「前沿傳遞」改變腸道微生物群和膽汁酸代謝對多囊的價值

劉湘源醫生 發佈 2020-01-05T17:36:28+00:00

作者:Qi X,et al.

作者:Qi X,et al.

翻譯:湖北十堰中醫院王家美

譯者簡介: 女,1971年出生,副主任醫師,從事婦產科臨床醫療20年,具有紮實理論基礎和豐富的臨床經驗,手術技術嫻熟,擅長各類婦產科各類疾病診治,尤其擅長產科重症病人搶救和婦科內分泌疾病救治,曾先後在國家級核心期刊上發表專業論文十餘篇,先擔任十堰市計劃生育委員會委員,十堰市婦產科專業委員會常務委員,十堰市圍產醫學專業委員會常務委員。

【摘要】

多囊卵巢綜合徵(PCOS)的特點是雄激素過量、排卵功能障礙和多囊卵巢,並經常伴有胰島素抵抗。多囊卵巢綜合徵的排卵功能障礙和胰島素抵抗機制仍然難以捉摸,從而限制了治療的發展。

代謝健康的改善,與相對較高的微生物群基因含量及增加的微生物多樣性有關。本研究旨在研究腸道微生物群及其代謝物對多囊卵巢綜合徵相關卵巢功能障礙和胰島素抵抗調節的影響。

研究發現,在多囊卵巢綜合徵個體的腸道微生物群中,硫化桿菌顯著升高,同時減少糖氧膽酸和脫氧膽酸水平。從患有多囊卵巢綜合徵婦女身上移植大腸桿菌,會導致卵巢功能紊亂、胰島素抵抗、膽汁酸代謝改變、白介素-22分泌減少和不育。

誘導腸道組淋巴細胞分泌IL-22反過來改善多囊卵巢綜合徵表型。這一發現與多囊卵巢綜合徵的個人IL-22水平降低一致。這項研究表明,改變腸道微生物群,改變膽汁酸代謝和/或增加IL-22水平可能對多囊卵巢綜合徵的治療有價值。

附原文:

Polycystic ovary syndrome (PCOS) is characterized by androgen excess, ovulatory dysfunction and polycystic ovaries1, and is often accompanied by insulin resistance2. The mechanism of ovulatory dysfunction and insulin resistance in PCOS remains elusive, thus limiting the development of therapeutics. Improved metabolic health is associated with a relatively high microbiota gene content and increased microbial diversity3,4. This study aimed to investigate the impact of the gut microbiota and its metabolites on the regulation of PCOSassociated ovarian dysfunction and insulin resistance. Here, we report that Bacteroides vulgatus was markedly elevated in the gut microbiota of individuals with PCOS, accompanied by reduced glycodeoxycholic acid and tauroursodeoxycholic acid levels. Transplantation of fecal microbiota from women with PCOS or B. vulgatus-colonized recipient mice resulted in increased disruption of ovarian functions, insulin resistance, altered bile acid metabolism, reduced interleukin-22 secretion and infertility. Mechanistically, glycodeoxycholic acid induced intestinal group 3 innate lymphoid cell IL-22 secretion through GATA binding protein 3, and IL-22 in turn improved the PCOS phenotype. This finding is consistent with the reduced levels of IL-22 in individuals with PCOS. This study suggests that modifying the gut microbiota, altering bile acid metabolism and/or increasing IL-22 levels may be of value for the treatment of PCOS.

引自:

Qi X, Yun C, Sun L, et al. Nat Med: Gut microbiota–bile acid–interleukin-22 axis orchestrates polycystic ovary syndrome.2019-07-22

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