循环中的乌伯利诺基因增加了严重的酒精诱导性肝炎的炎症和皮质类固醇不响应
Manisha Yadav1, Abhishak Gupta2, Babu Mathew1
1Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi 110070, India.
概括
在严重的酒精相关性肝炎 (SAH) 中,高的乌比利诺基因水平预测治疗反应不佳和早期死亡率. 肠道微生物组调节,特别是减少胆红素还原酶,可能会改善SAH患者的结果.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 代谢学 代谢学 代谢学
- 微生物组研究 微生物组研究
背景情况:
- 严重的酒精相关性肝炎 (SAH) 是一个严重的健康挑战,死亡率高,治疗效率有限.
- 早期识别不太可能对治疗有反应的患者和处于早期死亡风险的患者对于临床管理至关重要.
- 了解宿主新陈代谢和肠道微生物群之间的相互作用是解开SAH病变的关键.
研究的目的:
- 确定血生物标志物,预测SAH患者对普得尼索隆的不反应和早期死亡率.
- 研究宿主微生物群相互作用,代谢变化和SAH治疗结果之间的关系.
- 探索肠道微生物组调制作为SAH治疗策略的潜力.
主要方法:
- 在SAH患者队列中使用高分辨率质谱分析进行血代谢分析.
- 机器学习算法和严重性指数用于生物标志物验证的应用.
- 对便微生物群组成和与血代谢概况和临床结果的相关性进行分析.
主要成果:
- 在SAH患者中,血中提高的氨基基素水平 (3.6倍增加) 与治疗不响应显著相关.
- 血 urobilinogen>0.07 mg/mL显示高预测准确度的不响应 (AUC>0.97) 和早期死亡率 (AUC = 0.94).
- 泌尿素水平与肠道微生物变化 (Firmicutes,Proteobacteria),炎症和肠道透性受损相关,影响葡萄糖皮质体受体信号传递.
结论:
- 血urobulinogen是治疗不响应和严重酒精相关性肝炎的死亡率的强有力的早期预测器.
- 宿主微生物群相互作用,以特定的代谢概况和肠道失生症为特征,是SAH进展和治疗失败的核心因素.
- 针对肠道微生物群,例如通过减少胆红素还原酶活性,为改善SAH的临床结果提供了一个有希望的途径.
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