摘要
Objective To compare the effects of laparoscopic surgery with various approaches on intestinal barrier function,red blood cell immunity,and prognosis in patients with right hemicolectomized colon cancer.Methods A prospective selection of 110 patients with right hemicolectomized colon cancer admitted to our hospital from April 2019 to April 2021 was conducted.Patients were divided into groups A(n= 55)and B(n= 55)using a simple randomization method.During the treatment period,two cases of loss of follow-up occurred in Group A and three in Group B.Finally,53 from Group A and 52 participants from Group B completed the study.Both groups underwent laparoscopic surgery.Group A underwent a cephalic approach,whereas Group B underwent an intermediate approach.The periopera-tive indexes,complications,prognosis,intestinal barrier function(endotoxin,D-lactic acid,and diamine oxidase),red blood cell immune complex rate(RBC-ICR),RBC-C3b receptor rosette rate(RBC-C3bRR),and erythrocyte adhesion to tumor cell rosette rate(TRR)of the two groups were determinedd.Results Group A had less intraoperative bleeding,shorter central lymph node dissection time,shorter operative time,and lower complication rate(P＜0.05)than Group B.Endotoxin,diamine oxidase,and D-lactate levels in both groups were higher 3 d after surgery than before surgery(P＜0.05).Three days after surgery,the RBC-ICR of both groups was higher than before surgery,whereas the TRR and RBC-C3bRR were lower than before surgery(P＜0.05).After 1 year of follow-up,no statistically sig-nificant difference in distant metastasis,local recurrence,and survival rates were observed between the two groups(P＞0.05).Conclusion The two approaches used in this study have similar effects in right hemicolectomized colon cancer.The cephalic approach for laparoscopic sur-gery shortened the surgical time and reduced complications.
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Objective:To investigate the risk factors and their warning effectiveness for postoperative intestinal barrier dysfunction (IBD) in patients with severe traumatic brain injury (sTBI).Methods:A retrospective cohort study was conducted to analyze the clinical data of 101 patients with sTBI admitted to Wuxi Branch of Zhongda Hospital Affiliated to Southeast University from May 2020 to February 2023, including 63 males and 38 females, aged 21-81 years [(53.4±14.2)years]. All the patients underwent emergency surgery. The patients were divided into IBD group ( n=67) and non-IBD group ( n=34) according to whether or not they had IBD after surgery. The gender, age, basic diseases (hypertension and diabetes), types of intracranial hematoma (subdural, epidural, and intracerebral hematoma), preoperative Glasgow Coma Scale (GCS), cerebral hernia, intraoperative initial intracranial pressure (iICP), operation time, removal of bone flap, treatment time in ICU, initiation time of enteral nutrition, and use of broad-spectrum antibiotics were recorded in the two groups. Univariate and multivariate binary Logistic regression analyses were conducted to assess the correlations between above-mentioned indicators and incidence of postoperative IBD in sTBI patients and determine the independent risk factors for sTBI. Receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate the warning effectiveness of each risk factor for IBD. Results:The results of the univariate analysis showed that preoperative GCS, cerebral hernia, intraoperative iICP, removal of bone flap, treatment time in ICU, initiation time of enteral nutrition, and use of broad-spectrum antibiotics were significantly correlated with the incidence of IBD in sTBI patients ( P<0.05 or 0.01), while there were no correlations of IBD with gender, age, basic diseases, types of intracranial hematoma and operation time ( P>0.05). The results of the multivariate binary Logistic regression analysis showed that preoperative GCS≤5 points ( OR=2.49, 95% CI 1.17, 5.32, P<0.05), intraoperative iICP>23 mmHg (1 mmHg=0.133 kPa)( OR=1.20, 95% CI 1.03, 1.39, P<0.05), and initiation time of enteral nutrition>24 hours ( OR=10.03, 95% CI 1.26, 80.21, P<0.05) were highly correlated with postoperative IBD in sTBI patients. The results of the ROC curve analysis showed that intraoperative iICP had the highest warning value (AUC=0.91, 95% CI 0.85, 0.96), followed by preoperative GCS (AUC=0.88, 95% CI 0.82, 0.95), and initiation time of enteral nutrition had the lowest warning value (AUC=0.78, 95% CI 0.69, 0.87). Conclusions:Preoperative GCS≤5 points, intraoperative iICP>23 mmHg, and initiation time of enteral nutrition>24 hours are independent risk factors for postoperative IBD in sTBI patients. The warning value of intraoperative iICP ranks the highest for postoperative IBD in sTBI patients, followed by preoperative GCS, with initiation time of enteral nutrition having the lowest warning value.
