粪便菌群移植治疗现状及其应用前景

粪便菌群移植(fecal microbiota transplantation,FMT)可以重建正常肠道微生态结构,治疗肠道菌群紊乱性疾病。国内外均有FMT的相关报道,但FMT的具体机制及标准化过程并不明确。本研究针对现有的FMT开展案例,对FMT操作方法、研究治疗现状及应用前景作一综述。     

粪菌移植治疗肠易激综合征研究进展

粪菌移植(faecal microbiota transplantation,FMT)是将从健康供体获得的粪便悬液转移至患者消化道,从而恢复肠道正常微生物组成和功能的一种治疗方法。近年来,FMT治疗肠易激综合征(irritable bowel syndrome,IBS)的疗效和经济效益越来越受到研究者的重视。这种方法已经成为艰难梭菌感染(Clostridium difficile infection,CDI)的成熟替代疗法。此外,FMT还在炎症性肠病(inflammatory bowel disease,IBD)和胃肠疾病以外的疾病,如心血管疾病、自身免疫性疾病和代谢综合征等多种疾病的治疗中取得了显著进展。关于FMT仍有许多未解的问题,需要在这一领域进行更多研究。本文就IBS的发病机制、FMT的疗效和安全性进行综述。     

Bacillus megaterium WZ009催化合成(R)-4-氯-3-羟基丁酸乙酯和(S)-3-羟基-γ-丁内酯

以外消旋4-氯-3-羟基丁酸乙酯为唯一C源的富集培养筛选得到一株菌株WZ009,经16S rDNA测序鉴定为巨大芽胞杆菌(Bacillus megaterium)。B.megaterium WZ009静息细胞可以立体选择性催化(S)-4-氯-3-羟基丁酸乙酯水解和脱氯反应得到光学纯的(R)-4-氯-3-羟基丁酸乙酯(e.e.≥99%)和(S)-3-羟基-γ-丁内酯(e.e.≥95%)。笔者对B.megaterium WZ009不对称催化反应影响因素(温度、pH、中和剂、底物浓度、时间进程以及细胞重复利用)进行优化研究,确定了该反应体系最优条件:底物浓度200 mmol/L,中和剂氨水,pH 7.2,40℃反应12 h,转化率达到50.6%,底物对映体过量值为99.6%。该生物催化合成(R)-4-氯-3-羟基丁酸乙酯和(S)-3-羟基-γ-丁内酯过程具有良好的工业化应用前景。     

粪菌移植体系的整体整合医学思考

虽然已有越来越多的证据支持粪菌移植(fecal microbiota transplantation,FMT)的重要临床价值,但是大量的研究者和医生基于其现有的知识结构难以理解和用好FMT。重点从FMT的概念认知、最新FMT体系状态以及未来发展方向等角度进行综述和讨论。     

冰冻粪菌移植治疗艰难梭菌相关腹泻效果的Meta分析

目的 应用Meta分析评价冰冻粪菌移植(FMT)治疗艰难梭菌感染(CDI)相关腹泻的效果。 方法 计算机检索CNKI、CBM、WanFang Data、PubMed、EMbase、Web of Science、The Cochrane Library数据库关于冰冻FMT治疗CDI相关腹泻的随机对照试验,检索时限均为建库至2019年8月。 结果 共纳入8个研究,包括665例患者。Meta分析结果显示:冰冻FMT相比万古霉素/非达霉素治疗CDI相关腹泻差异有统计学意义[OR=23.94,95% CI=(6.80,84.34),P0.05)。多次FMT相比单次FMT能显著治愈CDI相关腹泻,差异有统计学意义[OR=9.79,95% CI=(4.27,22.46),P0.05)。 结论 冰冻FMT相比万古霉素/非达霉素治疗CDI相关腹泻有更好的疗效,且通过灌肠或结肠镜移植冰冻/冻干粪菌可以是一种替代新鲜粪菌的治疗方法,同时多次FMT治疗CDI相关腹泻的治愈率高于单次FMT,CDI患者不良反应和病亡率的发生与FMT无直接关系。以上结论需要更多高质量的研究加以证实。     

犁头霉11α-羟基化制备16β-甲基-11α,17α,21-三羟基孕甾-1,4-二烯-3,20-二酮

选育到一株对16β-甲基,17α,21-二羟基孕甾-1,4-二烯-3,20-二酮(Ⅱa)11α-羟基化活性强的犁头霉A28菌株,并发现底物21-乙酰化(Ⅱb)可明显提高11α-羟基化的能力.在适宜的转化条件下,Ⅱb投料浓度0.5%,产物16β-甲基-11α,11α,21-三羟基孕甾-1,4-二烯-3,20-二酮(Ⅲ)收率为73%,结构经波谱分析确认.     

