Leaky gut

漏肠
  • 文章类型: Journal Article
    肝硬化中常见肠道菌群失调和细胞因子异常。本研究旨在评估它们之间的相关性。
    在肝硬化患者和对照组的血浆中,使用多重测定检查27种细胞因子。检查了亚硝酸盐(内皮功能障碍生物标志物一氧化氮的稳定代谢物)和脂多糖(LPS)的血浆水平。通过16SrRNA基因测序评估粪便微生物群。
    IL-1b水平,IL-2,IL-6,IL-13,IP-10,IFN-g,TNF-a,LPS,肝硬化患者的亚硝酸盐含量高于对照组,而IL-4,IL-7和PDGF-BB的水平较低。LPS水平与IL-1b水平直接相关,IL1-Ra,IL-9,IL-17,PDGF-BB,IL-6,TNF-a,和亚硝酸盐。亚硝酸盐水平与TNF-α水平显著直接相关,GM-CSF,IL-17和IL-12与IL-7水平呈负相关。TNF-a水平与腹水严重程度和淋巴结的丰度直接相关,肠杆菌科,Veillonellaceae,和克雷伯菌属,虽然与Firmicutes的丰度成反比,梭菌,和下颗粒。IFN-g水平与拟杆菌科的丰度直接相关,乳酸杆菌科,拟杆菌,和Megasphaera,与Verrucomicrobiota的丰度成反比,Akkermansiaceae,科氏杆菌科,Akkermansia,Collinsella,还有Gemella.IL-1b水平与Comamonadaceae和肠杆菌科的丰度直接相关,与Marinifilaceae和Dialister的丰度成反比。IL-6水平与肠杆菌科细菌的丰度直接相关,肝性脑病,和腹水的严重程度,与肽链球菌科的丰度呈负相关,链球菌科,和链球菌。
    有害肠道微生物群分类群和内毒素血症的丰度与促炎细胞因子的水平直接相关。
    UNASSIGNED: Gut dysbiosis and abnormal cytokine profiles are common in cirrhosis. This study aimed to evaluate the correlations between them.
    UNASSIGNED: In the blood plasma of cirrhosis patients and controls, 27 cytokines were examined using a multiplex assay. The plasma levels of nitrites (stable metabolites of the endothelial dysfunction biomarker nitric oxide) and lipopolysaccharide (LPS) were examined. The fecal microbiota was assessed by 16S rRNA gene sequencing.
    UNASSIGNED: Levels of IL-1b, IL-2, IL-6, IL-13, IP-10, IFN-g, TNF-a, LPS, and nitrites were higher in cirrhosis patients than in controls, while levels of IL-4, IL-7, and PDGF-BB were lower. The LPS level was directly correlated with the levels of IL-1b, IL1-Ra, IL-9, IL-17, PDGF-BB, IL-6, TNF-a, and nitrites. The nitrite level was significantly directly correlated with the levels of TNF-a, GM-CSF, IL-17, and IL-12, and inversely correlated with the IL-7 level. TNF-a levels were directly correlated with ascites severity and the abundance of Negativicutes, Enterobacteriaceae, Veillonellaceae, and Klebsiella, while inversely correlated with the abundance of Firmicutes, Clostridia, and Subdoligranulum. IFN-g levels were directly correlated with the abundance of Bacteroidaceae, Lactobacillaceae, Bacteroides, and Megasphaera, and inversely correlated with the abundance of Verrucomicrobiota, Akkermansiaceae, Coriobacteriaceae, Akkermansia, Collinsella, and Gemella. IL-1b levels were directly correlated with the abundance of Comamonadaceae and Enterobacteriaceae and inversely correlated with the abundance of Marinifilaceae and Dialister. IL-6 levels were directly correlated with the abundance of Enterobacteriaceae, hepatic encephalopathy, and ascites severity, and inversely correlated with the abundance of Peptostreptococcaceae, Streptococcaceae, and Streptococcus.
