■几十年来,通过静脉穿刺减少铁一直是治疗血色素沉着病的基石,报告的健康益处很多。反复放血可导致肠道铁吸收的代偿性增加,降低肠道铁的可用性。鉴于大多数肠道细菌高度依赖铁来生存,我们假设,通过降低肠道铁水平,开腹可以改变肠道微生物群。
■临床参数,在接受铁还原治疗的一组血色素沉着病患者治疗前和治疗期间,对其粪便细菌组成和代谢组进行了评估.
■系统性铁还原与肠道微生物组的改变有关,在那些经历了减少的粪便铁供应的人中,有明显的变化。例如,prausnitzii粪杆菌的水平,一种与改善结肠健康有关的细菌,因粪便铁减少而增加。同样,代谢组学变化与粪便铁水平降低相关.
这些发现强调了在静脉穿刺过程中经历结肠铁减少的患者的肠道微生物组的显著变化。粪便铁的靶向消耗可能代表代谢和炎性疾病的新疗法。值得进一步调查。
■反复静脉穿刺导致的铁耗竭是血色病治疗的主要手段,铁超负荷症.手术与一些健康益处有关,包括肝功能检查的改善,肝脏疤痕的逆转,降低患肝癌的风险。在铁耗尽期间,从胃肠(GI)道的铁吸收增加以补偿治疗时的铁损失。铁的可利用性在胃肠道中是有限的,并且对于许多肠道细菌的生长和功能是至关重要的。在这项研究中,我们表明,在静脉切除治疗后结肠中铁的可用性降低导致肠道细菌组成的变化,一个发现,到目前为止,尚未在血色素沉着症患者中进行研究。
UNASSIGNED: Iron reduction by
venesection has been the cornerstone of treatment for haemochromatosis for decades, and its reported health benefits are many. Repeated phlebotomy can lead to a compensatory increase in intestinal iron absorption, reducing intestinal iron availability. Given that most gut bacteria are highly dependent on iron for survival, we postulated that, by reducing gut iron levels,
venesection could alter the gut microbiota.
UNASSIGNED: Clinical parameters, faecal bacterial composition and metabolomes were assessed before and during treatment in a group of patients with haemochromatosis undergoing iron reduction therapy.
UNASSIGNED: Systemic iron reduction was associated with an alteration of the gut microbiome, with changes evident in those who experienced reduced faecal iron availability with
venesection. For example, levels of Faecalibacterium prausnitzii, a bacterium associated with improved colonic health, were increased in response to faecal iron reduction. Similarly, metabolomic changes were seen in association with reduced faecal iron levels.
UNASSIGNED: These findings highlight a significant shift in the gut microbiome of patients who experience reduced colonic iron during venesection. Targeted depletion of faecal iron could represent a novel therapy for metabolic and inflammatory diseases, meriting further investigation.
UNASSIGNED: Iron depletion by repeated venesection is the mainstay of treatment for haemochromatosis, an iron-overload disorder.
Venesection has been associated with several health benefits, including improvements in liver function tests, reversal of liver scarring, and reduced risk of liver cancer. During iron depletion, iron absorption from the gastrointestinal (GI) tract increases to compensate for iron lost with treatment. Iron availability is limited in the GI tract and is crucial to the growth and function of many gut bacteria. In this study we show that reduced iron availability in the colon following
venesection treatment leads to a change in the composition of the gut bacteria, a finding that, to date, has not been studied in patients with haemochromatosis.