具有差向选择性还原(R)-6-氰基-5-羟基-3-羰基己酸叔丁酯活性的微生物菌株筛选和鉴定

从土样中分离得到一株具有差向选择性还原(R)-6-氰基-5-羟基-3-羰基己酸叔丁酯活性的微生物菌株ZJB-09225,经生理生化特征鉴定和18S rDNA测序后鉴定为卡里比克毕赤酵母(Pichia caribbic ZJB-09225)。研究结果发现,在最适发酵条件下培养32 h,生物量为8.8 g/L,体积酶活达7.2 U/L;P.caribbic ZJB-09225最适作用温度、最适作用pH值分别为35℃和7.5。在最适的催化条件下,P.caribbic ZJB-09225细胞催化50.0 g/L(R)-6-氰基-5-羟基-3-羰基己酸叔丁酯3 h后,产物6-氰基-(3R,5R)-二羟基己酸叔丁酯得率3.4%,产物d.e.值99.5%以上。     

粪菌移植技术中肠道噬菌体对疾病影响的研究进展

粪菌移植(fecal microbiota transplantation, FMT)是一种创新的方法,通过将健康供体的粪便微生物群移植到疾病患者体内,达到重建肠道微生态平衡的目的,为治疗疾病提供帮助。粪菌移植技术在复发性艰难拟梭菌感染(recurrent Clostridioides difficile infection, rCDI)的治疗中效果很好,并且其治疗潜力不仅局限于胃肠道疾病,而且在其他与微生物相关的疾病中被不断挖掘。探索FMT成功治疗疾病的影响因素,除了肠道细菌的恢复,还涉及肠道噬菌体的调节。肠道噬菌体是肠道微生物群的重要组成部分,在细菌的复杂动力学中发挥着重要作用,其转移可能与FMT的疗效有关。本综述回顾了肠道噬菌体的生物学特性和主要的生物信息学分析策略,总结了FMT中肠道噬菌体作用的临床研究,探讨了FMT中肠道噬菌体群落的变化和可能的作用机制,讨论了肠道噬菌体与FMT疗效的关系及其存在的安全性问题,既能提高对FMT中肠道噬菌体作用的理解,也能推动FMT的临床应用。     

高选择性不对称还原N,N-二甲基-3-酮-3-(2-噻吩)-1-丙胺的重组氧化还原酶催化性质及其酶促转化

【目的】通过表达多种重组立体选择性氧化还原酶,分析其催化不对称还原N,N-二甲基-3-酮-3-(2-噻吩)-1-丙胺(DKTP)的性质,从而构建酶促合成(S)-N,N-二甲基-3-羟基-3-(2-噻吩)-1-丙胺(DHTP)的反应体系。【方法】基于已有立体选择性氧化还原酶重组大肠杆菌,通过Ni离子亲和层析法纯化得到重组氧化还原酶,以DKTP为底物,考察不同重组氧化还原酶对DKTP的催化活性和选择性,进一步对高选择性酶促合成(S)-DHTP的重组酶CR2进行性质分析,并考察其在最适条件下不对称还原DKTP的过程。【结果】筛选获得产物构型为(S)-型的催化活性最高的酶为CR2,该酶米氏常数Km为0.135 mmol/L,kcat/Km为3.689 L/(mmol·s),最适p H 8.4(0.1 mol/L三乙醇胺缓冲液),最适反应温度为35°C,在10-45°C条件下和p H 7.5-8.5较为稳定,Zn2+离子对酶活有促进作用。CR2催化DKTP不对称还原反应6 h后,DHTP的产率达92.1%、光学纯度达99.9%。【结论】基于活性和选择性分析,获得不对称还原DKTP的目标酶CR2,其催化特性有利于高立体选择性还原DKTP生成度洛西汀中间体(S)-DHTP,从而为进一步提高酶促不对称还原DKTP的转化效率提供研究基础。     

