Kab mob plab hnyuv microbiota thiab raum kab mob
Feb 28, 2023
Myung-Gyu Kim, Jihyun Yang, Sang-Kyung Jo
Division of Nephrology, Department of Internal Medicine, Kauslim University College of Medicine, Seoul, Republic of Kauslim
Cov zej zog loj microbial nyob hauv lub plab raws li lub cev endogenous thiab cuam tshuam nrog tus tswv tsev physiology los ntawm kev sib raug zoo symbiotic, cuam tshuam kev noj qab haus huv. Kev nce qib tsis ntev los no hauv cov txheej txheem kev sib txuas siab tau ua rau nws nkag siab zoo dua cov zej zog microbial thiab lawv cov teebmeem ntawm cov tswv. Tsiaj txhu thiab kev tshawb fawb soj ntsuam tau muab pov thawj ntau heev los qhia tias microbiota plays lub luag haujlwm tseem ceeb hauvmob raum mob, mob raum raug mob, nephrolithiasis, thiabraumKev hloov pauv los ntawm kev hloov pauv txoj haujlwm ntawm txoj hnyuv, tswj cov kab mob hauv zos thiab cov kab mob hauv lub cev, tswj kev tsim cov tshuaj metabolic, thiab cuam tshuam rau kev tiv thaiv kab mob. Txawm hais tias qhov tseeb ntawm lub hauv paus ntawm kev hloov pauv microbial thiab nws qhov cuam tshuam rau kev loj hlob ntawm tus kab mob tseem tsis paub meej, kev sib cuam tshuam rau lub raum-hluav taws xob ua lub luag haujlwm tseem ceeb hauv kev pib thiab kev loj hlob ntawm cov kab mob raum thiab, yog li ntawd, tuav cov lus cog tseg raws li lub hom phiaj kho. Ntawm no, peb tshuaj xyuas cov ntaub ntawv tsis ntev los no hais txog kev sib raug zoo ntawm cov kab mob microbes thiab tib neeg hauv ntau yam kab mob raum thiab sib tham txog yav tom ntej ntawm kev tshawb fawb microbial hauv nephrology.
Ntsiab lus: Mob raum raug mob, Mob raum mob, Microbiota, Nephrolithiasis, Kev hloov pauv
Taw qhia
Ntau tshaj 100 trillion microorganisms suav nrog cov kab mob, fungi, thiab protozoa (sib sau npe hu ua microbiota) tsim cov kab mob hauv tib neeg lub plab thiab cuam tshuam nrog lawv tus tswv tsev, ncaj qha lossis tsis ncaj qha cuam tshuam rau tus tswv tsev noj qab haus huv. Cov kab mob microbial raug xa mus ua ntej los ntawm qhov chaw mos ntawm qhov chaw mos thaum yug los, thiab cov zej zog microbial no hloov pauv hauv cov lus teb rau ntau yam stimuli xws li kev noj zaub mov, kev ntxhov siab, thiab kev siv tshuaj tua kab mob. Lub plab hnyuv microbiota yog tus cwj pwm los ntawm kev sib txawv tseem ceeb; Txawm li cas los xij, cov kab mob microbial tseem nyob ruaj khov nyob rau lub sijhawm thiab zoo sib xws hauv cov tsev neeg nrog rau cov tib neeg los ntawm ib cheeb tsam nrog kev noj zaub mov zoo. Cov qauv ntawm microbiota yog sib npaug ua haujlwm los ntawm kev sib raug zoo lossis kev sib raug zoo nrog tus tswv tsev. Yog li, cov kev hloov hauv plab hnyuv microbial tshuav, hu ua dysbiosis, yog txuam nrog cov plab hnyuv microbiota uas tsis muaj qhov sib npaug nrog cov kev hloov pauv ntau thiab zoo hauv cov khoom muaj pes tsawg leeg thiab kev ua haujlwm metabolic. Dysbiosis tuaj yeem ua rau muaj kab mob hauv ntau yam kab mob, suav nrog kev rog rog, mob qog noj ntshav, ntshav qab zib, mob plab hnyuv, mob hawb pob, thiab kab mob plawv. Hauv qhov kev tshuaj xyuas no, lub luag haujlwm tseem ceeb ntawm txoj hnyuv microbiota hauv ntau yamkab mob raumthiab yav tom ntej ntawm kev tshawb fawb microbiome tau tham txog.
