JGH: 肠道微生物群衍生合生元配方 (SIM01) 可以作为COVID-19的新型辅助疗法

2022-05-28 xuyihan MedSci原创

肠道菌群是指定植在人体肠道内并长期与人体相互依存的细菌群,包括40多个菌属,400到500种菌种,数量达100万亿之多,是人体细胞的10倍,重量上相当于一个人的肝脏。

越来越多的证据表明,肠道微生物群在 COVID-19 中发挥着重要作用。我们之前报道过,COVID-19 患者的粪便微生物群发生了改变,其特征是机会性病原体富集和有益共生菌减少。前期研究结果表明,肠道菌群失调与 COVID-19 的严重程度相关,并且即使在呼吸道样本中的 SARS-CoV-2 被清除和呼吸道症状消退后这样的现象仍持续存在。新出现的证据表明,益生菌可调节宿主免疫功能并降低儿童和成人上呼吸道感染的严重程度。然而,肠道微生物群的调节是否可以改善 COVID-19 的结果在很大程度上是未知的。SIM01 是一种由 3 种冻干双歧杆菌组成的口服胶囊化制剂,该配方旨在补充 COVID-19 患者与免疫防御相关的缺失细菌。本项研究旨在评估 SIM01 作为 COVID-19 住院患者免疫反应和肠道微生物群的辅助治疗的疗效。

 

在本项研究中,在香港传染病转诊中心收治的 COVID-19 患者获得了双歧杆菌菌株、低聚半乳糖、低聚木糖和抗性糊精合成的 SIM01的新配方治疗。同期将另一个独立传染病团队下收治但未接受 SIM01 的 COVID-19 患者作为实验对照。根据治疗指南,所有患者都接受了 COVID-19 的标准治疗。最后研究人员评估了患者从入院到第 5 周的抗体反应、血浆促炎标志物、鼻咽 SARS-CoV-2 病毒载量和粪便微生物群谱的变化。

 

研究结果显示连续25名 COVID-19 患者接受 SIM01 治疗28天;30名未接受该配方的患者作为阴性对照。与对照组相比,接受SIM01的患者产生SARS-CoV-2 IgG抗体的人数显着增加(88% VS 63.3%;P = 0.037)。SIM01 组和对照组中分别有 1 名(4%)和 8 名患者(26.7%)在出院时未能产生阳性IgG抗体。在第 5 周,白细胞介素 (IL)-6、单核细胞趋化蛋白-1 (MCP-1)、巨噬细胞集落刺激因子 (M-CSF)、肿瘤坏死因子 (TNF-α) 和 IL-1RA 的血浆水平在 SIM01治疗组中显着降低,但在对照组中不显着。鼻咽部 SARS-CoV-2 病毒载量与 SIM01干预呈显着负相关。宏基因组分析表明,在第 4 周和第 5 周,在 COVID-19 患者中发现了更丰富的 SIM01 配方中的细菌种类,导致共生细菌富集并抑制了机会性病原体的生长。

 

本项研究表明使用新型肠道微生物群衍生合生元配方 SIM01 可加速针对 SARS-CoV-2 的抗体形成,降低鼻咽病毒载量,减少促炎免疫标志物,并恢复肠道菌群失调。

 

 

原始出处:

Lin Zhang. Et al. Gut microbiota-derived synbiotic formula (SIM01) as a novel adjuvant therapy for COVID-19: An open-label pilot study. Journal of Gastroenterology and Hepatology.2022.

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