缺血性脑卒中患者不同时期肠道菌群的多样性分析
摘要
目的探讨缺血性脑卒中患者在卒中不同时期的肠道菌群变化情况,以为临床治疗提供新方法。方法连续收集15例缺血性脑卒中患者(观察组)在急性期(2周内)、恢复期(2周至1个月)的首个粪便标本,采用高分子量测序平台对大便标本的16SRNA V3-V4区进行定性分析,与20例健康成人体检者(对照组)粪便标本统计数据进行比较。结果与对照组比较,观察组患者在急性期、恢复期的肠道菌群多样性均减少(P<0.05);观察组患者恢复期较急性期的肠道菌群多样性增加(P<0.05)。对照组的特征性菌群为拟杆菌类(Bacteroides)、柔嫩梭菌属(Faecalibacterium);观察组患者急性期的特征性菌群为普罗威登斯菌属(Providencia)、颤杆菌克属(Oscillibacter),恢复期的特征性菌群为Providencia、瘤胃菌科(Ruminococcaceae),但观察组患者急性期与恢复期的肠道菌群比较,未发现有明显统计学差异的物种。结论缺血性脑卒中患者急性期、恢复期均出现肠道菌群多样性减少、有益菌减少、机会性致病菌增多等肠道菌群紊乱表现;脑卒中恢复期较急性期肠道菌群多样性增加。
引文
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[2]DONG J Y,ISO H,KITAMURA A,et al.Multivitamin use and risk of stroke mortality:the Japan collaborative cohort study[J].Stroke,2015,46(5):1167-1172.
[3]IADECOLA C,ANRATHER J.The immunology of stroke:from mechanisms to translation[J].Nat Med,2011,17(7):796-808.
[4]SHICHITA T,SUGIYAMA Y,OOBOSHI H,et al.Pivotal role of cerebral interleukin-17-producing gammadeltaT cells in the delayed phase of ischemic brain injury[J].Nat Med,2009,15(8):946-950.
[5]BENAKIS C,BREA D,CABALLERO S,et al.Commensal microbiota affects ischemic stroke Outcome by regulating intestinalγδT cells[J].Nat Med,2016,22(5):516-523.
[6]LIESZ A,HU X M,KLEINSCHNITZ C,et al.Functional role of regulatory lymphocytes in stroke:facts and controversies[J].Stroke,2015,46(5):1422-1430.
[7]YIN J,LIAO S X,HE Y,et al.Dysbiosis of gut microbiota with reduced trimethylamine-N-oxide level in patients with large-artery atherosclerotic stroke or transient ischemic attack[J].J Am Heart Assoc,2015,4(11):e002699.
[8]DETHLEFSEN L,MCFALL-NGAI M,RELMAN D A.An ecological and evolutionary perspective on human-microbe mutualism and disease[J].Nature,2007,449(7164):811-818.
[9]MAI V,DRAGANOV P V.Recent advances and remaining gaps in our knowledge of associations between gut microbiota and human health[J].World J Gastroenterol,2009,15(1):81-85.
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[11]WINEK K,DIRNAGL U,MEISEL A.The gut microbiome as therapeutic target in central nervous system diseases:implications for stroke[J].Neurotherapeutics,2016,13(4):762-774.
[12]QIN J J,LI Y R,CAI Z M,et al.A metagenome-wide association study of gut microbiota in type 2diabetes[J].Nature,2012,490(7418):55-60.
[13]ABU-SHANAB A,QUIGLEY E M.The role of the gut microbiota in nonalcoholic fatty liver disease[J].Nat Rev Gastroenterol Hepatol,2010,7(12):691-701.
[14]范文涛,闫咏梅,别玉龙,等.脑卒中后抑郁症患者肠道菌群的多样性分析[J].南方医科大学学报,2016,36(10):1305-1311.
[15]渠静,许娜,张君,等.肠道菌群和缺血性脑卒中的研究进展[J].医学综述,2018,24(5):926-930.
[16]王珊,夏耿红,何彦,等.氧化三甲胺分布特征及其与肠道菌群的关联性[J].南方医科大学学报,2016,36(4):455-460.
[17]WANG H X,WANG Y P.Gut microbiota-brain axis[J].Chin Med J,2016,129(19):2373-2380.
[18]BUROKAS A,MOLONEY R D,DINAN T G,et al.Microbiota regulation of the Mammalian gut-brain axis[J].Adv Appl Microbiol,2015(91):1-62.
[19]MONTIELCASTRO A J,GONZLEZCERVANTES RM,BRAVORUISECO G,et al.The microbiota-gut-brain axis:neurobehavioral correlates,health and sociality[J].Frontiers in Integrative Neuroscience,2013(7):70.
[20]WANG Y,KASPER L H.The role of microbiome in central nervous system disorders[J].Brain Behav Immun,2014,38(5):1-12.
[21]LYTE M.Microbial endocrinology in the microbiome-gutbrain axis:how bacterial production and utilization of neurochemicals influence behavior[J].PLoS Pathog,2013,9(11):e1003726.
[22]张美凤,金相任,潘如昕,等.肠道菌群对缺血性脑卒中影响的研究进展[J].医学综述,2017,23(18):3634-3637.
[23]PONFERRADA A,CASO J R,ALOU L,et al.The role of PPARgamma on restoration of colonic homeostasis after experimental stress-induced inflammation and dysfunction[J].Gastroenterology,2007,132(5):1791-1803.
[24]CASO J R,HURTADO O,PEREIRA M P,et al.Colonic bacterial translocation as a possible factor in stress-worsening experimental stroke outcome[J].Am J Physiol Regul Integr Comp Physiol,2009,296(4):R979-R985.
[25]SINGH V,ROTH S,LLOVERA G,et al.Microbiota dysbiosis controls the neuroinflammatory response after stroke[J].JNeurosci,2016,36(28):7428-7440.