Lub microbiota ua ib lub cev endogenous
Lub plab hnyuv microbiota ua ntau yam haujlwm thaum tswj kev sib raug zoo nrog tus tswv tsev. Colonic microbiota ferment tsis-digestible carbohydrates nrog rau kev noj haus fibers, cellulose, thiab resistant starch los tsim luv-chain fatty acids (SCFAs; acetate, propionate, butyrate, thiab lwm yam). SCFAs ua haujlwm ua lub zog rau cov kab mob colonocytes, ntxiv dag zog rau txoj hnyuv hauv plab thiab ua kom muaj zog tiv thaiv kab mob thiab kev tiv thaiv kab mob. Lub microbiota koom nrog hauv kev sib txuas ntawm ntau cov vitamins (vitamin B12, thiamine, riboflavin, thiab vitamin K) thiab cov metabolism ntawm cov amino acids.
Lub plab hnyuv microbial zej zog pab txhawb kev loj hlob thiab kev loj hlob ntawm kev tiv thaiv kab mob. Qhov tsis xws luag hauv kev txhim kho cov kab mob qog nqaij hlav hauv plab, Peyer's thaj ua rau thaj, thiab mesenteric lymph nodes hauv cov nas tsis muaj kab mob qhia txog lub luag haujlwm tseem ceeb ntawm microbiota hauv kev txhim kho lub cev. Cov nas uas tsis muaj kab mob kuj pom tias muaj cov kab mob immunoglobulin A ntau lawm thiab ua rau muaj kev cuam tshuam rau thiab kev tuag los ntawm qee cov kab mob pathogenic, qhia tias microbiota tseem ceeb hauv lub cev tiv thaiv kab mob. Epithelial hlwb thiab lub cev tiv thaiv kab mob sib tham nrog cov microbiota thiab paub txog cov kab mob pathogenic lossis lawv cov khoom lag luam metabolic thiab tom qab ntawd nce cov tshuaj tiv thaiv kab mob thiab cov kab mob inflammatory cytokines los ntawm kev ua kom muaj cov kab mob nuclear kappa B (NF-κB). Kev ua kom lub cev tsis muaj zog los ntawm cov kab mob plab hnyuv ua rau lub cev tiv thaiv kab mob tseem ceeb, ua kom ob qho tib si pro-inflammatory thiab counter-regulatory, thiab kev tiv thaiv kab mob, thiab qhov sib npaug ntawm cov teeb liab no los ntawm induction ntawm ntau lub cev tiv thaiv kab mob yog qhov tseem ceeb rau kev saib xyuas ntawm lub cev ib txwm muaj. . Hohomeostasis ntawm lub cev tiv thaiv kab mob sib pauv ntawm microbiota thiab tus tswv tsev yog qhov tseem ceeb rau kev txhim kho cov kab mob lymphoid thib ob.
Kev sib cuam tshuam ntawm microbial-epithelial kuj tseem ua haujlwm los tiv thaiv thiab tswj txoj hnyuv los ntawm ntau lub tswv yim, suav nrog kev tiv thaiv kab mob los ntawm kev sib txuas rau cov plab hnyuv epithelial, ua kom muaj kev tiv thaiv kab mob, thiab tswj cov mucus zog. Cov kab mob ntawm cov nas tsis muaj kab mob nrog kev sib xyaw ntawm Lactobacillus strains tau pom tias yuav txhim khu kev ruaj ntseg, qhia tias microbiota tseem ceeb hauv kev tswj hwm kev ruaj ntseg. Ntxiv nrog rau kev ua haujlwm metabolic thiab kev tiv thaiv kab mob, cov hnyuv microbiota tau pom tias yuav pab txhawb txoj kev loj hlob ntawm cov kab mob enteric paj hlwb. Nyob rau hauv cov ntsiab lus, raws li ib tug endogenous kab mob, lub plab thiab microbiota ua ntau yam physiological lub luag hauj lwm nyob rau hauv tus tswv, nrog rau cov metabolism hauv, kev tswj ntawm kev ruaj ntseg, kev loj hlob ntawm lub cev, kev tiv thaiv kab mob, thiab maturation ntawm enteric paj hlwb. Qhov kev paub no tau ua rau lub tswv yim hais tias dysbiosis pab txhawb rau lub pathogenesis ntawm cov kab mob hauv plab, tsis tsuas yog cov kab mob hauv plab, tab sis kuj muaj ntau yam kab mob metabolic, mob qog noj ntshav, kab mob inflammatory, thiab kab mob plawv, thiab cov tswv yim hais txog cov microbiota tuav cov lus cog tseg hauv kev tiv thaiv thiab kho cov kab mob no. .