乙醇脱氢酶与葡萄糖脱氢酶偶联催化制备(S)-1-(2,6-二氯-3-氟苯基)乙醇

(S)-1-(2,6-二氯-3-氟苯基)乙醇是抗癌药物克唑替尼的手性合成前体,可由2,6-二氯-3-氟苯乙酮经乙醇脱氢酶催化还原制备,还原中所需的还原型辅酶Ⅱ再生是该反应的技术瓶颈.本研究构建重组大肠杆菌E.coli BL21-ADH和E.coli BL21-GDH,实现了葡萄糖脱氢酶和乙醇脱氢酶的共表达,并进行偶联转化.结果表明,当在反应温度为30℃,pH为7的条件下,(S)-l-(2,6-二氯-3-氟苯基)乙醇的产量达到最高,在投料量为6％时,该体系转化率为93.75％.     

Crosstalk between adipose tissue and the microbiota-gut-brain axis in metabolic diseases

Recently, the microbiota-gut-brain axis (MGBA) has emerged as a target for therapeutic innovation. Impairment of dynamic relationships within the MGBA promotes the pathological features of metabolic diseases. However, experimental data on the MGBA has limited clinical application. This review summarizes recent studies and proposes that exploring the interaction among peripheral organs and the MGBA could verify the dominant role of the latter in the onset of metabolic diseases and promote the clinical application of research outcomes. We first emphasize the molecular basis of metabolic diseases caused by MGBA disorders, which manifests as bidirectional relationship. We also summarize related therapeutic strategies, along with limitations in their clinical application. Adipose tissue (AT) is dynamic during metabolic activities and might interact with components in the MGBA. Therefore, it is interesting to explore the interplay among the MGBA and different kinds of AT, including thermogenic adipose tissue and white adipose tissue (WAT). In addition, we also evaluate the functional specificity of adipose tissue derived mesenchymal stem cells (ADSCs) and the beige adipose tissue. Understanding the heterogeneity and molecular basis of the interaction between different kinds of AT and the MGBA could accelerate innovation in the diagnosis and therapy of metabolic diseases.     

Electroacupuncture modulates the intestinal microecology to improve intestinal motility in spinal cord injury rats

Spinal cord injury (SCI) is a disease involving gastrointestinal disorders. The underlying mechanisms of the potential protective effects of electroacupuncture (EA) and 5-hydroxytryptamine (5-HT) system on SCI remain unknown. We investigated whether EA improves gut microbial dysbiosis in SCI and regulates the 5-HT system. 16S rDNA gene sequencing was applied to investigate alterations in the gut microbiome of the rats. Faecal metabolites and the expression of the 5-HT system were detected. EA and faecal microbiota transplantation (FMT) treatment facilitated intestinal transmission functional recovery and restored the colon morphology of SCI rats. The composition of the intestinal microbiota, including numbers of phylum Proteobacteria, class Clostridia, order Bacteroidales, and genus Dorea, were amplified in SCI rats, and EA and FMT significantly reshaped the intestinal microbiota. SCI resulted in disturbed metabolic conditions in rats, and the EA and FMT group showed increased amounts of catechin compared with SCI rats. SCI inhibited 5-HT system expression in the colon, which was significantly reversed by EA and FMT treatment. Therefore, EA may ameliorate SCI by modulating microbiota and metabolites and regulate the 5-HT system. Our study provides new insights into the pathogenesis and therapy of SCI from the perspective of microbiota and 5-HT regulation.     