摘要
Objective:To observe the effects of acupuncture and moxibustion on interleukin(IL)-9/IL-9 receptor(IL-9R)in the colon tissue of rats with ulcerative colitis(UC)and investigate the protective mechanism of acupuncture and moxibustion on the intestinal mucosal barrier in UC rats. Methods:Male Sprague-Dawley rats were randomly divided into a normal control(NC)group and a modeling group.UC models were prepared by giving 4%dextran sulfate sodium(DSS)water for 7 d.After the successful construction of the UC rat model,the modeling group was randomly divided into a UC group,a herb-insulated moxibustion(HM)group,and an electroacupuncture(EA)group.HM and EA interventions at bilateral Tianshu(ST25)were performed once a day for 7 d.Hematoxylin-eosin(HE)staining was used to observe the histopathological changes in the colon.The serum concentrations of IL-9,IL-6,IL-1β,and hemoglobin-H(HbH)were determined by enzyme-linked immunosorbent assay.The protein expression levels of IL-9,IL-9R,claudin-2,zonula occludens-1(ZO-1),and occludin in the colon tissue were measured by Western blotting or immuno-histochemistry.Immunofluorescence was used to detect the co-expression of PU.1 and CD4 with the IL-9 protein. Results:Compared with the NC group,the colon tissue of UC rats was severely damaged and ulcerated with congestion and edema,and the colonic histopathological score increased significantly(P<0.01).The serum HbH concentration decreased significantly(P<0.01),while the serum concentrations of IL-9,IL-6,and IL-1β increased(P<0.01).The protein expression of colonic ZO-1 and occludin decreased significantly(P<0.01),while the protein expression of colonic IL-9 and IL-9R increased(P<0.05).The positive co-expression levels of IL-9/PU.1 and IL-9/CD4 increased in the colon tissue(P<0.05).Compared with the UC group,the colonic mucosal structures were gradually repaired in both HM group and EA group,and healed ulcers could be observed,the colonic histopathological score decreased significantly(P<0.05).The serum concentration of HbH increased(P<0.01),while the serum concentrations of IL-9,IL-6,and IL-1β decreased(P<0.05).The protein expression levels of ZO-1 and occludin increased(P<0.05),while the protein expression levels of IL-9 and IL-9R decreased(P<0.01).The positive co-expression levels of IL-9/PU.1 and IL-9/CD4 decreased in the colon tissue(P<0.05). Conclusion:Both HM and EA can inhibit the protein expression levels of IL-9 and IL-9R in the UC colon by regulating the transcription factor PU.1,promote the repair of intestinal mucosal barrier,and down-regulate protein contents of proinflammatory factors IL-9,IL-6,and IL-1β in the serum,which may be one of the key mechanisms of acupuncture and moxibustion in reducing the inflammation of UC colonic mucosa and protecting the intestinal mucosal barrier.
摘要
The intestinal flora and gut barrier function are of great significance for gut function and human health. When the intestinal flora is disrupted and the gut barrier structure is disrupted, it can lead to bacterial translocation, endotoxin influx into the bloodstream, and the production of pro-inflammatory factors, leading to various tissue damage in the body. Tongfu method in TCM can affect the intestinal environment by regulating intestinal permeability and immune response, restoring normal intestinal movement, and regulating the structure and metabolites of intestinal flora, thereby maintaining intestinal homeostasis and body health. The research on regulating intestinal flora and improving intestinal barrier function by Tongfu method can provide reference for further research on the relationship between TCM and intestinal microecology, and provide ideas for clinical treatment.