plab hnyuv microbiotathiab mob raum mob
Ntau qhov kev tshawb fawb tau pom tias muaj dysbiosis hauv cov qauv tsiaj thiab tib neeg uas muaj mob ntevmob raum (CKD). HauvCKDcov neeg mob uremia,plab hnyuvedema, lub sij hawm mus rau lub sij hawm ntev, kev txwv tsis pub noj fiber ntau, metabolic acidosis, thiab nquag siv tshuaj tua kab mob tuaj yeem ua rau dysbiosis ncaj qha thiab ib puag ncig hloov plab hnyuv.
Nug cov ntaub ntawv ntxiv:david.deng@wecistanche.com
Hauv kev tshawb fawb thaum ntxov, Vaziri et al. pom qhov sib txawv tseem ceeb hauv kev nplua nuj ntawm 190 kab mob ua haujlwm taxonomic chav nyob nruab nrab ntawm theem kawgkab mob raum(ESKD) thiab tswj kev noj qab haus huv. Lawv tau pom tias muaj ntau ntawm cov kab mob saccharolytic xws li Lactobacillus thiab Bifidobacteria txo qis hauv ESKD, thaum cov kab mob proteolytic xws li Clostridium thiab Bacteroides nce. Txawm hais tias urea supplementation tsis tuaj yeem ua rau muaj kev cuam tshuam zoo li dysbiosis hauv tus qauv nas ntawm CKD, kev sib sau ntawm cov co toxins tuaj yeem cuam tshuam tsis zoo rau kev loj hlob ntawm cov kab mob commensal thiab tej zaum yuav muaj lub luag haujlwm rau dysbiosis. Ib txoj kev tshawb fawb tsis ntev los no ntawm Suav ESKD cov neeg mob tau tshaj tawm txog kev txo qis ntawm cov kab mob butyrate uas tsim cov kab mob xws li Roseburia, Faecalibacterium, Coprococcus, thiab Prevotella. Wong et al. qhia txog kev nthuav dav ntawm cov tsev neeg cov kab mob uas tsim cov urease, indole, thiab p-cresol-forming enzymes, thaum cov tsev neeg cov kab mob tsim SCFAs raug txo. Muab cov teebmeem tshuaj lom ntawm cov metabolites thiab cov txiaj ntsig zoo ntawm SCFA, dysbiosis hauv cov neeg mob ESKD yuav ua tau qee lub luag haujlwm hauv kev txhim kho cov kab mob hauv lub cev thiab cov tsos mob uremic.
Cov kab mob plab hnyuv, tsim los ntawm ib txheej txheej epithelial thiab mucus txheej, tiv thaiv kev hloov pauv ntawm cov ntsiab lus luminal thaum tso cai xaiv cov khoom noj khoom haus, dej, thiab electrolytes. Dysbiosis hauvCKDtau pom tias muaj feem cuam tshuam nrog kev cuam tshuam ntawm kev cuam tshuam uas yuav ua rau kis kab mob los yog lawv cov metabolites. Cov kev tshawb fawb tau pom tias muaj qhov nce permeability rau exogenous polyethylene glycol los yog nce circulating endotoxin ntau ntau hauv cov neeg mob CKD, qhia txog kev txhim kho kev xa mus los ntawm kev cuam tshuam. Urea ncaj qha provokes qhov txo qis hauv transepithelial tsis kam ntawm kab lis kev cai enterocytes, thiab plab hnyuv edema thiab cheeb tsam ischemia hauvCKDtuaj yeem ua rau kev txhim kho ntawm lub plab khoob. Nyob rau theem molecular, kev cuam tshuam hauv plab hnyuv tau cuam tshuam nrog kev txo qis ntawm kev qhia tawm ntawm tshav kub poob siab protein 70 (HSP70) thiab claudin -1, nce kev nthuav qhia ntawm pore-forming claudin -2, thiab epithelial apoptosis nyob rau hauv txoj hnyuv ntawm tus qauv ntawm nasCKD. Hauv kev tshawb fawb tsis ntev los no ntawm CKD, dysbiosis thiab teeb meem cuam tshuam tau pom tau txuas nrog kev hloov pauv ntawm lub cev tiv thaiv kab mob los ntawm kev ua kom cov kab mob inflammatory macrophages nrog kev tsim cov inflammatory cytokines. Qhov no tuaj yeem ua rau muaj kab mob hauv lub cev thiab ua rau mob plawv / raum tsis zoo.
