病的病因学出发,对目前应用益生菌治疗IBD及其治疗机制的研究进展进行综述.     

潘氏细胞与炎症性肠病研究进展

<正>潘氏细胞(paneth cells,PCs)是小肠腺的特征性细胞,可分泌防御素等多种抗菌物质,抑制肠道细菌过度繁殖,在维持肠道内稳态、参与固有免疫方面发挥重要作用。炎症性肠病(inflammatory bowel disease,IBD)主要包括克罗恩病(crohn's disease,CD)和溃疡性结肠炎(ulcerative colitis,UC),其发病机制复杂,受环境因素、遗传因素及肠道菌群等多种因素的影响,主要表现为肠道免疫系统对肠道菌群的不良免疫反应。近年来,有关PCs与IBD的相关性研究较多,现本文就其研究进展作一综述如下。     

肠道菌群及其代谢物与溃疡性结肠炎的研究进展

溃疡性结肠炎(ulcerative colitis, UC)是慢性炎症性肠病(inflammatory bowel disease, IBD)的一种主要类型,其具有发病率高、病程复杂等特点。目前,临床治疗手段主要以抗炎治疗、免疫调节为主。虽然这些治疗手段能改善UC的症状,但临床疗效有待提升。因此,寻找更有效的治疗方式是十分必要的。肠道菌群的代谢通过调控炎症、细胞生长、内环境稳态等方式在UC的发生、发展中发挥重要作用。现就肠道菌群结构变化和肠道菌群代谢物(短链脂肪酸、色氨酸、胆汁酸和三甲胺氮氧化物)对UC发生、发展的可能机制,以及菌群移植、益生菌、益生元和合生元疗法应用于UC的防治作用作一概述。     

Th17细胞及相关细胞因子在炎症性肠病中的作用

<正>炎症性肠病(inflammatory bowel disease,IBD)包括溃疡性结肠炎(ulcerative colitis,UC)和克罗恩病(Crohn's disease,CD),是严重影响人类健康的慢性消化道疾病,其病因和致病机制尚未明确。越来越多研究表明,遗传易感性和环境因素在UC和CD的发病中起关键作用,可引起肠腔内细菌、抗原等物质移位至黏膜固有层,最终导致黏膜屏障功能异常[1]。     

肠道菌群代谢物与炎症性肠病关系的研究进展CSCD

人类肠道菌群是一个复杂的共生微生物系统,长期定植于人类的胃肠道中,通过发酵产生大量的代谢产物,如短链脂肪酸、色氨酸及吲哚衍生物、胆汁酸和三磷酸腺苷等,对人体产生局部和全身的作用,并与炎症性肠病(inflammatory bowel disease,IBD)的发生发展密切相关。近年来,基于高通量基因测序技术的肠道微生物组学和代谢组学已成为新的研究热点,通过研究微生物群的小分子代谢物,发现微生物、代谢物和宿主三者间相互作用的潜在机制,而肠道菌群代谢物与IBD密切相关,这为预防和治疗IBD提供了新的策略。本文就近年来肠道菌群主要代谢物与IBD之间的关系及其潜在机制的重要研究成果进行综述。     

炎症性肠病与肠道微生态的研究进展

炎症性肠病(inflammatoryboweldisease,IBD)是一种肠道慢性炎症性疾病,其发病机制尚不清楚。然而,IBD的发病率不断上升给患者及其家属带来了巨大的经济负担,需要找到积极有效的治疗方法来帮助患者。最新的观点认为,宿主和肠道微生物之间的平衡被打破会触发遗传易感个体的免疫炎症反应。肠道菌群失调在炎症性肠病的发病及发展过程中起着重要的作用。临床研究发现,IBD患者肠道菌群失调程度不同,而联合应用益生菌可以改善这些患者的症状。越来越多的研究者密切关注肠道菌群与IBD的关系,并进行了深入的基础和临床研究。本文从肠道菌群对IBD的生理影响以及益生菌和粪便细菌移植等方面进行综述。     

Effect of Probiotic Use on Adverse Events in Adult Patients with Inflammatory Bowel Disease: a Retrospective Cohort Study