    UNASSIGNED: The abundance of harmful gut microbiota taxa and endotoxinemia directly correlates with the levels of proinflammatory cytokines.
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  • 文章类型: Journal Article
    系统性红斑狼疮(SLE)是一种自身免疫性疾病,其特征是免疫系统功能障碍,可导致严重的健康问题和死亡。最近的研究强调了肠道微生物群改变在调节SLE炎症和疾病严重程度中的作用。这篇综述特别总结了狼疮各种小鼠模型中肠道微生物群组成的变化。通过关注这些差异,我们旨在阐明临床前环境中肠道菌群失调与SLE发生和进展之间的复杂关系.
    Systemic lupus erythematosus (SLE) is an autoimmune disorder characterized by immune system dysfunction that can lead to serious health issues and mortality. Recent investigations highlight the role of gut microbiota alterations in modulating inflammation and disease severity in SLE. This review specifically summaries the variations in gut microbiota composition across various murine models of lupus. By focusing on these differences, we aim to elucidate the intricate relationship between gut microbiota dysbiosis and the development and progression of SLE in preclinical settings.
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  • 文章类型: Journal Article
    2020年1月发生的COVID-19全球突发公共卫生事件促使对该病毒的发病机制和临床表现的研究激增。虽然已经发表了许多关于COVID-19感染急性影响的报告,该综述探讨了COVID-19的多方面长期影响,特别关注严重的孕产妇COVID-19感染,肠道微生物群菌群失调,和后代的神经发育障碍。严重的COVID-19感染与免疫系统激活增强和胃肠道症状有关。严重的COVID-19还可能导致肠道微生物群菌群失调和肠粘膜屏障受损,通常被称为“漏肠”。增加的肠道通透性促进炎症细胞因子的通过,起源于发炎的肠粘膜和肠道,进入血液,从而影响怀孕期间的胎儿发育,并可能增加自闭症和精神分裂症等神经发育障碍的风险。当前的综述讨论了细胞因子信号分子的作用,小胶质细胞,和突触修剪,强调他们可能参与母体COVID-19感染后神经发育障碍的发病机制。此外,这篇综述探讨了益生菌干预在减轻与COVID-19相关的肠道菌群失调和炎症反应方面的潜力,为未来优化孕产妇和胎儿健康结局的研究提供了途径.
    The global public health emergency of COVID-19 in January 2020 prompted a surge in research focusing on the pathogenesis and clinical manifestations of the virus. While numerous reports have been published on the acute effects of COVID-19 infection, the review explores the multifaceted long-term implications of COVID-19, with a particular focus on severe maternal COVID-19 infection, gut microbiome dysbiosis, and neurodevelopmental disorders in offspring. Severe COVID-19 infection has been associated with heightened immune system activation and gastrointestinal symptoms. Severe COVID-19 may also result in gut microbiome dysbiosis and a compromised intestinal mucosal barrier, often referred to as \'leaky gut\'. Increased gut permeability facilitates the passage of inflammatory cytokines, originating from the inflamed intestinal mucosa and gut, into the bloodstream, thereby influencing fetal development during pregnancy and potentially elevating the risk of neurodevelopmental disorders such as autism and schizophrenia. The current review discusses the role of cytokine signaling molecules, microglia, and synaptic pruning, highlighting their potential involvement in the pathogenesis of neurodevelopmental disorders following maternal COVID-19 infection. Additionally, this review addresses the potential of probiotic interventions to mitigate gut dysbiosis and inflammatory responses associated with COVID-19, offering avenues for future research in optimizing maternal and fetal health outcomes.