糖皮质激素在慢性疼痛中的双重作用机制

糖皮质激素(glucocorticoid,GC)是下丘脑-垂体-肾上腺(hypothalamic-pituitary-adrenal,HPA)轴分泌的最终效应激素,通过与糖皮质激素受体(glucocorticoid receptors,GR)结合行使功能。研究发现,GC在慢性疼痛中表现双重作用,内源性GC作为抗炎类固醇通过募集免疫细胞、抑制激酶通路、调节神经胶质细胞在部分类型的神经病理性疼痛及炎性痛中发挥抑痛作用,但在应激情况下,GC水平异常升高参与中枢神经系统神经元的凋亡、兴奋、记忆等,通过调控不同的信号反应或微环境促进病理性疼痛。本文综述GC在慢性疼痛中的作用,了解其发挥镇痛或致痛的双重作用机制。     

Therapeutic Anti-Depressant Potential of Microbial GABA Produced by Lactobacillus rhamnosus Strains for GABAergic Signaling Restoration and Inhibition of Addiction-Induced HPA Axis Hyperactivity

The role of the microbiota–gut–brain (MGB) axis in mood regulation and depression treatment has gained attention in recent years, as evidenced by the growing number of animal and human studies that have reported the anti-depressive and associated gamma-aminobutyric acid-ergic (GABAergic) effects of probiotics developed from Lactobacillus rhamnosus bacterial strains in the gut microbiome. The depressive states attenuated by these probiotics in patients suffering from clinical depression also characterize the severe and relapse-inducing withdrawal phase of the addiction cycle, which has been found to arise from the intoxication-enabled hyperregulation of the hypothalamic–pituitary–adrenal (HPA) axis, the body’s major stress response system, and a corresponding attenuation of its main inhibitory system, the gamma-aminobutyric acid (GABA) signaling system. Therefore, the use of probiotics in the treatment of general cases of depression provides hope for a novel therapeutic approach to withdrawal depression remediation. This review discusses potential therapeutic avenues by which probiotic application of Lactobacillus rhamnosus strains can be used to restore the central GABAergic activity responsible for attenuating the depression-inducing HPA axis hyperactivity in addiction withdrawal. Also, information is provided on brain GABAergic signaling from other known GABA-producing strains of gut microbiota.     

粪菌移植治疗儿童难治性功能性便秘4例

目的观察粪菌移植对儿童难治性功能性便秘的临床疗效并探讨其机制。方法对4例临床确诊为难治性功能性便秘患儿给予粪菌移植治疗,观察和记录患儿临床症状改善情况并收集供体和粪菌移植治疗前后患儿粪便标本,利用Illumina MiSeq测序平台进行16SrRNA测序,并对测序结果进行生物信息学分析。结果 4例患儿接受粪菌移植治疗后排便状况明显改善,大便次数增加、粪便硬度变软、腹部胀痛明显缓解。粪菌移植后,患儿肠道菌群多样性下降,患儿与供体的肠道菌群差异先增大后逐渐缩小。菌群分析显示患儿肠道有害菌受到抑制、有益菌增加。结论粪菌移植可有效改善儿童难治性功能性便秘的临床症状,具有疗程短、治疗方便、无明显不良反应等优点。     

Serotonin transporter modulation in blood lymphocytes from patients with major depression

1. Serotonin is a neurotransmitter in the central nervous system which has been implicated in the aetiology and pathogenesis of affective disorders. The serononergic system also plays several roles in the immune system through the expression of a number of its receptor subtypes in the immune cells.2. Following release serotonin is inactivated by reuptake into neurons and other cells by a specific serotonin sodium and chloride-dependent transporter molecule, whose structure has been elucidated.3. Measurement [³H]paroxetine binding showed that human lymphocytes contain a high-affinity serotonin transporter.4. To assess the serotonin function in major depression, we investigated serotonin transporter density in blood lymphocytes from patients with this disorder and selected according to the interview of the American Psychiatric Association.5. Patients were divided into two groups and treated with two different antidepressant drugs, one group receiving fluoxetine, a selective serotonin reuptake inhibitor, and another mirtazapine, an antagonist of ₂-adrenergic auto and heteroreceptors, for a period of 6 weeks.6. Blood samples were obtained before and after the treatment, lymphocytes were isolated by Ficoll/Hypaque gradient, subjected to differential adhesion to plastic, and cell membranes were prepared for binding assay of [³H]paroxetine.7. Lymphocytes serotonin transporter number was significantly reduced, while the affinity was unchanged, in patients with major depression disorder as compare to controls.8. In addition, there was a partial recovery in lymphocytes serotonin(5HT) transporter number in the period posterior to the antidepressants administration, accompanied with clinical and depression rating scales improvement. Serotonin was determined in platelet-poor plasma and in lymphocytes before and after drugs administration, showing a significant decrease in the patients treated compared to untreated and controls.9. These results are evidence of the potential interaction between the nervous and immune systems. The mechanisms underlying this interaction are under study, and might be related to modifications in the expression or function of the serotonin transporters in lymphocytes of depressed patients.     

