IBD: 粪微生物群改变与克罗恩病患者接受英夫利昔单抗治疗后获得临床和内镜缓解有关

2020-10-10 MedSci原创 MedSci原创

炎症性肠病(IBD)是一种慢性复发的肠道疾病,主要包括克罗恩病(CD)和溃疡性结肠炎(UC)。

         炎症性肠病(IBD)是一种慢性复发的肠道疾病,主要包括克罗恩病(CD)和溃疡性结肠炎(UC),尽管目前尚不清楚IBD的确切病因和发病机制,但最普遍接受的共识是IBD的全球传播似乎与饮食和环境的西化有关,这会诱发对复杂环境因素的异常免疫反应,并增加了遗传易感人群中IBD的风险。越来越多的研究报告指出,肠道菌群组成和功能的改变与IBD的发生和发展有关,但是,尚不清楚微生物组的组学特征是否可以预测疾病的发生和发展,抗肿瘤坏死因子(TNF)的治疗彻底改变了IBD的药物治疗模式,但是,多达30%的患者在诱导期后无临床获益,高达50%的患者必须中止治疗。那么本项研究就假设IFX治疗期间肠道菌群的变化是可变的,而这种变化会影响IFX治疗的临床和内镜反应,并对此开展研究。

 

 

        研究人员使用16S测序分析了49例活动性CD患者的粪便相关菌群,这些患者分别于基线,第6周和第30周接受粪便检查。此外,研究人员在第6周对患者的肠道菌群的改变进行研究,以探究其预测第14周和第30周对IFX治疗的临床和内镜反应的潜力。

 

        研究结果显示:IFX治疗后的CD患者粪便微生物群组成的多样性和丰富性明显增加,产生短链脂肪酸的细菌的显着增加以及致病菌数量明显减少。此外,在治疗期间,十字形科和蓝藻科菌群的比例增加与IFX疗效相关;这些类群在第6周的总增加值分别在第14周和第30周时预测临床反应的准确性分别为83.4%和84.2%,在预测第30周时内镜反应的预测价值为89.1%。

 

        本项研究通过前瞻性的探索发现IFX可以通过改变微生物群组成和功能来减少CD相关的肠道微生物营养不良。第6周的鞭毛虫科和蓝藻科菌群增多与IFX的临床和内镜反应有关。

 

 

原始出处:

Xiaojun Zhuang. Et al. Fecal Microbiota Alterations Associated With Clinical and Endoscopic Response to Infliximab Therapy in Crohn’s Disease. Inflammatory Bowel Diseases.2020.

 

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    2020-10-12 bnurmamat
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