J Clin Invest:富含梭菌的微生物群会促进肠易激综合征患者粪便胆汁酸的过度排泄

2020-08-01 MedSci原创 MedSci原创

粪便胆汁酸(BA)过多被认为是腹泻为主的肠易激综合征(IBS-D)的机制之一。然而,导致BA排泄过多的因素尚未明了。鉴于肠道微生物群在BA代谢中的重要性,我们推测肠道菌群失调可能导致IBS-D中BA排

粪便胆汁酸(BA)过多被认为是腹泻为主的肠易激综合征(IBS-D)的机制之一。然而,导致BA排泄过多的因素尚未明了。鉴于肠道微生物群在BA代谢中的重要性,我们推测肠道菌群失调可能导致IBS-D中BA排泄过多。

 

研究纳入290名IBS-D患者和89名健康志愿者,进行与BA相关的代谢和元基因组分析。

 

结果发现,24.5%的IBS-D患者表现出总BA排泄过多和粪便中BA转化菌的改变。值得注意的是,梭状芽孢杆菌(如梭状芽孢杆菌)的增加与粪便BAs和血清7α-羟基-4-胆甾烯-3-酮(C4)水平呈正相关,但与血清成纤维细胞生长因子19(FGF19)浓度呈负相关。此外,富含IBS-D粪便微生物群或梭状芽孢杆菌的菌落增强了小鼠血清C4和肝脏共轭BAs,但降低了回肠FGF19的表达。使用万古霉素抑制梭状芽孢杆菌可得到相反的结果。梭状芽孢杆菌衍生的BAs在体外和体内都抑制了肠道FGF19的表达。

 

总之,本研究表明,富含梭菌的微生物群会促进IBS-D患者BA的过度排泄。

 

原始出处:

 

Ling ZhaoWei Yang, et al., A Clostridia-rich microbiota enhances bile acid excretion in diarrhea-predominant irritable bowel syndrome. J Clin Invest. 2020 Jan 2;130(1):438-450. doi: 10.1172/JCI130976

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    2020-08-03 Homburg
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内脏超敏反应在肠易激综合征(IBS)患者中很常见。本项研究调查了炎症分子(例如组胺和蛋白酶)是否激活了过氧化物合酶2(COX2),以增加肥大细胞对前列腺素E2(PGE2)的合成,从而激活了前列腺素(E

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利那洛肽(Linaclotide)是鸟苷酸环化酶C激动剂,可缓解具有主要便秘(IBS-C)症状的肠易激综合征,但如何改善人类的疼痛尚不清楚。

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肠易激综合症(IBS)与微生物的组成不良有关。本项研究旨在探讨粪便菌群移植(FMT)治疗IBS的疗效。