Mind-altering with the gut: Modulation of the gut-brain axis with probiotics

It is increasingly evident that bidirectional interactions exist among the gastrointestinal tract, the enteric nervous system, and the central nervous system. Recent preclinical and clinical trials have shown that gut microbiota plays an important role in these gut-brain interactions. Furthermore, alterations in gut microbiota composition may be associated with pathogenesis of various neurological disorders, including stress, autism, depression, Parkinson’s disease, and Alzheimer’s disease. Therefore, the concepts of the microbiota-gut-brain axis is emerging. Here, we review the role of gut microbiota in bidirectional interactions between the gut and the brain, including neural, immune-mediated, and metabolic mechanisms. We highlight recent advances in the understanding of probiotic modulation of neurological and neuropsychiatric disorders via the gut-brain axis.     

Heat-killed Lactobacillus helveticus strain MCC1848 confers resilience to anxiety or depression-like symptoms caused by subchronic social defeat stress in mice

The gut microbiota is involved in the pathogenesis of stress-related disorders. Probiotics can benefit the central nervous system via the microbiota–gut–brain axis, which raises the possibility that probiotics are effective in managing depression. In the present study, we examined the effects of heat-killed Lactobacillus helveticus strain MCC1848 in subchronic and mild social defeat stress (sCSDS) model mice (a widely used animal model of depression). MCC1848 supplementation significantly enhanced the interaction time in the social interaction test and sucrose preference ratio in the sucrose preference test, suggesting that MCC1848 improved anxiety- or depressive-like behaviors in sCSDS mice. The gene expression profile analysis of the nucleus accumbens, which plays an important role in stress resilience, indicated that MCC1848 ameliorated sCSDS-induced gene expression alterations in signal transduction or nervous system development. These findings suggest that MCC1848 supplementation is useful as a preventive strategy for chronic-stress-induced depression.     

Disruptive physiology: olfaction and the microbiome–gut–brain axis

This review covers the field of olfaction and chemosensation of odorants and puts this information into the context of interactions between microbes and behaviour; the microbiome–gut–brain axis (MGBA). Recent emphasis has also been placed on the concept of the holobiome which states that no single aspect of an organism should be viewed separately and thus must include examination of their associated microbial populations and their influence. While it is known that the microbiome may be involved in the modulation of animal behaviour, there has been little systematized effort to incorporate into such studies the rapidly developing knowledge of the wide range of olfactory systems. The classical olfactory system is evolutionarily conserved in multiple taxa from insects through to fish, reptiles and mammals, and is represented by the largest gene families in vertebrates. Mice have over 1000 different olfactory receptors and humans about 400. They are distributed throughout the body and are even found in spermatozoa where they function in chemotaxis. Each olfactory receptor has the unique functional capability of high‐affinity binding to several different molecular ligands. These and other properties render the cataloguing of odorants (odorome) with specific actions a difficult task. Some ectopic olfactory receptors have been shown to have functional effects in the gut and kidney, highlighting the complexity of the systems engaged by odorants. However, there are, in addition to classical olfactory receptors, at least two other families of receptors involved in olfaction that are also widely found expressed on tissues in many different organs in addition to the nervous system and brain: the trace‐amine associated and formyl peptide receptors. Bacteria can make many if not most odorants and are responsible for recognition of species and relative relatedness, as well as predator presence, among many other examples. Activation of different combinations of olfactory receptors by bacterial products such as β‐phenylethylamine have been shown even to control expression of emotions such as fear and aggression. The number of examples of bacterial products and volatile odorants influencing brain function and behaviour is expanding rapidly. Since it is recognized that many different bacterial products and metabolites also function as social cues, and may themselves be directly or indirectly causative of behavioural change, it becomes ever more important to include olfaction into studies of the MGBA. Clearly there are broader implications for the involvement of olfaction in this rapidly evolving field. These include improvement in our understanding of the pathways engaged in various behaviours, and the identification of novel approaches and new targets in efforts to modulate behavioural changes.