Alterations of intestinal microflora are involved in the pathogenesis and natural history of inflammatory bowel diseases (IBDs). Manipulation of human gut microbiota with probiotics may be a therapeutic option. In this retrospective cohort study, the benefits of probiotic use in reducing adverse events were analyzed. Data from clinical charts of IBD patients followed up for at least 36 months were retrieved. The occurrence of adverse events including the need for systemic steroids, hospitalization, and surgery related to IBD was analyzed according to age, gender, body mass index, treatments, IBD phenotype, disease duration, and probiotic use. The amount of probiotic use was calculated as the ratio of time under probiotic treatment to the disease duration starting from the date of the first probiotic administration and expressed as a percentage. Patients were stratified according to the percentage of probiotic use as ≤?24%, 25–74%, and ≥?75%, and the number of adverse events per patient-years was calculated. Results were adjusted for Crohn’s disease (CD) and ulcerative colitis (UC) by multivariate analysis including study variables. Data from 200 patients (78 CD, 122 UC; 117 females; mean age 40.6?±?15.3 years; mean disease duration 12.1?±?8.7 years) were available. CD patients taking probiotics for 25–74% of the disease duration experienced a 64% reduction in total adverse events. The need for systemic steroids, hospitalization, and surgery dropped to zero events per person-year in UC patients and decreased by 93% (p?<?0.001) in CD patients taking probiotics for ≥?75% of the disease duration. Our findings suggest that the use of probiotics may be an additional therapeutic tool in patients with IBD.

     

Probiotics are a good choice in remission of inflammatory bowel diseases: A meta analysis and systematic review

Altered gut bacteria and bacterial metabolic pathways are two important factors in initiation and progression of inflammatory bowel disease (IBD). However, efficacy of probiotics in remission of patients with IBD has not been characterized. This study was performed on the studies that specifically assessed the efficacy of probiotics in attaining clinical response on patients with various types of IBD. The efficacy of variant species of probiotics in different conditions and the influence of study quality in outcomes of randomized controlled trials (RCTs) were also assessed. The RCTs were collected by searching in MEDLINE Web of Science and Google scholar. Then all studies were abstracted in abstraction form and the outcomes were analyzed with fixed‐effect and mixed‐effect models for assessment of efficacy of variant species of probiotics in subgroups of IBDs. Analysis of 9 trials showed that probiotics had not significant effect on Crohn's disease (CD) (p = 0.07) but analysis of 3 trials in children with IBD revealed a significant advantage (p < 0.01). Analysis of 18 trials revealed that probiotics in patients with Ulcerative colitis (UC) in different conditions have significant effects (p = 0.007). VSL#3 probiotics in patients with UC had significant effect (p < 0.01). Combination of Lactobacillus probiotic, prebiotics had significant effect (p = 0.03) only in patients with UC. Combination of Saccharomyces boulardii, Lactobacillus, and VSL#3 probiotics in CD had also a trend for efficiency (p = 0.057). In children with IBD, the combination of Lactobacillus with VSL#3 probiotics had significant effect (p < 0.01). Probiotics are beneficial in IBD, especially the combination ones in UC.

     

Targeted Metagenome Based Analyses Show Gut Microbial Diversity of Inflammatory Bowel Disease patients

Inflammatory bowel disease (IBD) is a multifactorial disease including both genetic and environmental factors. We compared the diversity of intestinal microbesamong a cohort of IBD patients to study the microbial ecological effects on IBD. Fecal samples from patients were sequenced with next generation sequence technology at 16S rDNA region. With statistical tools, microbial community was investigated at different level. The gut microbial diversity of Crohn’s disease (CD) patients and colonic polyp (CP) patients significantly different from each other. However, the character of ulcerative colitis (UC) patients has of both CD and CP features. The microbial community from IBD patients can be very different (CD patient) or somewhat similar (UC patients) to non-IBD patients. Microbial diversity can be an important etiological factor for IBD clinical phenotype.     

Role of nutrition and microbiota in susceptibility to inflammatory bowel diseases

Inflammatory bowel diseases (IBDs), Crohn's disease (CD), and ulcerative colitis (UC) are chronic inflammatory conditions, which are increasing in incidence, prevalence, and severity, in many countries. While there is genetic susceptibility to IBD, the probability of disease development is modified by diet, lifestyle, and endogenous factors, including the gut microbiota. For example, high intakes of mono- and disaccharides, and total fats consistently increases the risk developing both forms of IBD. High vegetable intake reduces the risk of UC, whereas increased fruit and/or dietary fiber intake appears protective against CD. Low levels of certain micronutrients, especially vitamin D, may increase the risk of both diseases. Dietary patterns may be even more important to disease susceptibility than the levels of individual foods or nutrients. Various dietary regimes may modify disease symptoms, in part through their actions on the host microbiota. Both probiotics and prebiotics may modulate the microflora, and reduce the likelihood of IBD regression. However, other dietary factors affect the microbiota in different ways. Distinguishing cause from effect, and characterizing the relative roles of human and microbial genes, diet, age of onset, gender, life style, smoking history, ethnic background, environmental exposures, and medications, will require innovative and internationally integrated approaches.     