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ObjectiveTo observe the effect of Qingfei Huatan Zhuyu decoction on the lung and intestinal function of rats with chronic obstructive pulmonary diseases （COPD） and explore the deep-seated mechanism of its embodiment of lung and intestinal co-treatment. MethodA total of 60 Wistar rats were randomly divided into six groups， with 10 rats in each group， and the groups were control group， model group， acute syrup group （10 g·kg-1·d-1）， and low， medium， and high-dose groups （10， 15， 20 g·kg-1·d-1） of Qingfei Huatan Zhuyu decoction. The COPD rat model was established by lipopolysaccharide tracheal drip combined with the smoke inhalation method， and the acute syrup group and the Qingfei Huatan Zhuyu decoction group were administered by gavage with corresponding dose concentrations respectively， while the rest groups were controlled by saline gavage， and the lung function and blood gas indexes of rats were monitored after the last administration. The histopathological changes in the lung and intestine were observed microscopically. The expression of serum interleukin-6 （IL-6）， tumor necrosis factor-α （TNF-α）， and secretory immunoglobulin A （IgA） in colon tissue were measured by enzyme-linked immunosorbent assay （ELISA）. The biochemical indexes such as serum diamine oxidase （DAO）， D-lactic acid， and malondialdehyde （MDA） were measured. Immunohistochemistry was used to detect the expression of tight junction protein （Occludin） in rat colon tissue. The expression of F4/80 positive alveolar macrophages in rat lung tissue， and the expression of α-actin （α-SMA） and colonic atresia small band protein-1 （ZO-1） were determined by immunofluorescence. The protein expression of p-NF-κB p65， NF-κB p65， p-p38 MAPK， and p-p38 MAPK and the expression of Occludin and ZO-1 in colon tissue were detected in rat lung tissue by Western blot. ResultCompared with the normal group， the model group had pulmonary dysfunction， reduced forced vital capacity （FVC）， arterial partial oxygen pressure （PaO2）， arterial oxygen saturation （SaO2）， and dynamic lung compliance （Cdyn） （P<0.01）， and the pathological changes in the lung and intestine were obvious. The expressions of IL-6， TNF-α， DAO， D-lactic acid， and MDA in serum were increased （P<0.05，P<0.01）， and the protein expression ratio of p-NF-κB p65/NF-κB p65 and p-p38 MAPK/p38 MAPK in lung tissue was increased. The expression of F4/80 positive macrophages in lung tissue was enhanced. The expression of IgA， Occludin， and ZO-1 in colon tissue decreased （P<0.05，P<0.01）. Compared with the model group， the pulmonary function of the rats in the acute syrup group and groups of Qingfei Huatan Zhuyu decoction was significantly improved， and the FVC， PaO2， SaO2， and Cdyn were increased （P<0.05， P<0.01）. The pathological changes in the lung and intestine were significant. The expressions of IL-6， TNF-α， DAO， D-lactic acid， and MDA in serum were decreased （P<0.05，P<0.01）， and the expressions of F4/80 positive macrophages in lung tissue were decreased （P<0.01）. The protein expression ratio of p-NF-κB p65/NF-κB p65 and p-p38 MAPK/p38 MAPK in lung tissue decreased （P<0.01）， and the expression of IgA， Occludin， and ZO-1 in colon tissue increased （P<0.01）. ConclusionQingfei Huatan Zhuyu decoction can effectively reduce the symptoms of COPD rats， and its mechanism of action is related to inhibiting the inflammatory response of lung tissue and improving the barrier function of the intestinal mucosa.
摘要
Ulcerative colitis(UC)is characterized by chronic relapsing intestinal inflammation.Currently,there is no effective treatment for the disease.According to our preliminary data,1,8-cineole,which is the main active compound of Amomum compactum Sol.ex Maton volatile oil and an effective drug for the treat-ment of pneumonia,showed remarkable anti-inflammatory effects on colitis pathogenesis.However,its mechanism of action and direct targets remain unclear.This study investigated the direct targets and mechanism through which 1,8-cineole exerts its anti-inflammatory effects using a dextran sulfate so-dium salt-induced colitis mouse model.The effects of 1,8-cineole on macrophage polarization were investigated using activated bone marrow-derived macrophages and RAW264.7 cells.In addition,1,8-cineole targets were revealed by drug affinity responsive target stability,thermal shift assay,cellular thermal shift assay,and heat shock protein 90(HSP90)adenosine triphosphatases(ATPase)activity assays.The results showed that 1,8-cineole exhibited powerful anti-inflammatory properties in vitro and in vivo by inhibiting the macrophage M1 polarization and protecting intestinal barrier function.Mech-anistically,1,8-cineole directly interacted with HSP90 and decreased its ATPase activity,also inhibited nucleotide-binding and oligomerization domain-,leucine rich repeat-,and pyrin domain-containing 3(NLRP3)binding to HSP90 and suppressor of G-two allele of SKP1(SGT1)and suppressed NLRP3 inflammasome activation in macrophages.These results demonstrated that 1,8-cineole is a potential drug candidate for UC treatment.
