利法西明可降低严重急性胰腺炎的肠道性炎症:实验动物模型和随机对照试验
Yao-Yu Zou1, Bing-Jun Yu1, Cong He1
1Department of Gastroenterology, Jiangxi Provincial Key Laboratory of Digestive Diseases, Jiangxi Clinical Research Center for Gastroenterology, Digestive Disease Hospital, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, Jiangxi, China.
利法西明治疗减少了严重急性胰腺炎 (SAP) 模型和患者的全身炎症和改变了肠道微生物群. 然而,它并没有减少感染并发症,因此需要进一步研究其治疗潜力.
科学领域:
- 胃肠病学 胃肠病学
- 微生物学 微生物学
- 免疫学 免疫学 免疫学
背景情况:
- 严重的急性胰腺炎 (SAP) 涉及全身炎症和肠道屏障功能障碍,通常与肠道失调有关.
- 利法西明是一种不可吸收的抗生素,它调节肠道微生物群,在SAP中具有潜在的治疗应用.
研究的目的:
- 通过小鼠模型和临床试验,研究严重急性胰腺炎 (SAP) 中利法西明的作用和机制.
- 在SAP中评估利法西明对胰腺损伤,全身炎症和肠道微生物群组成的影响.
主要方法:
- 使用了小鼠模型和单中心,开放标签,随机对照试验 (n=60).
- 评估胰腺损伤,系统性炎症标志物 (WBC,TNF-α),培养确认的感染,便微生物组合 (甲基因组学).
主要成果:
- 利法西明在小鼠和患者中减轻了胰腺损伤和全身炎症.
- 在接受rifaximin治疗的患者中观察到WBC和TNF-α的显著减少.
- 便分析显示,素降解细菌 (例如,Akkermansia) 和相关酶的减少.
- 里法西明和对照组之间在培养确认的感染发病率上没有显著差异.
结论:
- 利法西明在预测的SAP患者中改善了全身炎症标志物和改变了肠道微生物组特征.
- 它没有在90天内减少培养确认的传染性并发症.
- 需要进一步的大规模随机对照试验来证实这些发现,并探索rifaximin在SAP中的治疗作用.
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