Expression of Toll-like receptor 2 (TLR2), TLR4, and CD14 in biopsy samples of patients with inflammatory bowel diseases: upregulated expression of TLR2 in terminal ileum of patients with ulcerative colitis.

Dysregulation of innate and adaptive intestinal immune responses to bacterial microbiota is supposed to be involved in pathogenetic mechanisms of inflammatory bowel diseases (IBDs). We investigated expression of Toll-like receptor 2 (TLR2), TLR4, and their transmembrane coreceptor CD14 in biopsy samples from patients with IBD and in non-inflamed gut mucosa from controls. Small intestine and colon samples were obtained by colonoscopy from patients with Crohn's disease (CD), ulcerative colitis (UC), and controls. Immunohistochemical analysis of cryostat sections using polyclonal and monoclonal antibodies specific for TLR2, TLR4, and CD14 showed a significant increase in TLR2 expression in the terminal ileum of patients with inactive and active UC against controls. Significant upregulation of TLR4 expression relative to controls was found in the terminal ileum and rectum of UC patients in remission and in the terminal ileum of CD patients with active disease. CD14 expression was upregulated in the terminal ileum of CD patients in remission and with active disease, in the cecum of UC patients in remission and with active disease, and in rectum of UC patients with active disease. Hence, dysregulation of TLR2, TLR4, and CD14 expression in different parts of the intestinal mucosa may be crucial in IBD pathogenesis.     

The role of stress in the development and clinical course of inflammatory bowel disease: epidemiological evidence

BACKGROUND: It is unclear whether psychological stress contributes to the inflammatory process in the inflammatory bowel diseases (IBD), ulcerative colitis (UC) and Crohn's disease (CD). This review assesses the epidemiological evidence regarding a causal link between stress and gut inflammation in IBD. METHODS: A Medline search identified prospective studies of the effects of stress on subsequent disease activity and randomized controlled studies of the effects of psychological interventions on disease course in IBD. Controlled retrospective studies were included in the review of aspects of the stress-inflammatory relationship for which few prospective studies are available (e.g. the link between stress and disease onset). Studies were assessed qualitatively. RESULTS: Among 9 longitudinal studies of stress or depression and disease course, a significant stress-inflammation relationship has been found when UC and CD are studied independently (4 of 4 studies positive) but studies of mixed samples of CD and UC have mostly had negative results (1 of 5 studies positive). Evidence of a contribution of stress to disease onset is very weak. The results of 5 studies of psychological interventions in IBD have been negative or modestly supportive of benefit. Confidence in therapeutic benefits of psychological interventions results is limited by methodological weaknesses in these studies. DISCUSSION: There is consistent evidence for a contribution of psychological factors to IBD disease course, especially stress in UC and depressive symptoms in CD. More rigorous tests of psychological interventions in IBD are needed.     

Genetic Association of Peptidoglycan Recognition Protein Variants with Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) is a common disease, includes Crohn''s disease (CD) and ulcerative colitis (UC), and is determined by altered gut bacterial populations and aberrant host immune response. Peptidoglycan recognition proteins (PGLYRP) are innate immunity bactericidal proteins expressed in the intestine. In mice, PGLYRPs modulate bacterial populations in the gut and sensitivity to experimentally induced UC. The role of PGLYRPs in humans with CD and/or UC has not been previously investigated. Here we tested the hypothesis that genetic variants in PGLYRP1, PGLYRP2, PGLYRP3 and PGLYRP4 genes associate with CD and/or UC and with gender and/or age of onset of disease in the patient population. We sequenced all PGLYRP exons in 372 CD patients, 77 UC patients, 265 population controls, 210 familial CD controls, and 24 familial UC controls, identified all polymorphisms in these populations, and analyzed the variants for significant association with CD and UC. We identified 16 polymorphisms in the four PGLYRP genes that significantly associated with CD, UC, and/or subgroups of patient populations. Of the 16, 5 significantly associated with both CD and UC, 6 with CD, and 5 with UC. 12 significant variants result in amino acid substitutions and based on structural modeling several of these missense variants may have structural and/or functional consequences for PGLYRP proteins. Our data demonstrate that genetic variants in PGLYRP genes associate with CD and UC and may provide a novel insight into the mechanism of pathogenesis of IBD.     

Dark-purple rice extract modulates gut microbiota composition in acetic acid– and indomethacin-induced inflammatory bowel disease in rats

International Microbiology - Ulcerative colitis (UC) and Crohn’s disease (CD) are two major forms of inflammatory bowel disease (IBD). The disease has been linked with gut microbiota...