背景:艰难梭菌是一种机会性感染,可导致抗结核相关性腹泻和毒性巨结肠。
目的:本系统综述研究旨在研究多酚的抗菌和抗毒素特性及其对减少艰难梭菌感染(CDI)相关并发症的影响。
方法:本系统评价是根据PRISMA指南2020进行的。多个数据库,包括WebofScience,PubMed,科克伦图书馆,EMBASE,还有Scopus,对现有文献进行了彻底搜索。在考虑审查的纳入和排除标准后,共包括18篇文章。收集数据并将其记录到Excel文件中,以便进一步调查和得出结论。
结果:多酚通过降低活性氧(ROS)水平,炎症因子白细胞介素10(IL-10),减少核因子-κB(NF-κB)和肿瘤坏死因子-α(TNF-α),IL-6,IL-1α,IL-1β,粒细胞集落刺激因子(G-CSF),单核细胞趋化蛋白-1(MCP-1)和巨噬细胞炎性蛋白-1α(MIP-1α)水平,调节Bcl-2和Bax的表达,使艰难梭菌的生长和复制条件更加困难,并防止其产生毒素。此外,多酚可以抑制益生元的特性,促进有益的双歧杆菌和乳杆菌的生长,从而调节肠道微生物群,对不同的C.dif-ficile发挥抗菌活性。它们还通过抑制艰难梭菌TcdA和TcdB的产生来诱导它们的有益效果。
结论:据报道,在临床前研究中,多酚通过几种机制抑制艰难梭菌生长和毒素产生。然而,需要更多的临床研究来研究它们在人类中的安全性。
BACKGROUND: Clostridium difficile is an opportunistic infection that can lead to antibi-otic-associated diarrhea and toxic megacolon.
OBJECTIVE: This systematic review study aimed to investigate polyphenols\' antibacterial and anti-toxin properties and their effects on reducing complications related to C. difficile Infections (CDI).
METHODS: This systematic review was conducted following the PRISMA guideline 2020. Multiple databases, including Web of Science, PubMed, Cochrane Library, EMBASE, and Scopus, were searched thoroughly for existing literature. After considering the inclusion and exclusion criteria for the review, 18 articles were included. Data were collected and registered into an Excel file for further investigations and conclusions.
RESULTS: Polyphenols by reducing Reactive Oxygen Species (ROS) levels, increasing inflammatory factor Interleukin 10 (IL-10), reducing Nuclear Factor kappa B (NF-κB) and Tumour Necrosis Fac-tor-α (TNF-α), IL-6, IL-1α, IL-1β, Granulocyte Colony-stimulating Factor (G-CSF), and Monocyte Chemoattractant Protein-1 (MCP-1) and Macrophage Inflammatory Protein-1 alpha (MIP-1α) lev-els, and regulating the expression of Bcl-2 and Bax, make the growth and replication conditions of C. difficile more difficult and prevent it from producing toxins. Furthermore, polyphenols can ex-hibit prebiotic properties, promoting the growth of beneficial Bifidobacterium and Lactobacillus species and consequently regulating gut microbiota, exerting antimicrobial activities against C. dif-ficile. They also induce their beneficial effects by inhibiting the production of C. difficile TcdA and TcdB.
CONCLUSIONS: Polyphenols have been reported to inhibit C. difficile growth and toxin production by several mechanisms in preclinical studies. However, more clinical studies are needed to investigate their safety in humans.