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Objective:To observe the pathological changes of different intestinal parts and the changes of intestinal barrier function in mice with acute necrotizing pancreatitis (ANP) induced by sodium taurocholate.Methods:A total of 18 male C57BL/6 mice were randomly divided into sham operation group, ANP 24 h group and ANP 48 h group with 6 mice in each group. The ANP model was established by retrograde injection of 2 μl/g 5% sodium taurocholate into the pancreaticobiliary duct. The sham operation group only underwent intubation. The survival status was recorded. The pathology of pancreatic and intestinal tissues were observed using hematoxylin-eosin staining, and the pathological scores were evaluated. The activities of serum amylase and lipase were measured by automatic biochemistry analyzer. Serum D-lactate levels were detected by ELISA. The expression of tight-junction proteins ZO-1 and occludin in small intestinal tissue was detected by Western blotting.Results:The survival rates of sham operation group, ANP 24 h group and ANP 48 h group were 100%, 36.4% and 25.0%, respectively. The pancreatic pathological scores of sham operation group, ANP 24 h group and ANP 48 h group were (0.67±0.82), (10.58±0.64) and (8.81±1.55); the serum amylase activities were (479.14±86.42), (5998.72±2096.31) and (3055.43±2336.5)U/L; the serum lipase activities were (18.56±3.84), (558.20±559.65) and (112.58±94.91)U/L. The pancreatic pathological scores, serum amylase and lipase levels in ANP group were higher than those in sham operation group, and the increase in ANP 24 h group was more significant, and the difference was statistically significant (all P value <0.05). The upper small intestine pathological scores in different groups were (0.17±0.41), (2.11±1.41) and (1.61±0.80); The lower small intestine pathological scores were (0.17±0.41), (1.00±0.76) and (1.06±0.25); the colonic pathological scores were (0.33±0.52), (0.67±0.82) and (0.67±0.52), respectively. The serum D-lactic acid level was (388.92±126.30), (2159.11±386.12) and (307.69±141.18) μmol/L. The expression of ZO-1 was (0.87±0.08), (0.19±0.18) and (0.50±0.19); the expression of occludin was (0.98±0.04), (0.13±0.08) and (0.69±0.04). The pathological scores of upper and lower segments of small intestine in ANP 24 h group and ANP 48 h group were significantly higher than those in the sham operation group (all P value <0.05). There was no significant difference on colonic pathological score among the three groups. The serum D lactate level in the ANP 24 h group was significantly higher than that in the sham operation group ( P<0.05), but there was no significant difference between the ANP 48 h group and the sham operation group. The expression of ZO-1 and occludin was decreased in ANP group compared with that in the sham operation group ( P value <0.05). Conclusions:ANP mouse model was successfully induced by sodium taurocholate, and the intestinal pathological changes were mainly concentrated on the small intestine, especially upper part of small intestine. The dysfunction of intestinal barrier was significantly aggravated within 24 hours after modeling, and the intestinal barrier function gradually recovered after 48 hours.
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Intestinal barrier function impairment can lead to bacterial and toxin translocation in critically ill patients and is an important factor in gut-derived infections and even multiple organ failure. Early enteral nutrition (EEN) can nourish the intestine, prevent bacterial translocation, effectively maintain intestinal barrier function and immune function and provide metabolic substrates for the body, bringing clinical benefits. For critically ill patients such as those with severe acute pancreatitis, severe burns and severe traumatic brain injury and those after major abdominal surgery, there is evidence-based proof supporting EEN while in patients with uncontrolled shock and severe hypoxemia and acidosis, the initiation of EEN should be delayed. EEN in critically ill patients can be applied orally or through nasogastric tube. Dietary fiber-free intact protein preparations are recommended at initiation and administration via continuous pumping can improve EEN gastrointestinal tolerability.
