肠道菌群与骨质疏松症中西医研究进展
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摘要
骨质疏松症在我国广泛流行,严重影响老年人的生存质量,并给患者、家庭、社会造成严重的心理负担和经济负担。近年来肠道微生态的研究已成为热点,其对骨质疏松症的影响也被人们所关注。本文从肠道菌群与骨质疏松症的紧密关系、基于肠道菌群治疗骨质疏松症的临床研究与实验研究等方面进行综述,总结中西医在该方向的研究进展,为骨质疏松症的临床治疗提供一种新方法。
Osteoporosis is widely prevalent in our country. It has a serious impact on the life quality of the elderly, and serious economic burdens and psychological burdens on patients, families and society. In recent years, the research of intestinal microflora has aroused great concern, and more and more attention has been paid to the effect of its therapeutical function on osteoporosis. This review summarizes the progress and hotspots in recent Traditional Chinese Medicine and Western Medicine researches of the close associations among intestinal microflora and osteoporosis, the clinical and experiment study on the treatment of osteoporosis through modulate intestinal microflora. This may provide a new method for the clinical treatment of osteoporosis.
Osteoporosis is widely prevalent in our country. It has a serious impact on the life quality of the elderly, and serious economic burdens and psychological burdens on patients, families and society. In recent years, the research of intestinal microflora has aroused great concern, and more and more attention has been paid to the effect of its therapeutical function on osteoporosis. This review summarizes the progress and hotspots in recent Traditional Chinese Medicine and Western Medicine researches of the close associations among intestinal microflora and osteoporosis, the clinical and experiment study on the treatment of osteoporosis through modulate intestinal microflora. This may provide a new method for the clinical treatment of osteoporosis.
引文
[1] Espinoza JL, Elbadry MI, Nakao S. An altered gut microbiota May trigger autoimmune-mediated acquired bone marrow failure syndromes[J]. Clin Immunol, 2016, 171(8): 62-64.
[2] Villa CR, Ward WE, Comelli EM. Gut microbiota- bone axis. Critical Reviews in Food Science and Nutrition[J], 2017, 57(8):1664-1672.
[3] McCabe L, Britton RA, Parameswaran N. Prebiotic and Probiotic regulation of Bone Health: Role of the Intestine and its Microbiome[J]. Current Osteoporosis Reports, 2015, 13(6):363-371.
[4] Eckburg PB, Bik EM, Bernstein CN, et al. Diversity of the human intestinal microbial flora[J]. Science, 2005,308(5728):1635-1638.
[5] 王飙,赵和平,高文杰,等.骨质疏松症患者肠道菌群多样性分析[J].中国骨质疏松杂志,2018,24(1):98-101.
[6] Li JY, Chassaing B, Tyagi AM, et al. Sex steroid deficiency associated bone loss is microbiota dependent and prevented by probiotics[J]. The Journal of Clinical Investigation, 2016, 126(6):2049-2463.
[7] Claesson MJ, Cusack S, O'Sullivan O, et al. Composition, variability, and temporal stability of the intestinal microbiota of the elderly[J]. Proceedings of the National Academy of Sciences of the United States of America, 2011,108(Suppl.1): 4586-4591.
[8] Li JY, Chassaing B, Reott M, et al. Gut microbiota plays a pivotal role in the bone loss induced by sex steroid deficiency[J]. Journal of Bone and Mineral Research,2014,29(Suppl.1):1029-1040.
[9] Charatcharoenwitthaya N, Khosla S, Atkinson EJ, et al. Effect of Blockade of TNF-α and Interleukin-1 Action on Bone Resorption in Early Postmenopausal Women[J]. Journal of Bone and Mineral Research, 2007,22(5): 724-729.
[10] 贾小玥, 郑黎薇, 袁泉. 肠道菌群:绝经后骨质疏松防治新靶点[J].中国骨质疏松杂志, 2017,23(3):392-401.
[11] Sjogren K, Engdahl C, Henning P, et al. The gut microbiota regulates bone mass in mice[J]. Bone, 2012, 50(1):91-92.
[12] Sjgren K, Engdahl C, Henning P, et al. The gut microbiota regulates bone mass in mice[J]. Journal of Bone and Mineral Research, 2012, 27(6):1357-1367.
[13] Hilmi I, Sunderesvaran K, Ananda V, et al. Increased fracture risk and osteoporosis not associated with vitamin D levels in Malaysian patients with inflammatory bowel disease[J]. Journal of Clinical Endocrinol Metabolism, 2013,98(6):2415-2421.