Uremic toxins muab tau los ntawm lub plab yog txuam nrog cov txiaj ntsig tsis zooCKD. Protein-bound uremic toxins xws li p-cresyl sulfate los yog indoxyl sulfate, tsim los ntawm fermentation ntawm tyrosine los yog tryptophan los ntawm plab hnyuv kab mob, raug tso tawm los ntawm tubular secretion nyob rau hauv lubraum, ua rau cov ntshav nce siab hauv cov neeg mob CKD. Indoxyl sulfate tau tshaj tawm tias yuav ua rau kom muaj kev loj hlob ntawm kev loj hlob - qhia thiab oxidative kev nyuaj siab, txhawb cov leeg nqaij calcification thiab ua rau endothelial cell dysfunction. Cov protein-bound uremic toxins thaum kawg ua rau muaj kev pheej hmoo ntawm cov kab mob plawv, kev tuag, thiab CKD kev loj hlob. Trimethylamine N-oxide (TMAO), lwm yam uremic toxin muab los ntawm cov kab mob metabolism ntawm quaternary amines, tau raug tshaj tawm tias muaj feem cuam tshuam nrog kev tuag ntau ntxiv hauv cov neeg mob.CKD.
Raws li cov kev tshawb pom no, cov tswv yim kho mob tsom rau cov microbiota, suav nrog prebiotics, cov khoom noj tsis txaus noj uas induces activation ntawm cov kab mob; probiotics, muaj sia nyob; synbiotics, ua ke ntawm prebiotics thiab probiotics; thiab adsorbents, uas adsorb cov tshuaj lom, yuav pab tau rau kev kho CKD. AST-120, ib qho insoluble enteric carbon adsorbent uas tuaj yeem cuam tshuam cov tsub zuj zuj ntawm indoxyl sulfate, tau pom tias yuav ncua kev lim ntshav thiab ua kom txo qis glomerular pom tus nqi txawm hais tias tsis zoo tshwm sim hauv kev sim ob qhov muag tsis pom kev tsis ntev los no. Probiotic supplementation tsis ntev los no tau pom tias txhim kho cov piam thaj homeostasis nrog kev txo qis ntawm cov cim ntawm qhov mob thiab oxidative kev nyuaj siab hauv cov neeg mob ntshav qab zib hemodialysis. Hauv kev sib tw, ob qhov muag tsis pom kev, cov tshuaj placebo-tswj crossover sim rau cov neeg mob nrog CKD, cov tshuaj synbiotics tau pom muaj txiaj ntsig zoo ntawm cov ntshav p-cresyl sulfate txo qis cuam tshuam nrog kev hloov pauv ntawm fecal microbiota. Txawm li cas los xij, kev tshawb fawb soj ntsuam luam tawm rau hnub no tsis muaj pov thawj muaj zog ntawm kev ua tau zoo ntawm pre- lossis probiotics hauv cov neeg mob CKD, tej zaum vim muaj cov kev tshawb fawb tsawg thiab cov qauv me me. Qhov tseem ceeb tshaj, tsis muaj kev nkag siab txog cov yam ntxwv ntawm dysbiosis uas muaj kev sib raug zoo nrog CKD yog qhov teeb meem tseem ceeb tshaj plaws hauv kev tshawb fawb kev txhais lus tsom rau microbiome. Interestingly, Lobel et al. Tsis ntev los no tau pom tias kev noj zaub mov noj uas ua rau muaj kev hloov pauv tom qab hloov pauv hauv microbial enzymes tuaj yeem cuam tshuam CKD kev loj hlob los ntawm kev tsim cov tshuaj uremic toxin yam tsis hloov pauv cov microbiome muaj pes tsawg leeg. Cov txiaj ntsig no qhia tias cov tswv yim kho mob tsom rau cov kab mob metabolites lossis txoj hauv kev metabolic yuav ua tau zoo dua li cov kev cuam tshuam rau cov zej zog microbiota. Muab hais tias ib lub cev loj ntawm cov pov thawj qhia qhov tseem ceeb ntawmcev-gutKev sib cuam tshuam hauv cov neeg mob nrog CKD, kev nkag siab zoo dua ntawm cov txheej txheem molecular hauv qabcev-gutcrosstalk, ntxiv kev txhim kho hauv microbiome tsom xam cov tswv yim, thiab txhim kho bioinformatics cov cuab yeej xav tau.