摘要
Objective:To explore the relationship between intestinal flora disorder and intestinal barrier dysfunction in patients with sepsis.Methods:A prospective observational study was conducted to include 10 patients with sepsis (sepsis group) admitted to the ICU of General Hospital of Ningxia Medical University from February 2017 to June 2017, 10 normal postoperative patients (non-sepsis group) admitted to the ICU of General Hospital of Ningxia Medical University in the same period, and 10 healthy persons (control group) were served as controls. General information was recorded. Fecal samples of the three groups of experimental subjects were detected and analyzed by using 16S rRNA gene sequencing technology. The venous blood of the sepsis and non-sepsis groups were collected and the levels of D-lactic acid and bacterial endotoxin in were measured by enzymatic method at the corresponding time points. The correlation between the levels of D-lactic acid and bacterial endotoxin and intestinal flora of patients with sepsis was analyzed.Results:The change consistency of pathogenic bacteria between clinical infection and intestinal pathogenic bacteria in patients with sepsis was observed and analyzed. Sputum culture of patients with sepsis was Acinetobacter baumannii (corresponding patient number: S5, S6, S8), Stenotrophomonas maltophilia (corresponding patient number: S6, S7), and Enterococcus (corresponding patient number: S7). In the intestinal flora of corresponding patients, the OUT abundance were increased. Patients with sepsis (corresponding patient number S7) showed E. coli in blood culture, and in his intestinal flora the OUT abundance was increased. Correlation analysis showed that the serum D-lactic acid level was negatively correlated with the proportion of Firmicutes in intestinal flora in the non-sepsis and sepsis groups, while was positively correlated with the proportion of Firmicutes (r value: -0.532, 0.468, respectively, P<0.05). Conclusions:The gut microbiota dysbiosis is correlated with intestinal barrier function in sepsis patients with sepsis. The spread of pathogenic bacteria between clinical infection and intestinal bacteria in sepsis patients has potential consistency.
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Alanyl-glutamine dipeptide is an important component in parenteral nutrition, which can be decomposed into alanine and L-glutamine in vivo. It plays multiple functions including maintaining intestinal barrier, improving immunity, promoting protein synthesis, and regulating the production and release of inflammatory mediators. Substantial clinical evidences have demonstrated its favorable effectiveness and safety. Rational application of alanyl-glutamine dipeptide can reduce postoperative complications, shorten hospital stay and save medical costs. There are still controversies at home and abroad on the applicable population and dosage of alanyl-glutamine dipeptide. Chinese Society of Parenteral and Enteral Nutrition organized China's experts of related disciplines to compile international standards in accordance with the latest guidelines and consensus, so as to achieve the goal of standardized application and patient benefits.
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Objective:To investigate the effects of total glucosides of paeony （TGPs） on intestinal motility， barrier function， and gut microbiota in non-obese diabetic （NOD） mice with Sjogren's syndrome （SS）. Method:Thirty NOD mice were randomly assigned into the model group （deionized water）， prebiotic fructo-oligosaccharide （FOS） group （700 mg∙kg<sup>-1</sup>）， and the low- （160 mg∙kg<sup>-1</sup>）， medium- （320 mg∙kg<sup>-1</sup>）， and high-dose （640 mg∙kg<sup>-1</sup>） TGP groups， with six mice in each group. Moreover， the BALB/c mice were employed as the normal control and administered with deionized water. The food and water intakes， number of discharged fecal particles， and fecal moisture content were observed to evaluate the effect of TGPs on intestinal motility in SS mice. The levels of <italic>D</italic>-lactate （<italic>D</italic>-Lac） content， diamine oxidase （DAO）， and junction-associated protein zonula occludens-1 （ZO-1） in mouse serum were detected by enzyme linked immunosorbent assay （ELISA）. The fecal samples collected at different time points were determined by spread plate method and gas chromatography for uncovering the intestinal microbial communities and the content of short-chain fatty acids. Result:Compared with the normal group， the model group exhibited decreased food and water intakes （<italic>P</italic><0.01）， weakened intestinal propulsion （<italic>P</italic><0.01）， elevated <italic>D</italic>-Lac and DAO （<italic>P</italic><0.05，<italic>P</italic><0.01）， lowered ZO-1 and SCFAs （<italic>P</italic><0.05，<italic>P</italic><0.01）， and reduced number of intestinal bacteria （<italic>P</italic><0.01）. The comparison with the model group revealed that TGPs significantly increased the number of discharged fecal particles and fecal moisture content （<italic>P</italic><0.05，<italic>P</italic><0.01）， enhanced intestinal propulsion （<italic>P</italic><0.05， <italic>P</italic><0.01）， decreased serum <italic>D</italic>-Lac and DAO levels （<italic>P</italic><0.05，<italic>P</italic><0.01）， and up-regulated ZO-1 expression （<italic>P</italic><0.01）. Apart from increasing the proportions of <italic>Bifidobacterium</italic> and <italic>Lactobacillus</italic> and decreasing the proportion of<italic> Enterobacter </italic>in intestinal flora （<italic>P</italic><0.05，<italic>P</italic><0.01）， TGPs also accelerated the production of acetic acid and butyric acid （<italic>P</italic><0.05，<italic>P</italic><0.01）. Conclusion:TGPs attenuate SS-mediated constipation and restore the impaired intestinal barrier function in mice by increasing fecal moisture content， boosting intestinal motility， regulating intestinal microbial communities， elevating acetic acid and butyric acid levels， and up-regulating tight junction protein expression.
