Gut:原发性胆汁性胆管炎肠道菌群失调并可以被熊去氧胆酸治疗部分逆转

2017-02-20 xing.T MedSci原创

本研究为PBC患者的肠道菌群提出了一个综合的认知观点。PBC患者肠道菌群发生失调,并且可以被UDCA部分缓解。该研究表明肠道菌群是PBC的一个潜在治疗靶点和诊断的生物学标志物。

最近已有文献报道了肠道菌群与一些慢性肝脏疾病之间存在密切的相关性。近日,消化病领域权威杂志Gut上发表了一篇研究文章,研究人员系统地将原发性胆汁性胆管炎(PBC)患者与健康对照者的肠道菌群进行了比较分析。

研究人员首先在60例接受熊去氧胆酸(UDCA)治疗的PBC患者和80例匹配的健康对照者中进行了一项横断面研究。其次,研究人员采用一个由19名治疗的PBC患者和34名正常对照者组成的独立队列进行研究结果验证。最后,研究人员在6个月 UDCA治疗之前和之后接受分析的37例PBC患者亚组进行了一项前瞻性研究。收集参与者粪便样本,通过16S核糖体RNA基因序列分析了肠道微生物情况。

在PBC患者中个体微生物多样性显著减少(P=0.03)。研究人员发现丰度显著降低的四个菌属和丰度显著增加的8个菌属与PBC密切相关(探索和验证数据中的曲线下面积分别为0.86和0.84)。值得注意的是,6个与PBC相关的菌属的丰度在经 UDCA治疗6个月后发生了逆转。尤其是在健康对照者中很丰富的普拉细菌,而且在gp210阳性患者中进一步减少,相比于gp210阴性患者(P=0.002)。令人感兴趣的结果是细菌入侵PBC患者的上皮细胞,这一推断的途径能力增强与属于肠杆菌科的细菌丰度密切相关。

本研究为PBC患者的肠道菌群提出了一个综合的认知观点。PBC患者肠道菌群发生失调,并且可以被UDCA部分缓解。该研究表明肠道菌群是PBC的一个潜在治疗靶点和诊断的生物学标志物。

原始出处:

Ruqi Tang, et al. Gut microbial profile is altered in primary biliary cholangitis and partially restored after UDCA therapy. Gut. 2017.  http://gut.bmj.com/content/early/2017/02/17/gutjnl-2016-313332

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原发性胆汁性胆管炎(PBC)常与其他自身免疫性疾病有关,但关于甲状腺疾病的影响(TD)对PBC自然史的影响,我们知之甚少。我们的目的是分析PBC和TD之间的关联。这项研究涉及921例PBC患者,纳入时间为1975-2015年,地点为帕多瓦市(376例)、巴塞罗那(545例)平均随访126.9±91.7个月。共150例(16.3 %)有TD,包括94例(10.2%)Hashimoto甲状腺炎,15例

Aliment Pharmacol Ther:原发性胆汁性胆管炎患者早期就有大脑变化

背景:原发性胆汁性胆管炎(PBC)患者可能会因为胆汁淤积和/或炎症过程,导致大脑的变化;这种变化与疲劳和认知功能障碍的系统性症状有关。 目的:探究早期PBC是否会发生大脑变化;如果早期出现大脑变化并出现进展,那么可以解释为什么这些症状会这么难治。 方法:使用磁化传递、弥散加权成像和1H磁共振波谱分析,对13名活检证实非肝硬化PBC患者进行了疾病早期大脑变化分析;并与17名健康志愿者的结