[14] Miznerova E, Hlavaty T, Koller T, et al. The prevalence and risk factors for osteoporosis in patients with inflammatory bowel disease[J]. Bratislava Medical Journal-Bratislavske Lekarske Listy I, 2013,114(8):439-445.
[15] Kahaly GJ, Schuppan D. Celiac disease and endocrine autoimmunity[J]. Digestive diseases,2015,33(2):155-161.
[16] McCabe LR, Irwin R, Schaefer L, et al. Probiotic use decreases intestinal inflammation and increases bone density in healthy male but not female mice[J]. Journal of Cellular Physiology, 2013,228(8):1793-1798.
[17] Ohlsson C, Sjogren K. Effects of the gut microbiota on bone mass[J]. Trends in Endocrinology and Metabolism, 2015, 26(2): 69-74.
[18] Avella MA, Place A, Du SJ, et al. Lactobacillus rhamnosus accelerates zebrafish backbone calcification and gonadal differentiation through effects on the GnRH and IGF systems[J]. Plos One, 2012,7(9):572-582
[19] Whisner CM, Martin BR, Schoterman MH, et al. Galactooligosaccharides increase calcium absorption and gut bifidobacteria in young girls: a double-blind cross-over trial[J]. British Journal of Nutrition, 2013, 110(7): 1292-1303.
[20] Abrams SA, Griffin IJ, Hawthorne KM, et al. A combination of prebiotic short and long chain inulin type fructans enhances calcium absorption and bone mineralization in young adolescents[J]. The American Journal of Clinical Nutrition,2005,82(2):471-476.
[21] Corrie M, Whisner, Berdine R, et al. Soluble Corn Fiber Increases Calcium Absorption Associated with Shifts in the Gut Microbiome: A Randomized Dose-Response Trial in Free-Living Pubertal Females[J]. The Journal of Nutrition, 2016,146(7):1298-1306
[22] Sartor RB. Therapeutic manipulation of the enteric microflora in inflammatory bowel diseases: antibiotics, probiotics, and prebiotics[J]. Gastroenterology, 2004,126(6):1620-1633.
[23] Mack DR. Probiotics in inflammatory bowel diseases and associated conditions[J]. Nutrients, 2011,3(2):245-264.
[24] Britton RA, Irwin R, Quach D, et al. Probiotic L. reuteri treatment prevents bone Loss in a menopausal ovariectomized mouse model[J]. Journal of Cellular Physiology,2014,229(11):1822-1830.
[25] Wu HL, Kim MY, Han JH. Icariin Metabolism by Human Intestinal Microflora Probiotic L. reuteri treatment prevents bone Loss in a menopausal ovariectomized mouse model[J]. Molecules, 2016, 21(9): 1158-1168.
[26] 杜欢,徐僮,李海娇,等.粪便类藏药的文献考证及研究现状[J].中国中药杂志, 2018,43(5):1054-1061.
[27] Kimoto-Nira H, Mizumachi K, Okamoto T, et al. Influence of longterm consumption of a lactococcus lactis strain on the intestinal immunity and intestinalflora of the senescence-accelerated mouse[J]. Br J Nutr, 2009,102(2):181-185.
[28] Garcia-Vieyra MI, Del Real A, Lopez MG. Agave fructans: their effect on mineral absorption and bone mineral content[J]. Journal of Medicinal Food,2014,17(11):1247-1255.
[29] Roberfroid MB, Cumps J, Devogelaer JP. Dietary chicory inulin increases whole body bone mineral density in growing male rats[J]. Journal of Nutrition, 2002,132(12):3599-3602.
[30] Takahara S, Morohashi T, Sano T,et al. Fructooligosaccharide consumption enhances femoral bone volume and mineral concentrations in rats[J]. Journal of Nutrition, 2000, 130(7):1792-1795.
[31] Weaver CM, Martin BR, Nakatsu CH, et al. Galactooligosaccharides improve mineral absorption and bone properties in growing rats through gut fermentation[J]. Journal of Agricultural and Food Chemistry, 2011, 59(12):6501-6510.
[32] Shiga K, Nishimukai M, Tomita F, et al. Ingestion of difructose anhydride III, a non-digestible disaccharide, improves postgastrectomy osteopenia in rats[J]. Scandinavian Journal of Gastroenterolgy, 2006, 41(10): 1165-1173.
[33] Sadeghi AA. Bone mineralization of broiler chicks challenged with salmonella enteritidis fed diet containing probiotic (bacillus subtilis)[J]. Probiotics and Antimicrobial Proteins, 2014,6(3-4):136-140.