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  • 文章类型: Journal Article
    从孵化中提供的益生菌对微生物群的发育有重大影响,以及环境和床上用品微生物群,塑造垃圾的微生物群落。我们研究了益生菌补充剂和使用地塞米松(DEX)诱导的漏肠挑战对凋落物微生物群落和凋落物参数的影响。益生菌产品是三种解淀粉芽孢杆菌菌株的混合物。将凋落物微生物群与其他肠道切片的微生物群落进行比较。与盲肠相比,凋落物样品具有更高的微生物多样性,Gizzard,空肠,和空肠粘膜。在我们的研究中检测到的凋落物门水平的微生物群与gizard微生物群之间的高度相似性可能是摄入的饲料和凋落物通过gizard的结果。此外,凋落物微生物群落从根本上不同于肠道微生物群,这由产仔中存在的属的数量证明,但在所有肠道切片中都不存在,反之亦然。此外,LEfSe分析确定了不同组的不同微生物类群,具有与不同治疗相关的特定属。就垃圾质量而言,DEX组中的鸟类水分含量明显更高,表明成功的漏肠挑战,而益生菌补充并没有显着影响水分水平。这些发现为凋落物的独特微生物群特征提供了全面的见解。
    Probiotics provided from hatch have a major influence on microbiota development, and together with environmental and bedding microbiota, shape the microbial community of the litter. We investigated the influence of probiotic supplementation and a leaky gut challenge induced using dexamethasone (DEX) on the litter microbial community and litter parameters. The probiotic product was a mix of three Bacillus amyloliquefaciens strains. The litter microbiota were compared to the microbial communities from other gut sections. The litter samples had higher microbial diversity compared to the caecum, gizzard, jejunum, and jejunal mucosa. The high similarity between the litter phylum-level microbiota and gizzard microbiota detected in our study could be a consequence of ingested feed and litter passing through the gizzard. Moreover, the litter microbial community is fundamentally distinct from the intestinal microbiota, as evidenced by the number of genera present in the litter but absent from all the intestinal sections and vice versa. Furthermore, LEfSe analysis identified distinct microbial taxa across different groups, with specific genera associated with different treatments. In terms of litter quality, the birds in the DEX groups had a significantly higher moisture content, indicating successful leaky gut challenge, while probiotic supplementation did not significantly affect the moisture levels. These findings provide comprehensive insights into the distinct microbiota characteristics of litter.
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  • 文章类型: Journal Article
    肠-皮肤轴最近已被广泛认可,发现肠道和皮肤通过双向连接相互影响;然而,确切的机制仍有待阐明。因此,我们的目的是研究慢性皮肤损伤对小鼠肠道的影响。遵循慢性皮肤损伤(CSD)模型,胶带剥离后,将4%十二烷基硫酸钠(SDS)施用于剃毛的鼠皮肤六次,持续2周。对小肠和大肠进行了组织学和免疫学分析,分别。使用异硫氰酸荧光素缀合的(FITC)-葡聚糖测量肠通透性。使用抗IL-13抗体研究了IL-13在回肠中的作用。使用TUNEL染色分析凋亡的肠细胞。在CSD模型的小肠中观察到绒毛萎缩,随着渗透率的增加。肥大细胞,但不是T细胞,嗜酸性粒细胞,肠粘膜中ILC-2也没有增加。然而,大肠未见明显变化.IL-13的mRNA表达仅在CSD模型的回肠中增加。CSD模型回肠中凋亡肠上皮细胞显著增加。施用抗IL-13抗体改善了由CSD引起的肠损伤,伴随着凋亡细胞和肥大细胞浸润的减少。皮肤损伤会导致小肠的形态变化,伴随着肠道通透性增加,可能通过IL-13诱导的上皮细胞凋亡。表面活性剂介导的机械皮肤损伤可导致肠漏。
    The gut-skin axis has recently been widely recognized, and both the gut and skin have been found to affect each other through a bidirectional connection; however, the precise mechanisms remain to be elucidated. Therefore, we aimed to investigate the effects of chronic skin damage (CSD) on mouse intestines. Following the CSD model, 4% sodium dodecyl sulfate was applied to the back-shaved murine skin six times for 2 weeks after tape stripping. The small and large intestines were analyzed histologically and immunologically, respectively. Intestinal permeability was measured using fluorescein isothiocyanate-conjugated-dextran. The role of interleukin-13 (IL-13) in the ileum was investigated using an anti-IL-13 antibody. Apoptotic intestinal cells were analyzed using TUNEL staining. Villus atrophy was observed in the small intestine in the CSD model, along with increased permeability. Mast cells, but not T cells, eosinophils, or innate lymph cell-2, were increased in the intestinal mucosa. However, no significant changes were observed in the large intestine. mRNA expression of IL-13 was increased only in the ileum of the CSD model. Apoptotic intestinal epithelial cells were significantly increased in the ileum of the CSD model. Administration of an anti-IL-13 antibody ameliorated the intestinal damage caused by CSD, along with decreased apoptotic cells and mast cell infiltration. Skin damage causes morphological changes in the small intestine, accompanied by increased intestinal permeability, possibly through the IL-13-induced apoptosis of mast cells in the epithelium. Surfactant-mediated mechanical skin damage can cause a leaky gut.
