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乙肝病毒相关慢加急性肝衰竭继发感染患者益生菌干预前后肠道菌群及免疫状态分析
Effect of probiotic intervention on intestinal flora and immune status in patients with secondary infections to HBV-related acute-on-chronic liver failure
- 第三军医大学学报 2019年41卷第8期 页码：794-798
- 作者机构：
610072 成都，四川省医学科学院·四川省人民医院感染科Department of Infections, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan Province, 610072, China
- 作者简介：
- 基金信息：四川省卫生计生委课题(100523)
DOI：10.16016/j.1000-5404.201811037
中图分类号： R378.2;R574;R575.3收稿：2018-11-07，
纸质出版：2019-04-30
- 稿件说明：
移动端阅览
杨仁国, 徐开菊, 周巧灵, 等. 乙肝病毒相关慢加急性肝衰竭继发感染患者益生菌干预前后肠道菌群及免疫状态分析[J]. 第三军医大学学报, 2019,41(8):794-798.
Renguo YANG, Kaiju XU, Qiaoling ZHOU, et al. Effect of probiotic intervention on intestinal flora and immune status in patients with secondary infections to HBV-related acute-on-chronic liver failure[J]. Journal of Third Military Medical University, 2019, 41(8): 794-798.
杨仁国, 徐开菊, 周巧灵, 等. 乙肝病毒相关慢加急性肝衰竭继发感染患者益生菌干预前后肠道菌群及免疫状态分析[J]. 第三军医大学学报, 2019,41(8):794-798. DOI： 10.16016/j.1000-5404.201811037.
Renguo YANG, Kaiju XU, Qiaoling ZHOU, et al. Effect of probiotic intervention on intestinal flora and immune status in patients with secondary infections to HBV-related acute-on-chronic liver failure[J]. Journal of Third Military Medical University, 2019, 41(8): 794-798. DOI： 10.16016/j.1000-5404.201811037.
摘要
目的
2
分析益生菌对乙肝病毒相关慢加急性肝衰竭(HBV-related acute-on-chronic liver failure，HBV-ACLF)继发感染患者肠道菌群及免疫状态的影响。
方法
2
收集本院2017年1月至2018年6月HBV-ACLF患者101例，分为HBV-ACLF组56例和HBV-ACLF继发感染组45例，另选择健康人67例为对照组。HBV-ACLF组和HBV-ACLF继发感染组均给予1个月的双歧杆菌四联活菌片治疗。记录患者治疗前后及对照组新鲜大便的乳酸杆菌、双歧杆菌、大肠杆菌、肠球菌、酵母菌、葡萄球菌、类杆菌和消化链球菌，收集外周血免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)、NK细胞活性、T淋巴细胞亚群(CD3
+
、CD4
+
、CD8
+
和CD4
+
/CD8
+
)、C反应蛋白(CRP)、肿瘤坏死因子(TNF-α)、白细胞介素-6(IL-6)和白细胞介素-8(IL-8)。
结果
2
治疗前，与对照组比较，HBV-ACLF患者肠道的乳酸杆菌、双歧杆菌、IgA、IgG、IgM、NK、CD4
+
和CD4
+
/CD8
+
显著降低(
P
<
0.05)，大肠杆菌、肠球菌、酵母菌、葡萄球菌、类杆菌、消化链球菌、CRP、TNF-α、IL-6和IL-8显著升高(
P
<
0.05)。与HBV-ACLF组比较，HBV-ACLF继发感染组患者肠道的乳酸杆菌、双歧杆菌、IgA、IgG、IgM、NK、CD4
+
和CD4
+
/CD8
+
显著降低(
P
<
0.05)，大肠杆菌、肠球菌、酵母菌、葡萄球菌、类杆菌、消化链球菌、CRP、TNF-α、IL-6和IL-8显著升高(
P
<
0.05)。治疗后HBV-ACLF患者肠道的乳酸杆菌、双歧杆菌、IgA、IgG、IgM、NK、CD4
+
和CD4
+
/CD8
+
均有不同程度升高(
P
<
0.05)，大肠杆菌、肠球菌、酵母菌、葡萄球菌、类杆菌、消化链球菌、CRP、TNF-α、IL-6和IL-8均有不同程度降低(
P
<
0.05)。3组受试者的CD3
+
和CD8
+
差异无统计学意义(
P
>
0.05)。
结论
2
HBV-ACLF继发感染的肠道菌群及免疫状态存在异常，益生菌有助于改善HBV-ACLF继发感染的肠道菌群及免疫状态。
Abstract
Objective
2
To assess the effect of probiotic intervention on intestinal flora and immune status in patients with secondary infections to HBV-related acute-on-chronic liver failure (HBV-ACLF).
Methods
2
A total of 101 patients with HBV-ACLF treated in our hospital between January
2017 and June
2018 were enrolled in this study
including 56 without secondary infections (HBV-ACLF group) and 45 with secondary infections to HBV-ACLF (secondary infection group)
with 67 healthy participants as controls. All the patients with HBV-ACLF were treated with bifidobacterium quadruple live bacteria tablets in addition to the routine treatments for 1 month. From all the participants
fecal
specimens were collected before and after the treatment to analyze the changes in
Lactobacillus
Bifidobacterium
Escherichia coli
Enterococcus
yeast
Staphylococcus
Bacteroides
and
Streptococcus mutans
; peripheral blood samples were also obtained for testing the serum levels of immunoglobulin A (IgA)
IgG and IgM using ELISA; the changes in T lymphocyte subsets CD3
+
CD4
+
and CD8
+
were detected using immunofluorescence flow cytometry
and the levels of C-reactive protein (CRP)
tumor necrosis factor-α(TNF-α)
interleukin-6 (IL-6) and interleukin-8(IL-8) were determined using ELISA.
