Nature:分娩方式或影响婴儿肠道菌群形成

2019-09-30 Admin 惠康桑格研究所

阴道分娩可能促进了母亲肠道菌群影响婴儿肠道菌群形成的过程,而不同分娩方式下导致的菌群差异会在一岁时基本消失。专家表明这一差异对健康的影响还不明确,但该研究将有助于细菌疗法的开发。



研究表明,顺产婴儿的肠道菌群与剖腹产婴儿不同。来自伦敦大学学院惠康-桑格研究所(Wellcome Sanger Institute)、伯明翰大学(University of Birmingham)的科学家和合作团队发现,顺产出生的婴儿大部分肠道细菌来自母亲,但是剖腹产出生的婴儿却不是这样——他们的肠道菌群中与医院环境有关的细菌更多。

婴儿肠道菌群的确切作用尚不清楚,也不确定出生时的菌群差异是否会对婴儿日后的健康产生影响。研究人员发现,顺产婴儿和剖腹产婴儿的肠道菌群差异到 1 岁时已经不再明显。但仍需要进行大量的后续研究,确定早期差异是否会影响健康。英国皇家妇产科学院(Royal College of Obstetricians and Gynaecologists)的专家们表示,这些发现并不意味着应该阻止妇女选择剖腹产。

9 月 18 日发表在《自然》(Nature)杂志上的一项目前规模最大的关于新生儿微生物菌群的研究也揭示了,顺产新生儿的微生物菌群成分并非来自母亲的阴道,而是来自母亲的肠道。这一研究结果也对之前颇有争议的做法提出了质疑:用母亲阴道内的细菌对剖腹产的婴儿进行擦拭。了解分娩过程对婴儿微生物群的影响将有助于细菌治疗方法的研究。

肠道微生物是由数百万种微生物组成的复杂生态系统,被认为对免疫系统的发育有重要作用。儿童早期如果缺乏与适当的微生物进行接触,则可能会患上自身免疫性疾病,如哮喘、过敏和糖尿病。然而,目前而言,对原始肠道菌群在婴儿免疫系统发育,和健康的重要性的了解,还不够明晰,对婴儿微生物菌群的形成方式,以及不同的出生方式对它的影响也缺乏了解。

为了更多地了解婴儿微生物菌群的形成,以及分娩方式是否会对这一过程产生影响,研究人员从近 600 名健康婴儿和 175 名母亲中获取了 1679 份肠道细菌样本,并进行了研究。粪便样本取自 4 天,7 天或 21 天大的婴儿,这些婴儿均在英国医院通过阴道分娩或剖腹产出生。研究还曾对一些婴儿进行了后续追踪研究,直到一岁。

通过 DNA 测序和基因组学分析,研究人员得以明确细菌的成分,并发现两种生产方式下的菌群成分存在着显着差异。他们发现,顺产的婴儿与剖腹产的婴儿相比,明显(通过母亲)获得了更多与健康相关的共生细菌。

惠康-桑格研究所的资深作者特雷弗·劳利(Trevor Lawley)博士说:“这是迄今为止,对新生儿微生物菌群进行的规模最大的基因组研究。我们发现,阴道分娩时细菌从母体传递给婴儿,因而分娩方式对新生儿的肠道菌群有很大影响。通过进一步了解哪些种类的细菌有助于婴儿形成健康的微生物菌群,可以帮助我们研发细菌疗法。”


图片来源:Pixabay

此前有限的研究表明,阴道细菌会通过产道运输给婴儿并被吞食。然而,这项大规模的研究发现,婴儿的肠道中几乎没有母亲的阴道细菌,这一结果在顺产或剖腹产的婴儿中并没有什么区别。

在出生过程中,婴儿会接触到母亲肠道的细菌。研究发现,在顺产情况下,母亲的肠道菌群是构成婴儿肠道菌群的主要来源,而对剖腹产出生的婴儿的菌群构成影响很小。因此,这项研究没有发现任何证据来支持有争议的“阴道播种”做法,而且这种做法可能会将一些危险的细菌传给婴儿。

通过剖腹产出生的婴儿,肠中大部分菌群来自于医院,而非母亲,而且这些细菌很可能有耐药性。研究人员从婴儿肠中分离出了 800 多种潜在致病菌,并进行培养和基因测序,证实了它们与英国医院中引起血液感染的菌株相同。虽然这些细菌在肠道内通常不会引起疾病,但如果它们进入到了错误的位置,或当免疫系统变得衰弱时,也会引起机体感染

这篇论文的资深作者、来自伦敦大学学院的奈杰尔·菲尔德(Nigel Field)教授说:“我们的研究表明,随着婴儿的成长,通过进食以及触碰周围事物而接触到的细菌使他们的肠道菌群变得越来越相似。在断奶后,剖腹产和顺产婴儿之间的肠道菌群差异基本消失。我们还不知道研究发现的肠道菌群的最初差异是否会对健康产生深远影响。”

妇产科顾问医生、英国皇家妇产科学院副院长艾莉森·赖特(Alison Wright)教授指出:“在很多情况下,剖腹产是一种挽救生命的方式,对孕妇和孩子来说都是正确的选择。微生物菌群对新生儿的确切作用,以及影响因素还不明确,所以我们认为这项研究不应该阻止妇女选择剖腹产作为生产方式。结果表明,我们需要更多的研究来提高对这一重要领域的理解。”

现在,所有进行剖腹产的孕妇在分娩前都会服用抗生素,以防止产妇术后感染,这意味着婴儿也会通过胎盘吸收一定剂量的抗生素。这也可能是导致两种生产方式下的婴儿微生物菌群差异的原因之一。

婴儿生物群落研究的首席研究员、伯明翰大学的彼得·布罗克赫斯特(Peter Brocklehurst)教授说:“婴儿出生后的最初几周是免疫系统发育的关键时期,但我们对此知之甚少。我们迫切需要继续跟进这项研究,观察早期的肠道菌群差异是否会在婴儿成长过程中引发任何健康问题。进一步的研究将帮助我们了解肠道菌群在婴幼儿时期的作用,并可以有助我们开发治疗方法,构建一个健康的微生物菌群。”

原始出处:

Yan Shao, Samuel C. Forster, Evdokia Tsaliki, et al. Stunted microbiota and opportunistic pathogen colonization in caesarean-section birth. Nature (2019).

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    2020-06-19 liye789132251
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    2019-10-16 1de33e15m69(暂无匿称)

    肠道微生物的产生酒精的那部分,我姑且称之为酒虫,是引起非酒精性脂肪肝的罪魁,可惜蒙牛伊利还没开发一种针对脂肪肝的酸奶,国家基金不能设个项目来试试

    0

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    2019-10-07 124bba39m15暂无昵称

    我们也做了这个研究

    0

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    2019-10-02 linlin2312
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    2019-10-01 飛歌

    学习了很有用不错

    0

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