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  • 文章类型: Journal Article
    目的:慢性阻塞性肺疾病(COPD)患者经常表现出无法维持姿势平衡的状态。然而,肠道通透性增加或肠道渗漏对COPD体位失衡的影响尚不清楚.
    方法:我们测量了血浆zonulin,肠漏的标志,与男性对照(n=70)和轻度患者(n=67)的姿势平衡有关,中等(n=66),和重度(n=58)COPD。我们使用了一个短的物理性能电池来评估仰卧时的姿势平衡,串联,和半串联位置。我们还测量了手握强度(HGS),步态速度,血浆C反应蛋白(CRP),和8-异前列腺素作为姿势失衡和漏肠之间的潜在机械联系。
    结果:COPD患者表现出更高的血浆zonulin,CRP,和8-异前列腺素水平和较低的平衡,HGS,和步态速度比对照组(所有p<0.05)。这些发现在中度和重度COPD患者中比轻度COPD患者更可靠。此外,血浆zonulin在诊断平衡不良方面表现出显著的潜力,低HGS,COPD患者的步态速度(均p<0.05)。我们还发现血浆zonulin与CRP和8-异前列腺素显著相关,提供高度的炎症和氧化应激作为肠漏和姿势失衡之间的机械联系。
    结论:血浆zonulin可能有助于评估COPD患者的姿势失衡。修复肠漏可以是改善COPD姿势控制的治疗目标。
    OBJECTIVE: Patients with chronic obstructive pulmonary disease (COPD) frequently exhibit an inability to maintain postural balance. However, the contribution of increased intestinal permeability or leaky gut to the postural imbalance in COPD is not known.
    METHODS: We measured plasma zonulin, a marker of leaky gut, with relevance to postural balance in male controls (n = 70) and patients with mild (n = 67), moderate (n = 66), and severe (n = 58) COPD. We employed a short physical performance battery to evaluate postural balance in supine, tandem, and semi-tandem positions. We also measured handgrip strength (HGS), gait speed, plasma c-reactive proteins (CRP), and 8-isoprostanes as potential mechanistic connections between postural imbalance and leaky gut.
    RESULTS: COPD patients demonstrated higher plasma zonulin, CRP, and 8-isoprostanes levels and lower balance, HGS, and gait speed than controls (all p < 0.05). These findings were more robust in patients with moderate and severe than mild COPD. In addition, plasma zonulin exhibited significant potential in diagnosing poor balance, low HGS, and gait speed in COPD patients (all p < 0.05). We also found significant correlations of plasma zonulin with CRP and 8-isoprostanes, providing heightened inflammation and oxidative stress as mechanistic connections between leaky gut and postural imbalance.
    CONCLUSIONS: Plasma zonulin may be helpful in evaluating postural imbalance in COPD patients. Repairing intestinal leaks can be a therapeutic target to improve postural control in COPD.