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Aim To study the effect of ulinastatin(UTI) on postoperative ileus(POI) and the intestinal barrier function in SD rats. Methods UTI was injected in three doses before, after and during abdominal surgery in SD rats. Evans blue was given by gavage 48 hours after the surgery and gastrointestinal propulsion rate was measured 30 minutes later. The end of ileum was collected for HE staining and AB/PAS staining to make tissue sections. The morphology of the intestinal villi and the number of goblet cells were observed under a light microscope. D-lactate and endotoxin kits were used to evaluate intestinal permeability. cDNA was extracted from the intestinal tissues to detect the levels of inflammatory factors and intestinal barrier-related genes by qPCR. Results In POI model group, the gastrointestinal propulsion rate decreased, and villi structure of small intestine was severely damaged; the levels of D-lactate, endotoxin and inflammatory factor mRNA increased; the number of goblet cells in crypt increased; the levels of MUC2 and MUC3 mRNA increased; the level of HD5 mRNA decreased. Pretreatment with medium dose UTI could significantly reverse the above situation. Conclusions Pretreatment with medium dose UTI can effectively reduce the intestinal inflammation and restore partially the intestinal barrier function in POI rats, thus preventing and treating the decrease of gastrointestinal propulsion rate caused by POI.
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Sepsis is attracting more attention recently, which endangering health of children. The gut, as the largest repository of bacteria, has long been hypothesized to be the motor of multiple organ dysfunc-tion syndrome. The changes are tightly associated with intestinal barrier function, epithelial cells and intestinal permeability. The intestinal commensal microflora is also altered in sepsis, with increases in microbial viru-lence and decreases in diversity, which leads to further pathologic responses within the host. This review focu-ses on the pathogenesis and the relation between sepsis and intestinal barrier function.
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Objective: To discuss the clinical efficacy of modified Da Chengqitang by enema in treatment of postoperative inflammatory intestinal obstruction (EPISBO) after the operation and its effect on inflammatory factors, gastrointestinal motility and intestinal barrier function. Method: One hundred and six patients were randomly divided into control group (52 cases) and observation group (54 cases) by random number table. Patients in both groups were given fasting for solids and liquids, gastrointestinal decompression, maintaining water and electrolyte balance, nutritional support and other basic therapies. Patients in control group were given somatostatin for injection for continuous micro-pumping, 0.003 5 mg·h-1·kg-1, dexamethasone acetate tablets, 2.5-5 mg/time, 2 time/days. Patients with concurrent infection got ceftazidime for injection, 30-100 mg·kg-1, 2-3 intravenous drips. In addition to the therapy of control group, patients in observation group were also given modified Da Chengqitang, 125 mL/time, 2 times/days. A course of treatment was 5 days. Time of remission of abdominal distention, recovery of exhaust gas, bowel sounds and diet, defecation, hospitalization and transitional surgery were recorded. And main gastrointestinal symptoms and signs were scored. And levels of serum interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), high-sensitivity C-reactive protein (hs-CRP), vasoactive intestinal peptide (VIP), gastrin, motilin, diamine oxidase and D lactic acid were detected. Result: After treatment, according to rank sum test analysis, the clinical efficacy in observation group was better than that in control group (PPPPα, hs-CRP, VIP, DAO, D-lactic acid and scores of main gastrointestinal symptoms and signs were all lower than those in control group (PPConclusion: In addition of routine therapy of western medicine, modified Dachengqi Tang had effects in resisting inflammation, regulating gastrointestinal hormones, and protecting intestinal barrier function, so can improve gastrointestinal motility, alleviate symptoms, shorten the course of disease and improve the clinical efficacy.