Lub plab hnyuv microbiota thiab mob raum raug mob
Tsis zoo li CKD, ob peb txoj kev tshawb fawb tau txheeb xyuas qhovcev-gutcrosstalk hauv mob raum raug mob (AKI). Hauv kev tshawb fawb tsis ntev los no los ntawm Yang et al., plab hnyuv dysbiosis, tus cwj pwm los ntawm kev nce hauv Enterobacteriaceae thiab txo qis hauv Lactobacilli thiab Ruminococcaceae, raug ntxias rau hnub 1 hauv nas ischemia / reperfusion raug mob (IRI) qauv. Tsis tas li ntawd, cov kws sau ntawv tau pom tias cov nas tsis muaj kab mob hloov nrog cov quav los ntawm IRI nas tau tsim muaj mob hnyav dua.mob raumpiv rau cov tswj. Cov txiaj ntsig no qhia tau tias tam sim ntawd hloov pauv hauvlub raum ua haujlwmlos yog raug mob txaus los ua rau dysbiosis nyob rau hauv lub sij hawm luv luv, thiab cov kev hloov hauv microbial muaj pes tsawg leeg yuav ua tau ib qho tseem ceeb hloov ntawm AKI. Hauv kev txhawb nqa ntawm cov kev tshawb pom no, cov kws sau ntawv kuj tau pom tias kev txo qis ntawm microbiota siv kev sib xyaw ua ke ntawm cov tshuaj tua kab mob tsis zoo ua ntej IRI txo qis kev raug mob postischemic. Hauv tib txoj kev tshawb fawb, cov kws sau ntawv tau qhia tiasraumIRI-induced dysbiosis yog txuam nrog cov plab hnyuv, hloov cov kab mob, thiab txo qis SCFA qib nrog rau kev ua kom muaj zog ntawm ob qho tib si hauv lub cev thiab kev tiv thaiv kab mob. Neutrophils thiab proinflammatory macrophages tau pom tias muaj nyob rau hauv lamina propria ntawm txoj hnyuv loj, thiab txoj kev Th17 tau pom tias yuav ua rau cov hnyuv. Microbial depletion ua rau inhibition ntawm Th17 activation thiab txo qis proinflammatory macrophage tsub zuj zuj hauv txoj hnyuv; tib lub sijhawm, nws nce qib ntawm kev tswj T hlwb thiab M2 macrophages hauv ob lub raum thiab cov hnyuv loj. Cov ntaub ntawv no qhia tau hais tias kev hloov pauv mucosal tiv thaiv kab mob cuam tshuam nrog dysbiosis yog ib qho tseem ceeb hauv lub raum-hlwb crosstalk hauv AKI. Tsis tas li ntawd, cov ntaub ntawv tseem qhia txog kev hloov pauv hauv microbiota thiab hauv kev tiv thaiv mucosal rau dysbiosis thiab kev hloov pauv hauv IRI-induced AKI, uas tuaj yeem ua rau lub raum raug mob ntxiv.
Lub plab-ob raum crosstalk hauv AKI tau txais kev txhawb nqa los ntawm ntau qhov kev tshawb fawb tsis ntev los no uas tau qhia txog cov teebmeem renoprotective ntawm probiotics lossis plab microbiota-derived metabolites. Lactobacillus salivarius BP121 tau pom tias txo qis cisplatin vimmob raumlos ntawm kev txo lub raum o, oxidative kev nyuaj siab, thiab qib ntshav ntawm uremic toxins. Ntawm cov plab hnyuv microbiota-derived metabolites, kev tswj hwm ntawm SCFAs (acetate, propionate, thiab butyrate) txo qis.mob raum,thiab cov teebmeem renoprotective ntawm cov molecules no tau txuam nrog nce autophagy, txo qhov mob, thiab txo oxidative kev nyuaj siab. Hauv kev tshawb fawb los ntawm Nakade li al., plab microbiota-derived D-serine tau pom tias txo qis tubular puas hauv AKI. Ua ke, cov ntaub ntawv no qhia tias lub plab microbiota tseem ceeb thiab tuaj yeem ua lub hom phiaj kho mob hauv AKI. Txawm li cas los xij, kev tshawb fawb ntxiv uas txhim kho peb txoj kev nkag siab ntawm lub raum-lub plab sib cuam tshuam yog tsim nyog los siv cov kev tshawb pom no hauv kev kho tib neeg AKI.