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  • 文章类型: Journal Article
    系统性红斑狼疮(SLE)是一种多因素的自身免疫性疾病,其特征是自身免疫耐受破坏和自身抗体的产生。引起免疫复合物的沉积,引发炎症和免疫介导的损伤。SLE发病机制涉及遗传易感性和环境因素的组合。临床表现是可变的,使早期诊断具有挑战性。热休克蛋白(Hsps),属于陪伴系统,与免疫系统相互作用,作为促炎因子,自身抗原,以及免疫耐受启动子。一些Hsps水平的增加和针对它们的自身抗体的产生与SLE发作和进展相关。这些自身抗体的产生归因于分子模拟,发生在病毒和细菌感染时,因为它们是进化高度保守的。肠道菌群失调与SLE的发生和严重程度有关。许多研究结果表明,共生细菌的蛋白质和代谢物可以模拟自身抗原,诱导自身免疫,因为分子模仿。这里,我们认为人类Hsps和肠道共生细菌之间的共有表位会导致产生与人类分子交叉反应的抗Hsp自身抗体,有助于SLE发病机制。因此,陪伴系统的参与,肠道菌群失调,应协调研究SLE的分子模拟。
    Systemic lupus erythematosus (SLE) is a multifactorial autoimmune disease characterized by self-immune tolerance breakdown and the production of autoantibodies, causing the deposition of immune complexes and triggering inflammation and immune-mediated damage. SLE pathogenesis involves genetic predisposition and a combination of environmental factors. Clinical manifestations are variable, making an early diagnosis challenging. Heat shock proteins (Hsps), belonging to the chaperone system, interact with the immune system, acting as pro-inflammatory factors, autoantigens, as well as immune tolerance promoters. Increased levels of some Hsps and the production of autoantibodies against them are correlated with SLE onset and progression. The production of these autoantibodies has been attributed to molecular mimicry, occurring upon viral and bacterial infections, since they are evolutionary highly conserved. Gut microbiota dysbiosis has been associated with the occurrence and severity of SLE. Numerous findings suggest that proteins and metabolites of commensal bacteria can mimic autoantigens, inducing autoimmunity, because of molecular mimicry. Here, we propose that shared epitopes between human Hsps and those of gut commensal bacteria cause the production of anti-Hsp autoantibodies that cross-react with human molecules, contributing to SLE pathogenesis. Thus, the involvement of the chaperone system, gut microbiota dysbiosis, and molecular mimicry in SLE ought to be coordinately studied.
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  • 文章类型: Journal Article
    类风湿性关节炎(RA)是一种以炎症和关节损害为特征的慢性自身免疫性疾病。现有的治疗方案主要集中在控制症状和减缓疾病进展。经常有副作用和局限性。肠道微生物组,胃肠道中存在的大量微生物群落,在健康和疾病中起着至关重要的作用。最近的研究表明,肠道微生物组和RA之间存在双向关系,强调其作为治疗选择的潜力。本文综述了肠道菌群与RA发生发展之间的相互作用,通过讨论菌群失调,肠道细菌的不平衡,可以通过多种机制促进RA,如分子模仿,漏肠,和代谢失调。益生菌,具有健康益处的活微生物,正在成为管理RA的有前途的工具。它们可以通过取代有害细菌来防止生态失调的负面影响,产生抗炎代谢产物,如短链脂肪酸(SCFA),直接影响免疫细胞,和改变宿主的新陈代谢。动物和临床研究表明,益生菌在改善RA症状和疾病结局方面具有潜力。然而,需要进一步的研究来优化益生菌菌株,剂量,和治疗方案,以实现RA的个性化和有效管理。本文综述了目前对肠道菌群及其在RA中的作用的认识,并讨论了未来的研究方向。除了肠道生态失调在RA中的作用外,新兴的策略,如粪便微生物群移植,益生元,和postbiotics提供令人兴奋的可能性。然而,肠道成分的个体差异需要个性化的治疗计划。需要建立长期影响和明确的规定。未来的研究侧重于宏基因组分析,联合疗法,和机制的理解将释放肠道微生物组调节的全部潜力,以实现有效的RA管理。
    Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation and joint damage. Existing treatment options primarily focus on managing symptoms and slowing disease progression, often with side effects and limitations. The gut microbiome, a vast community of microorganisms present in the gastrointestinal tract, plays a crucial role in health and disease. Recent research suggests a bidirectional relationship between the gut microbiome and RA, highlighting its potential as a therapeutic option. This review focuses on the interaction