[34] 黄月,武晓,薄云海,等.基于RP-UPLC-MS 和 HILIC-UPLC-MS的骨疏丹对糖皮质激素性骨质疏松模型大鼠干预作用的尿液代谢组学研究[J].中国药学杂志,2016,51(23):2045-2052.
[35] Gao MX, Tang XY, Zhang FX, et al. Biotransformation and metabolic profile of Xian-Ling-Gu-Bao capsule, a traditional Chinese medicine prescription, with rat intestinal microflora by ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry analysis[J]. Biomed Chromatogr, 2018, 32(4):4160-4174.
[36] Xu J, Zhao L, Tong X, et al. Structural modulation of gut microbiota during alleviation of type 2 diabetes with a Chinese herbal formula[J]. Isme Journal, 2015, 9(3):552-562.
[37] Wei X, Tao J, Xiao S, et al. Xiexin Tang improves the symptom of type 2 diabetic rats by modulation of the gut microbiota[J]. Scientific Reports. 2018, 8(1):3685.
[2] Villa CR, Ward WE, Comelli EM. Gut microbiota- bone axis. Critical Reviews in Food Science and Nutrition[J], 2017, 57(8):1664-1672.
[3] McCabe L, Britton RA, Parameswaran N. Prebiotic and Probiotic regulation of Bone Health: Role of the Intestine and its Microbiome[J]. Current Osteoporosis Reports, 2015, 13(6):363-371.
[4] Eckburg PB, Bik EM, Bernstein CN, et al. Diversity of the human intestinal microbial flora[J]. Science, 2005,308(5728):1635-1638.
[5] 王飙,赵和平,高文杰,等.骨质疏松症患者肠道菌群多样性分析[J].中国骨质疏松杂志,2018,24(1):98-101.
[6] Li JY, Chassaing B, Tyagi AM, et al. Sex steroid deficiency associated bone loss is microbiota dependent and prevented by probiotics[J]. The Journal of Clinical Investigation, 2016, 126(6):2049-2463.
[7] Claesson MJ, Cusack S, O'Sullivan O, et al. Composition, variability, and temporal stability of the intestinal microbiota of the elderly[J]. Proceedings of the National Academy of Sciences of the United States of America, 2011,108(Suppl.1): 4586-4591.
[8] Li JY, Chassaing B, Reott M, et al. Gut microbiota plays a pivotal role in the bone loss induced by sex steroid deficiency[J]. Journal of Bone and Mineral Research,2014,29(Suppl.1):1029-1040.
[9] Charatcharoenwitthaya N, Khosla S, Atkinson EJ, et al. Effect of Blockade of TNF-α and Interleukin-1 Action on Bone Resorption in Early Postmenopausal Women[J]. Journal of Bone and Mineral Research, 2007,22(5): 724-729.
[10] 贾小玥, 郑黎薇, 袁泉. 肠道菌群:绝经后骨质疏松防治新靶点[J].中国骨质疏松杂志, 2017,23(3):392-401.
[11] Sjogren K, Engdahl C, Henning P, et al. The gut microbiota regulates bone mass in mice[J]. Bone, 2012, 50(1):91-92.
[12] Sjgren K, Engdahl C, Henning P, et al. The gut microbiota regulates bone mass in mice[J]. Journal of Bone and Mineral Research, 2012, 27(6):1357-1367.
[13] Hilmi I, Sunderesvaran K, Ananda V, et al. Increased fracture risk and osteoporosis not associated with vitamin D levels in Malaysian patients with inflammatory bowel disease[J]. Journal of Clinical Endocrinol Metabolism, 2013,98(6):2415-2421.
[14] Miznerova E, Hlavaty T, Koller T, et al. The prevalence and risk factors for osteoporosis in patients with inflammatory bowel disease[J]. Bratislava Medical Journal-Bratislavske Lekarske Listy I, 2013,114(8):439-445.
[15] Kahaly GJ, Schuppan D. Celiac disease and endocrine autoimmunity[J]. Digestive diseases,2015,33(2):155-161.
[16] McCabe LR, Irwin R, Schaefer L, et al. Probiotic use decreases intestinal inflammation and increases bone density in healthy male but not female mice[J]. Journal of Cellular Physiology, 2013,228(8):1793-1798.
[17] Ohlsson C, Sjogren K. Effects of the gut microbiota on bone mass[J]. Trends in Endocrinology and Metabolism, 2015, 26(2): 69-74.
[18] Avella MA, Place A, Du SJ, et al. Lactobacillus rhamnosus accelerates zebrafish backbone calcification and gonadal differentiation through effects on the GnRH and IGF systems[J]. Plos One, 2012,7(9):572-582
[19] Whisner CM, Martin BR, Schoterman MH, et al. Galactooligosaccharides increase calcium absorption and gut bifidobacteria in young girls: a double-blind cross-over trial[J]. British Journal of Nutrition, 2013, 110(7): 1292-1303.