Intestinal microbiota thiab nephrolithiasis
Nephrolithiasis yog ib qho tshwm simkab mob raumtshaj tawm hauv 6.0 feem pua ntawm cov txiv neej thiab 1.8 feem pua ntawm cov poj niam nyob hauv Kaus Lim Kauslim. Qhov tshwm sim ntawm tus kab mob no nce kwv yees li peb npaug ntawm cov tib neeg uas muaj keeb kwm ntawm tus kab mob. Cov caj ces predisposition lossis ib puag ncig ib puag ncig sib koom los ntawm cov neeg hauv tsev tuaj yeem cuam tshuam cov kab mob pathophysiology. Cov concentrations ntawm urinary calcium, oxalate, phosphate thiab uric acid ua lub luag haujlwm tseem ceeb hauv kev tsim pob zeb, thiab cov pov thawj tshwm sim qhia tau tias muaj kev koom tes hauv plab / microbiome hauv pathogenesis ntawm nephrolithiasis. Oxalate, uas yog ib feem ntawm cov feem ntau homraumpob zeb, yog tawm los ntawm cov zis tom qab nqus hauv cov hnyuv. Tsis muaj cov kab mob commensal nrog oxalate-degrading kev ua haujlwm tau pom tias cuam tshuam nrog kev tsim pob zeb. Nyob rau hauv uric acid excretion, ib feem peb ntawm cov uric acid yog degraded los ntawm txoj hnyuv urinalysis, kuj qhia txog lub luag hauj lwm ntawm plab hnyuv microbiota nyob rau hauv lub pathogenesis ntawm uric acid pob zeb. Kev soj ntsuam tau pom tias tag nrho cov microbial muaj pes tsawg leeg hauv cov neeg mob lub raum pob zeb yog qhov sib txawv ntawm qhov kev tswj hwm kev noj qab haus huv, uas ntxiv txhawb cov hnyuv microbiota ua ib qho tseem ceeb hauv kev tsim pob zeb. Raws li kev tshuaj xyuas tsis ntev los no ntawm 25 cov kev tshawb fawb, kev nce hauv Enterobacteriaceae thiab Streptococaceae thiab txo qis hauv Prevotellaceae, Prevotella, thiab Roseburia yog cov yam ntxwv ntawm microbiota hauv cov neeg mob uas tsim pob zeb. Oxalobacter formigenes yog gram-negative, anaerobic kab mob uas degrade thiab, yog li ntawd, txo qhov nqus thiab tom qab tso zis ntawm oxalate, ua rau muaj peev xwm tiv thaiv calcium oxalate pob zeb tsim. Ib txoj kev tshawb xyuas cov ntaub ntawv uas 47 cov neeg mob uas muaj cov pob zeb calcium oxalate rov tshwm sim tau muab piv nrog 259 kev tswj tau pom tias colonization nrog O. formigenes txo qhov kev pheej hmoo ntawm cov pob zeb calcium oxalate rov qab los ntawm kwv yees li 70 feem pua. Txawm li cas los xij, txawm hais tias qhov kev tshawb fawb ua ntej tau ua nyob rau hauv cov qauv me me qhia tau hais tias ntxiv nrog O. formigenes txo qis cov zis lossis ntshav plasma oxalate, qhov kev sim tsis ntev los no rau cov neeg mob uas muaj thawj hyperoxaluria qhia tsis muaj txiaj ntsig ntawm O. formigenes supplementation.
Txawm hais tias ib hom kab mob microbial yuav tsis txaus txo qhov kev pheej hmoo ntawm kev pheej hmoo ntawm oxalate metabolism, kev sim kho mob ntawm microbiota modulation cov tswv yim, xws li kev kho mob nrog kev sib xyaw ntawm cov kab mob sib txawv, kev tswj kev noj zaub mov, thiab kev hloov fecal, tuav cov lus cog tseg, thiab lub plab hnyuv ib puag ncig tuaj yeem txiav txim siab. ib lub hom phiaj kho tshiab hauv nephrolithiasis.