between the gut microbiome and RA development, by discussing how dysbiosis, an imbalance in gut bacteria, can contribute to RA through multiple mechanisms such as molecular mimicry, leaky gut, and metabolic dysregulation. Probiotics, live microorganisms with health benefits, are emerging as promising tools for managing RA. They can prevent the negative effects of dysbiosis by displacing harmful bacteria, producing anti-inflammatory metabolites like short-chain fatty acids (SCFA), Directly influencing immune cells, and modifying host metabolism. animal and clinical studies demonstrate the potential of probiotics in improving RA symptoms and disease outcomes. However, further research is needed to optimize probiotic strains, dosages, and treatment protocols for personalized and effective management of RA. This review summarizes the current understanding of the gut microbiome and its role in RA and discusses future research directions. In addition to the established role of gut dysbiosis in RA, emerging strategies like fecal microbiota transplantation, prebiotics, and postbiotics offer exciting possibilities. However, individual variations in gut composition necessitate personalized treatment plans. Long-term effects and clear regulations need to be established. Future research focusing on metagenomic analysis, combination therapies, and mechanistic understanding will unlock the full potential of gut microbiome modulation for effective RA management.
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  • 文章类型: Journal Article
    背景:改变肠道代谢产物,特别是短链脂肪酸(SCFA),在帕金森病(PD)患者的粪便和血浆中观察到。
    目的:我们旨在研究两种SCFA受体的结肠表达,游离脂肪酸受体(FFAR)2和FFAR3,与PD患者的肠屏障完整性以及与临床严重程度的相关性。
    方法:在这项回顾性研究中,收集了37例PD患者和34例未受影响的对照组的结肠活检标本.在这个队列中,31名参与者(14名PD,17名对照)接受了一系列结肠活检。通过免疫荧光染色检测FFAR2、FFAR3和紧密连接标记物ZO-1的结肠表达。YouOnlyLookOnce(版本8,YOLOv8)算法用于免疫染色信号的自动检测和分割。使用运动障碍协会(MDS)-统一帕金森病评定量表(UPDRS)评估PD运动功能,便秘采用Rome-IV标准进行评估.
    结果:与对照组相比,PD患者的结肠ZO-1(p<0.01)和FFAR2(p=0.01)表达显着降低。在连续活检中,在PD诊断前的运动前阶段,FFAR2和FFAR3的结肠表达降低(均p<0.01)。MDS-UPDRS运动评分与结肠标志物水平无关。便秘严重程度与结肠ZO-1水平呈负相关(r=-0.49,p=0.02)。
    结论:与未受影响的对照组相比,PD患者中ZO-1和FFAR2的结肠表达较低,在PD运动前阶段,FFAR2和FFAR3水平下降。我们的发现暗示PD中存在漏肠现象,并加强了肠道代谢产物可能有助于PD的过程。
    BACKGROUND: Altered gut metabolites, especially short-chain fatty acids (SCFAs), in feces and plasma are observed in patients with Parkinson\'s disease (PD).
    OBJECTIVE: We aimed to investigate the colonic expression of two SCFA receptors, free fatty acid receptor (FFAR)2 and FFAR3, and gut barrier integrity in patients with PD and correlations with clinical severity.
    METHODS: In this retrospective study, colonic biopsy specimens were collected from 37 PD patients and 34 unaffected controls. Of this cohort, 31 participants (14 PD, 17 controls) underwent a series of colon biopsies. Colonic expression of FFAR2, FFAR3, and the tight junction marker ZO-1 were assayed by immunofluorescence staining. The You Only Look Once (version 8, YOLOv8) algorithm was used for automated detection and segmentation of immunostaining signal. PD motor function was assessed with the Movement Disorder Society (MDS)-Unified Parkinson\'s Disease Rating Scale (UPDRS), and constipation was assessed using Rome-IV criteria.