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Objective To investigate the effects of cholesterol-lowering probiotics, DM9054 com-bined with 86066, on the intestinal mucosal barrier and gut microbiota in mice with nonalcoholic fatty liver disease ( NAFLD) induced by high-fat diet and the possible mechanisms. Methods Twenty-four male mice deficient in the low-density lipoprotein receptor gene ( Ldlr- / - mice ) were randomly divided into three groups including control, NAFLD model and probiotic intervention groups. Mice in the three groups were given normal chow diet+normal saline, high-fat diet ( HFD)+normal saline, and HFD+cholesterol-lowering probiotics, respectively. The mouse model of NAFLD was established by feeding mice with high-fat diet (45％ of calories derived from fat diet) for 12 weeks. qPCR was performed to measure the expression of liv-er and intestinal inflammatory genes and liver cholesterol synthesis genes. Western blot assay was used to de-tect the expression of intestinal tight junction proteins and HMG-CoA reductase ( HMGCR ) . Pathological changes in tissues were evaluated by HE staining. Features of gut microbiota were analyzed by 16S rRNA gene sequencing. Results Cholesterol-lowering probiotics intervention attenuated HFD-induced hepatic steatosis, inflammatory responses and obesity and decreased the synthesis of liver cholesterol (P<0. 05). Moreover, inhibited gut inflammatory responses and improved intestinal barrier function were detected in the probiotic intervention group (P<0. 05). The composition of gut microbiota in mice of the probiotic intervention group was different from that of the model group, but similar to that of the control group. Con-clusions Cholesterol-lowering probiotics might attenuate NAFLD in mice through reducing liver cholesterol synthesis, alleviating liver and intestinal inflammation, improving intestinal mucosal barrier function and reg-ulating intestinal microbiota.
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Gram-negative bacteria Escherichia coli Nissle 1917 (EcN) is a non-lactobacillus probiotic. It has long been recognized that EcN could colonize in the intestinal tract and has important biological functions through interacting with intestinal epithelial cells and other enteric microorganisms. Intestinal barriers play a key role in maintaining the homeostasis and physiological functions of the intestinal tract, and the impairment of the barrier function is closely associated with the pathogenesis and development of a variety of diseases. Discovery of some probiotic bacteria that could maintain and repair intestinal barrier function is therefore of critical importance, contributing to develop novel strategies for prevention and treatment of some related diseases. Previous studies have demonstrated that EcN has profoundly protective effects on the intestinal barriers. Here, we systematically reviewed the recent progress on the protective roles of EcN playing in the intestinal barriers and the potential mechanisms.
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Intestinal mucosal mechanical barrier is one of the most important structure to maintain the body homeostasis.The occurrences of inflammatory bowel disease,necrotizing enterocolitis and poor prognosis of patients with obstructive jaundice are closely related to the damage of the mucosal barrier function.Long-term high fat diet and obstructive jaundice can cause the abnormality of bile acids metabolism.These pathological conditions are often associated with the destruction of intestinal mucosal barrier function.So the correlations between abnormal bile metabolism and intestinal mucosal mechanical barrier function have aroused interests of many researchers.They found that bile acids the important component of bile are closely related to the intestinal barrier function.The paper reviewed the recent articles and summarized the mechanisms of the deficiency of bile acids,excessive bile acids and abnormal bile acids composition damaging the intestinal mucosal barrier function.It will provide reference for the new fields of study,prevention of the toxic effects of bile acids and the improvement of the prognosis of patients.
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Objective@#To probe into the correlation between chronic liver disease and intestinal barrier function.@*Methods@#1 491 cases of hospitalized patients were enrolled, of which 741 cases were of chronic liver diseases, including 397 cases of fatty liver diseases, 230 cases of chronic hepatitis, 114 cases of liver cirrhosis, and 750 cases of non-hepatic diseases. All admitted patients’ intestinal barrier function like diamine oxidase (DAO), D-lactate, lipopolysaccharide, and biochemical indicators of liver functions were tested. According to different data, statistical analysis was done using t-test, ANOVA, Dunnett’s test, χ 2 test of fourfold table, Pearson’s correlation, and binary logistic regression.@*Results@#The intestinal barrier dysfunction was more likely to occur in the chronic liver disease group than that of non-hepatic disease group [54.15% (379/741) vs. 18.53% (139/750), χ 2 = 193.58, P < 0.001]. The correlation analysis between biochemical indicators of liver function and intestinal barrier function in chronic liver disease group showed that alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), and total bilirubin levels were more susceptible to intestinal barrier dysfunction than those with normal indexes (P < 0.05 ). GGT had stimulated DAO (P < 0.05, OR > 1), D-lactate (P < 0.05, OR > 1), lipopolysaccharide (P < 0.05, OR > 1), ALT and AST.@*Conclusion@#Chronic liver disease increases with damage to intestinal barrier function.