Txoj hnyuv microbiota thiab hloov lub raum
Dysbiosis nyob rau hauv cov neeg mobCKDtau tshwm sim los ua ib qho tseem ceeb hauv kev mob o thiab ua rau mob plawv ntxiv. Txawm li cas los xij, xav txog cov kev kho mob nyuaj dua ntawm cov neeg tau txais kev hloov pauv, xws li kev txhim kho uremia, kev tswj hwm cov tshuaj tiv thaiv kab mob, thiab kev siv tshuaj tua kab mob ntau zaus, nkag siab txog lub luag haujlwm ntawm plab hnyuv microbiota thiab nws cov kev cuam tshuam nrog lub cev tiv thaiv kab mob lossis cov txiaj ntsig ntawm tus neeg mob ua rau muaj kev cuam tshuam loj heev. kev sib tw. Fricke et al. qhia txog kev hloov pauv loj hauv microbiota hauv cov neeg mob hauv thawj lub hlis tom qabKev hloov lub raum (KT)nyob rau hauv kev koom tes nrog kev txhim kho lub raum ua haujlwm raws li kev tswj hwm ntawm cov tshuaj tiv thaiv kab mob prophylactic thiab koob tshuaj tiv thaiv kab mob siab. Txawm li cas los xij, tsis tu ncua raug rau cov tshuaj tiv thaiv kab mob thiab ntau yam teeb meem tom qab hloov pauv tuaj yeem ua rau muaj kev hloov pauv loj hauv cov kab mob microbial.
Hauv KT cov neeg tau txais kev pab, qhov sib npaug ntawm kev ua kom lub cev tiv thaiv kab mob allogeneic thiab kev siv tshuaj tiv thaiv kab mob yog qhov tseem ceeb hauv kev txiav txim siab qhov tshwm sim ntawm graft. Yog li, xav txog lub luag haujlwm tseem ceeb ntawm lub cev tiv thaiv kab mob ntawm plab hnyuv microbiota thiab ntau lub cev tiv thaiv kab mob, nws muaj peev xwm hais tias kev hloov pauv ntawm tus lej thiab cov khoom sib xyaw ntawm microbiota tuaj yeem muaj kev cuam tshuam loj heev rau cov txiaj ntsig ntawm kev cog qoob loo suav nrog kev tsis lees txais kev hloov pauv thiab kev kis kab mob tom qab.
Lee et al. tau tshaj tawm tias muaj ntau ntawm Enterococcus hauv cov quav quav hauv qhov quav tau cuam tshuam nrog cov kab mob urinary, thiab tsis muaj Bacteroides, Ruminococcus, Copro-coccus, thiab Dorea tau cuam tshuam nrog kev hloov pauv hauv lub raum. Ntxiv nrog rau cov hnyuv microbiota, Diaz li al. tau ua pov thawj tias kev tswj hwm mus sij hawm ntev ntawm cov tshuaj tiv thaiv kab mob ua kom yooj yim rau lub qhov ncauj colonization ntawm cov kab mob kis tau zoo, ua rau muaj kev kis kab mob ntau ntxiv tom qab hloov chaw.
Lwm qhov kev soj ntsuam uas microbial nyob deb ntawm tus neeg pub dawb thiab tus neeg txais tau pom qhov cuam tshuam tsis zoo nrog rau 6- hli kwv yees glomerular filtration tus nqi, qhia tias txoj hnyuv microbiota zoo sib xws yuav cuam tshuam rau cov txiaj ntsig graft. Hauv tib txoj kev tshawb fawb, qhov tsis sib xws ntawm microbiota ntawm tus neeg pub dawb thiab tus neeg txais tau cuam tshuam nrog kev nce ntxiv tom qab kis tus kab mob. Tsis tas li ntawd, qee yam kab mob microbial tau pom tias cuam tshuam rau cov ntshav ntawm cov tshuaj tiv thaiv kab mob los ntawm kev hloov tshuaj pharmacokinetics, uas yuav piav qhia txog qhov sib txawv ntawm tus kheej hauv tacrolimus koob tshuaj kom ua tiav cov txiaj ntsig kho mob. Lub xub ntiag ntawm qee hom kab mob hauv microbiota ua ntej KT tau tshaj tawm tias muaj feem cuam tshuam nrog kev tsis lees paub tom ntej, qhia txog lub luag haujlwm ua tau rau microbiota hauv kev tiv thaiv kab mob. Txawm li cas los xij, txawm tias muaj pov thawj loj hlob tuaj, qhov cuam tshuam los ntawm cov zej zog microbial ntawm kev tiv thaiv kab mob, kev tsis lees paub, lossis cov tshuaj pharmacokinetics tseem tsis paub ntau. Cov kev tshawb fawb yav tom ntej uas ntsuas qhov cuam tshuam ntawm kev hloov pauv ntev hauv tib neeg thiab lub luag haujlwm ntawm cov kab mob tshwj xeeb hauv cov pej xeem loj yuav pab qhia lub luag haujlwm ntawm microbiota hauv KT.