    RESULTS: Compared with controls, PD patients had significantly lower colonic expression of ZO-1 (p < 0.01) and FFAR2 (p = 0.01). On serial biopsy, colonic expression of FFAR2 and FFAR3 was reduced in the pre-motor stage before PD diagnosis (both p < 0.01). MDS-UPDRS motor scores did not correlate with colonic marker levels. Constipation severity negatively correlated with colonic ZO-1 levels (r = -0.49, p = 0.02).
    CONCLUSIONS: Colonic expression of ZO-1 and FFAR2 is lower in PD patients compared with unaffected controls, and FFAR2 and FFAR3 levels decline in the pre-motor stage of PD. Our findings implicate a leaky gut phenomenon in PD and reinforce that gut metabolites may contribute to the process of PD.
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  • 文章类型: Journal Article
    肠道通透性增加已被确定为与肠易激综合征(IBS)发展相关的许多病理生理因素之一,一种常见的肠-脑相互作用障碍。排列在肠道上的上皮细胞层在有限的程度上是可渗透的,细胞旁通透性的量受到严格控制以吸收离子,营养素,和管腔里的水。肠道对大分子的通透性增加可以由各种侮辱引发,包括感染,食物中毒的毒素,或者过敏原,这反过来又引起炎症反应,并与IBS患者的腹痛有关。这篇综述文章讨论了IBS的肠道通透性增加,通过与胃肠道专家初次接触后报告先前诊断为“肠漏综合征”的患者病例的镜头,重点关注IBS伴便秘(IBS-C)。我们回顾了几种测量患者肠道通透性的方法的优缺点,并讨论了在IBS-C患者的治疗过程中何时测量肠道通透性是合适的。此外,我们讨论了通过抑制钠-氢交换异构体3(NHE3)改变细胞内pH来恢复肠屏障至健康状态的可能机制。Tenapanor是一个最低限度的吸收,已被美国食品和药物管理局批准用于治疗成人IBS-C的NHE3小分子抑制剂。临床前研究表明,tenapanor可以通过抑制NHE3来影响紧密连接蛋白的构象,从而阻止大分子从肠腔的细胞旁转运,从而恢复IBS-C中的肠屏障。对经历腹痛的IBS-C患者进行通透性增加的测试可能有助于告知治疗方法的选择,并改变患者对“肠漏综合征”的误解。
    Increased intestinal permeability has been identified as one of the many pathophysiological factors associated with the development of irritable bowel syndrome (IBS), a common disorder of gut-brain interaction. The layer of epithelial cells that lines the intestine is permeable to a limited degree, and the amount of paracellular permeability is tightly controlled to enable the absorption of ions, nutrients, and water from the lumen. Increased intestinal permeability to macromolecules can be triggered by a variety of insults, including infections, toxins from food poisoning, or allergens, which in turn cause an inflammatory response and are associated with abdominal pain in patients with IBS. This review article discusses increased intestinal permeability in IBS, focusing on IBS with constipation (IBS-C) through the lens of a patient case with a reported prior diagnosis of \"leaky gut syndrome\" upon initial contact with a gastrointestinal specialist. We review advantages and disadvantages of several methods of measuring intestinal permeability in patients and discuss when measuring intestinal permeability is appropriate in the therapeutic journey of patients with IBS-C. Furthermore, we discuss a possible mechanism of restoring the intestinal barrier to its healthy state through altering intracellular pH by inhibiting sodium-hydrogen exchanger isoform 3 (NHE3). Tenapanor is a minimally absorbed, small-molecule inhibitor of NHE3 that has been approved by the US Food and Drug Administration for the treatment of IBS-C in adults. Preclinical studies showed that tenapanor may restore the intestinal barrier in IBS-C by affecting the conformation of tight junction proteins via NHE3 inhibition to block the paracellular transport of macromolecules from the intestinal lumen. Testing for increased permeability in patients with IBS-C who experience abdominal pain may help inform the choice of therapeutics and alter patients\' misconceptions about \"leaky gut syndrome\".
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