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通过微生物组成预测活跃UC中对系统性皮质类固醇的反应-一项前性多中心研究
Andreas Blesl1, Philipp Wurm1,2, Silvio Waschina3
1Department of Internal Medicine, Division of Gastroenterology and Hepatology, Medical University of Graz, Graz, Austria.
便微生物组的变化,而不是基线组成,预测性结肠炎中的皮质类固醇反应. 响应者显示有益细菌和丁酸盐合成转移.
科学领域:
- 胃肠病学 胃肠病学
- 微生物组研究的研究.
- 免疫学 免疫学 免疫学
背景情况:
- 皮质类固醇是中度至重度活性的性结肠炎 (UC) 的首要治疗方法.
- 相当一部分UC患者 (高达三分之一) 对皮质类固醇治疗没有反应.
- 预测对皮质类固醇的反应对于优化UC治疗策略至关重要.
研究的目的:
- 调查便微生物组成和代谢能力与性结肠炎患者全身皮质类固醇反应之间的关联.
- 确定潜在的微生物生物标志物,用于预测UC的治疗结果.
主要方法:
- 对接受全身皮质类固醇的93名活跃UC患者进行前性多中心研究.
- 在治疗前和4周后收集的便样本;通过16S rRNA基因测序 (QIIME 2) 分析微生物组.
- 微生物代谢途径使用节的流量平衡分析预测;根据症状改善,患者被分类为反应者或非反应者.
主要成果:
- 74%的患者对皮质类固醇有反应. 基线微生物多样性和组成不能可靠地区分响应者和不响应者,除了在生物素素患者中.
- 受访者表现出肠道微生物群多样性和组成的显著纵向变化,有益的种群 (例如,布劳蒂亚,阿纳洛斯蒂普,比菲多细菌) 的丰富以及预测的酸盐合成的增加.
- 非响应者表现出最小的分类学转变,Streptococcus salivarius的增加和微生物组形状与响应者不同.
结论:
- 基线便微生物组特征在活跃UC中对皮质类固醇反应的预测价值有限.
- 微生物组成和代谢功能的长度变化,特别是有益细菌和丁酸盐生产的恢复,与UC的成功皮质类固醇治疗有关.
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