Cov lus xaus
Kev nce qib hauv high-throughput sequencing thev naus laus zis tau muab kev nkag siab tsis tau pom dua rau hauv cov zej zog microbial complex ntawm ntau qhov chaw mucosal. Zoo ib yam li ob peb lwm yam mob metabolic thiab mob ntev xws li ntshav qab zib, rog rog, lossis mob caj dab rheumatoid, cov ntaub ntawv tawm tshiab tau pom tias kev hloov pauv ntawm plab hnyuv microbiota cuam tshuam nrog ntau yam.kab mob raum. Dysbiosis thiab cuam tshuam txog kev ua haujlwm tsis zoo, kev hloov pauv ntawm cov kab mob, thiab hloov pauv lub cev tiv thaiv kab mob tau pom tias ua lub luag haujlwm tseem ceeb hauv AKI thiab CKD. Ntau hom kab mob uas koom nrog hauv kev degradation ntawm oxalate tau pom tias cuam tshuam nrog oxalate pob zeb tsim, thiab cov kev tshawb fawb tsis ntev los no kuj qhia tias muaj kev cuam tshuam ntau dua ntawm microbiota thiabraumnyob rau hauv trans plantation tau txais (Fig. 1). Txawm li cas los xij, ntau ntawm cov kev tshawb fawb no tsuas yog qhia txog kev sib raug zoo, thiab kev sib raug zoo ntawm kev sib raug zoo tseem tsis meej. Txhawm rau txhim kho microbiota-targeted therapeu tics, kev tshawb fawb ntxiv txog kev tshem tawm cov txheej txheem hauv qab ntawm kev hloov pauv ntawm microbiota, metabolites, thiab lawv qhov cuam tshuam rau cov kab mob pathogenesis xav tau.
Txawm hais tias tau cog lus cov ntaub ntawv los ntawm ntau qhov kev sim tshuaj ntsuam xyuas cov txiaj ntsig ntawm pre-, pro-, thiab synbiotics hauv ntau yam.kab mob raum,lawv tau muab los ntawm cov kev tshawb fawb uas tau tso npe rau cov neeg mob tsawg xwb; kuj, cov txiaj ntsig tsis sib xws thiab txwv. Ntau yam xws li cov yam ntxwv ntawm tus kheej caj ces, haiv neeg, thiab ib puag ncig cuam tshuam cuam tshuam kev sib cuam tshuam ntawm cov zej zog microbial thiab tus tswv tsev, thiab tsom mus rau ib lub zej zog microbial yuav tsis muaj kev tswj hwm txaus ntawm cov tswv tsev thiab kev sib cuam tshuam microbial.
Txawm li cas los xij, microbiota ntawm qhov chaw mucosal yog qhov tsis paub dhau los uas tuaj yeem hloov kho pathogenesis thiab cov txiaj ntsig ntawm ntau yam.kab mob raum.Kev nkag siab zoo dua ntawm cov txheej txheem molecular txuas txuas hloov pauv microbiota thiab nws cov lus sib tham nrog cov tswv, nrog rau cov qauv tsiaj zoo dua qub thiab cov tswv yim tshuaj ntsuam xyuas, yuav tsum tau tsim los pab txhawb kev txhais cov kev tshawb pom no rau tib neeg.
Kev tsis sib haum xeeb
Txhua tus kws sau ntawv tsis muaj teeb meem ntawm kev txaus siab los tshaj tawm.
Nyiaj txiag
Txoj haujlwm no tau txais kev txhawb nqa los ntawm Kev Tshawb Fawb Kev Tshawb Fawb Txog Kev Tshawb Fawb los ntawm National Research Foundation ntawm Kaus Lim Kauslim tau nyiaj los ntawm Ministry of Education (2017R1A2B1002734).
Cov neeg sau ntawv pab txhawb
Conceptualization: MGK, SKJ
Sau ntawv-thawj tsab ntawv: MGK, SKJ
Sau- tshuaj xyuas & kho: Txhua tus kws sau ntawv
Txhua tus kws sau ntawv tau nyeem thiab pom zoo cov ntawv sau kawg.
Cov ntaub ntawv
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Nug cov ntaub ntawv ntxiv:david.deng@wecistanche.com