[20] Abrams SA, Griffin IJ, Hawthorne KM, et al. A combination of prebiotic short and long chain inulin type fructans enhances calcium absorption and bone mineralization in young adolescents[J]. The American Journal of Clinical Nutrition,2005,82(2):471-476.
[21] Corrie M, Whisner, Berdine R, et al. Soluble Corn Fiber Increases Calcium Absorption Associated with Shifts in the Gut Microbiome: A Randomized Dose-Response Trial in Free-Living Pubertal Females[J]. The Journal of Nutrition, 2016,146(7):1298-1306
[22] Sartor RB. Therapeutic manipulation of the enteric microflora in inflammatory bowel diseases: antibiotics, probiotics, and prebiotics[J]. Gastroenterology, 2004,126(6):1620-1633.
[23] Mack DR. Probiotics in inflammatory bowel diseases and associated conditions[J]. Nutrients, 2011,3(2):245-264.
[24] Britton RA, Irwin R, Quach D, et al. Probiotic L. reuteri treatment prevents bone Loss in a menopausal ovariectomized mouse model[J]. Journal of Cellular Physiology,2014,229(11):1822-1830.
[25] Wu HL, Kim MY, Han JH. Icariin Metabolism by Human Intestinal Microflora Probiotic L. reuteri treatment prevents bone Loss in a menopausal ovariectomized mouse model[J]. Molecules, 2016, 21(9): 1158-1168.
[26] 杜欢,徐僮,李海娇,等.粪便类藏药的文献考证及研究现状[J].中国中药杂志, 2018,43(5):1054-1061.
[27] Kimoto-Nira H, Mizumachi K, Okamoto T, et al. Influence of longterm consumption of a lactococcus lactis strain on the intestinal immunity and intestinalflora of the senescence-accelerated mouse[J]. Br J Nutr, 2009,102(2):181-185.
[28] Garcia-Vieyra MI, Del Real A, Lopez MG. Agave fructans: their effect on mineral absorption and bone mineral content[J]. Journal of Medicinal Food,2014,17(11):1247-1255.
[29] Roberfroid MB, Cumps J, Devogelaer JP. Dietary chicory inulin increases whole body bone mineral density in growing male rats[J]. Journal of Nutrition, 2002,132(12):3599-3602.
[30] Takahara S, Morohashi T, Sano T,et al. Fructooligosaccharide consumption enhances femoral bone volume and mineral concentrations in rats[J]. Journal of Nutrition, 2000, 130(7):1792-1795.
[31] Weaver CM, Martin BR, Nakatsu CH, et al. Galactooligosaccharides improve mineral absorption and bone properties in growing rats through gut fermentation[J]. Journal of Agricultural and Food Chemistry, 2011, 59(12):6501-6510.
[32] Shiga K, Nishimukai M, Tomita F, et al. Ingestion of difructose anhydride III, a non-digestible disaccharide, improves postgastrectomy osteopenia in rats[J]. Scandinavian Journal of Gastroenterolgy, 2006, 41(10): 1165-1173.
[33] Sadeghi AA. Bone mineralization of broiler chicks challenged with salmonella enteritidis fed diet containing probiotic (bacillus subtilis)[J]. Probiotics and Antimicrobial Proteins, 2014,6(3-4):136-140.
[34] 黄月,武晓,薄云海,等.基于RP-UPLC-MS 和 HILIC-UPLC-MS的骨疏丹对糖皮质激素性骨质疏松模型大鼠干预作用的尿液代谢组学研究[J].中国药学杂志,2016,51(23):2045-2052.
[35] Gao MX, Tang XY, Zhang FX, et al. Biotransformation and metabolic profile of Xian-Ling-Gu-Bao capsule, a traditional Chinese medicine prescription, with rat intestinal microflora by ultra-performance liquid chromatography coupled with quadrupole time-of-flight tandem mass spectrometry analysis[J]. Biomed Chromatogr, 2018, 32(4):4160-4174.
[36] Xu J, Zhao L, Tong X, et al. Structural modulation of gut microbiota during alleviation of type 2 diabetes with a Chinese herbal formula[J]. Isme Journal, 2015, 9(3):552-562.
[37] Wei X, Tao J, Xiao S, et al. Xiexin Tang improves the symptom of type 2 diabetic rats by modulation of the gut microbiota[J]. Scientific Reports. 2018, 8(1):3685.