Results
2
Compared with the control group
the patients with HBV-ACLF in both groups before the treatment showed significantly reduced abundance of intestinal
Lactobacilli
and
Bifidobacteria
and increased abundance of
Escherichia coli
Enterococcus
yeast
Staphylococcus
Bacteroides
and
Streptococcus pneumoniae
(
P
<
0.05)
with significantly lowered levels of IgA
IgG
IgM
NK
CD4
+
and CD4
+
/CD8
+
(
P
<
0.05) and elevated levels of CRP
TNF-α
IL-6 and IL-8 (
P
<
0.05); These changes were even more obvious in patients with secondary infections than in those without infections (
P
<
0.05). After the treatment
the intestinal
Lactobacilli
Bifidobacteria
and blood levels of IgA
IgG
IgM
NK
CD4
+
and CD4
+
/CD8
+
increased significantly (
P
<
0.05)
and intestinal
Escherichia coli
Enterococcus
yeast
Staphylococcus
Bacteroides
Streptococcus pneumoniae
and the levels of CRP
TNF-α
IL-6 and IL-8 were all decrea
sed in both HBV-ACLF group and the secondary infection group (
P
<
0.05). No significant differences in CD3
+
or CD8
+
cells were found among the 3 groups either before or after the treatment (
P
>
0.05).
Conclusion
2
The patients with secondary infections to HBV-ACLF have abnormal changes in intestinal flora and immune status
which can be improved by probiotic intervention.
关键词
Keywords
references
KANG Y, CAI Y. Gut microbiota and hepatitis-B-virus-induced chronic liver disease: implications for faecal microbiota transplantation therapy[J]. J Hosp Infect, 2017, 96(4): 342-348. DOI: 10.1016/j.jhin.2017.04.007.
REN Y D, YE Z S, YANG L Z, et al . Fecal microbiota transplantation induces hepatitis B virus E-antigen (HBeAg) clearance in patients with positive HBeAg after long-term antiviral therapy[J ] . Hepatology, 2017, 65(5): 1765-1768. DOI: 10.1002/hep.29 008.
XU D, HUANG Y, WANG J. Gut microbiota modulate the immune effect against hepatitis B virus infection[J]. Eur J Clin Microbiol Infectious Dis, 2015, 34(11): 2139-2147. DOI: 10.1007/s10096-015-2464-0.
ZHAO X H, CAO Z Y, SHEN Y, et al . Influence of Chongcao Yigan Capsule on function of intestinal flora and chemoprevention for patients with chronic hepatitis B-induced liver fibrosis[J ] . Asian Pac J Cancer Prev, 2014, 15(21): 9423-9426. DOI: 10.7314/apjcp.2014.15.21.9423.
陶亮, 任志刚, 王伟林.肝脏移植与肠道微生态变化的研究进展[J].中国微生态学杂志, 2014, 26(12): 1458-1462.
TAO L, REN Z G, WANG W L. Research advance on liver transplantation and intestinal microbial alterations[J]. Chin J Microecol, 2014, 26(12): 1458-1462.
SHARPTON S R, AJMERA V, LOOMBA R. Emerging role of the gut microbiome in nonalcoholic fatty liver disease: from composition to function[J]. Clin Gastroenterol Hepatol, 2019, 17(2): 296-306. DOI: 10.1016/j.cgh.2018.08.065.
HAGYMÁSI K, BACSÁRDI A, EGRESI A, et al . The role of gut microbiota in chronic liver diseases, and treatment possibilities[J ] . Orv Hetil, 2018, 159(36): 1465-1474. DOI: 10.1556/650.2018.31178.
徐恩君, 刘亚婷, 李涛. Toll样受体信号转导与原发性肝癌发生发展关系的研究进展[J].免疫学杂志, 2015(8): 727-732.
XU E J, LIU Y T, LI T. Study progress of relationship between Toll-like receptors signaling transduction and the occurrence and development of hepatocellular carcinoma[J]. Immunol J, 2015(8): 727-732.
TÖZVN N, VARDARELI E. Gut microbiome and gastrointestinal cancer: Les liaisons Dangereuses[J]. J Clin Gastroenterol, 2016, 50(Suppl 2): S191-S196. DOI: 10.1097/MCG.0000000000000714.
刘华, 苟小军, 曹健美.肠道菌群失调与慢性肝病[J].实用药物与临床, 2017, 20(9): 1098-1101.
LIU H, GOU X J, CAO J M. Imbalance of intestinal flora and chronic liver disease[J]. Pract Pharm Clin Remed, 2017, 20(9): 1098-1101.
DETZEL C J, HORGAN A, HENDERSON A L, et al . Bovine immunoglobulin/protein isolate binds pro-inflammatory bacterial compounds and prevents immune activation in an intestinal co-culture model[J ] . PLoS ONE, 2015, 10(4): e0120278. DOI:10.1371/journal.pone.0120278.
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