摘要
Objective To analyze the changes of levels of plasma diamine oxidase(DAO),D-lactate and endotoxin in children with different severity of hand-foot-mouth disease(HFMD),explore the changes of the function of intestinal mucosal barrier in children with HFMD,and investigate the sensitivity and early warning effect of the indexes described previously on the damage of intestinal mucosal barrier in children with severe HFMD.Methods Four hundred and seventy inpatient children in Xi′an Children′s Hospital from March 2016 to June 2017 suffered from HFMD were selected as the study group,and one hundred healthy children were selected as the control group in the same period.Children in the study group were divided into common group(n=300),severe group(n=110)and critical condition group(n=60)according to the sever-ity of the disease.The levels of plasma DAO,D-lactate and endotoxin from children in each group were com-pared.Results The plasma D-lactate level of the children in the study group was significantly higher than that in the control group,and the difference was statistically significant[(27.670 ± 6.273)mg/L vs.(25.585 ± 5.177)mg/L;t=3.515,P<0.05];but the differences of DAO and endotoxin compared with the control group were not statistically significant[(3.205 ± 0.956)U/L vs.(3.135 ± 0.884)U/L,P>0.05;(1.186 ± 0.486)U/L vs.(1.091 ± 0.494)U/L,P>0.05].The comparison of multiple groups showed that the differ-ence of plasma D-lactate levels was statistically significant(F=33.488,P<0.05),while the differences of the levels of DAO and endotoxin were not statistically significant among different severity groups(F=0.709, F=2.296,P>0.05).The level of plasma D-lactate in critical condition group[(32.502 ± 4.756)mg/L]was significantly higher than those in the severe group[(29.872 ± 6.468)mg/L],the common group [(25.896 ± 5.691)mg/L] and the control group,and the differences were statistically significant(P <0.05);the difference in plasma D-lactate levels in the severe and non-severe groups was statistically signifi-cant(P<0.05),and the difference between common group and control group was not statistically significant (P>0.05).Conclusion The intestinal permeability and intestinal mucosal barrier are impaired in children with severe and critical HFMD.Plasma D-lactate is significantly elevated in the early stage of intestinal barri-er injury.Compared with DAO and endotoxin,D-lactate is a sensitive and early warning index suggesting the impaired intestinal mucosal barrier function in severe and critical cases of HFMD.
摘要
Objective To observe the effect of parecoxib on intestinal barrier function of septic mice.Methods Sepsis was induced by cecal ligation and puncture (CLP) model.Twenty-one male C57BL/6 mice were randomly divided into three groups (n =7 in each group):group Sham,group CLP,group P (parecoxib 2 mg/kg was administered via gastric tube 2 h after CLP).In vivo intestinal permeability was measured using an in vivo ligated loop model 24 h after surgery.Twenty-one male C57BL/6 mice were randomly divided into three groups as before.The small intestine tissue sample was harvested 24 h after surgery.The intestinal pathological changes were observed under light microscope.The expression of tight junction proteins ZO-1,Occludin,and Claudin-1 in the ileum were measured by Western blot.IL-6 and PGE2 level in the ileum were measured by ELISA.Results Compared with group Sham,the intestinal permeability was significantly increased and there was a significant intestinal pathological injury in group CLP.IL-6 and PGE2 level in the ileum was sig nificantly increased and the expression of tight junction protein ZO-1,Occludin,and Claudin-1 in the ileum were reduced in the group CLP (P＜0.05).Compared with the group CLP,intestinal permeability and pathological injury was significantly reduced in the group P.The levels of IL-6 and PGE2 were significantly decreased (P＜0.05),the expression of ZO-1,Occludin,and Claudin 1 were upregulated in group P (P＜0.05).Conclusion Parecoxib can decrease the levels of proinflammatory factors and up-regulate the expression of tight junction to reverse intestinal barrier dysfunction caused by sepsis in mice.