LUB SIJ HAWM MICROBIOME HAUJ LWM HAUJ LWM HAUJ LWM HAUV BARIATRIC SurgeRY: A SYSTEMATIC REVIEWⅡ

Peb tau txheeb xyuas 28 kab lus hais txog kev soj ntsuam kev tshawb fawb lossis kev tshuaj xyuas cov ntaub ntawv raws li lawv cov yam ntxwv tseem ceeb, 82% (n=23) ntawm cov uas cuam tshuam txog kev tshawb fawb rov qab. Cov piv txwv ntawm cov kev tshawb fawb muaj li ntawm 9 mus rau 257 tus neeg koom thiab/orfecal kuaj. Cov kab mob sib kis tau pom tias muaj kev rog ntau dua hauv cov poj niam, xws li 24.4 txog 35.1%, nrog rau lub hnub nyoog nruab nrab ntawm 25-40 xyoo.Txhua cov lus xaiv tau nthuav tawm kev sib raug zoo ntawm IM hauv kev rog thiab nws qhov kev hloov pauv tom qab phais bariatric. Muaj qhov sib txawv ntawm hom kev phais mob bariatric, migrating ntawm RYGB, adjustable gastric banding, thiab verticalgastrectomy (VG). Ntawm 28 txoj kev tshawb fawb, 6 ntawm lawv tau soj ntsuam cov gutmicrobiota ntawm cov neeg rog rog uas raug phais bariatric thiab lawv kev sib raug zoo nrog DM2 / glucose metabolism / insulin tsis kam.

Nyem rau cov tshuaj hauv tsev rau cem quav

Tsib qhov kev tshawb fawb pom tau hais tias qhov tseem ceeb ntawm kev tsom xam fecal (metabolome) thiab noob caj noob ces, nrog rau epigenetics, rau yav tom ntej kev txhawb nqa los txhim kho lub plab microbiota hauv kev rog, xws li kev hloov pauv hauv fecal. Ib qho ntawm cov kab lus no kuj tau ua rau muaj kev sib raug zoo ntawm cov kab mob ua pa, xws li mob hawb pob, thiab kev rog dhau. Lwm txoj kev tshawb fawb tau soj ntsuam qhov tseem ceeb ntawm probiotics hauv microbiota tom qab kev phais mob, nrog rau nws txoj kev koom tes nrog saj thiab kev cuam tshuam ntawm qhov chaw mos microbiota. Ib qho ntawm cov kab lus tau tsa kev sib raug zoo ntawm IM nrog kev paub txog kev ua haujlwm thiab kev hloov pauv tom qab kev phais mob phais 1,25.Thaum kawg, peb muaj ib tsab xov xwm uas ntsuas qhov sib raug zoo ntawm IM thiab cov kua tsib acids hauv cov kab mob uas tsis yog-coholic fatty siab (NAFLD) thiab nws qhov thim rov qab tom qab kev phais bariatric.

Lub plab zom mov ua rau thaj tsam loj tshaj plaws ntawm tib neeg lub cev, nrog qhov loj ntawm kwv yees li 30-40 m², thiab nws yog qhov tshwj xeeb raug rau ib puag ncig xws li kev noj zaub mov, tshuaj tua kab mob, kab mob, thiab lwm yam kev ua neej xws li lub cev ua haujlwm 1. Tib neeg lub plab harbors kwv yees li 100 trillionmicrobes, uas muaj ntau yam physiological thiab biochemicalfunctions nyob rau hauv tib neeg lub cev14,16. Tus IM txawv ntawm ib tus neeg mus rau lwm tus vim tias nws txoj kev colonization pib thaum yug los thiab muaj peb theem: txij thaum yug mus txog rau kev txiav, los ntawm weaning mus rau neeg laus, thiab hnub nyoog laus.

Cov mis nyuj yog dawb ntawm cov kab mob, tab sis tsis ntev tom qab yug me nyuam, txoj hnyuv pib muaj neeg vim muaj kev cuam tshuam rau endogenous thiab exogenous. Thaum thawj 12-24 teev, cov kab mob tseem ceeb yog facultative anaerobes xws li Escherichiacoli, Enterococcus, thiab Streptococcus, uas yuav txhawb nqa lawv txoj kev loj hlob. Ib qho kev txiav txim siab tseem ceeb ntawm txoj kev loj hlob ntawm IM yog kev pub mis rau menyuam mos, txij li thaum kawg ntawm kev pub niam mis tshwj xeeb thiab kev qhia txog cov khoom noj khoom haus, muaj ntau qhov sib txawv ntawm cov kab mob, uas yuav ua rau cov neeg laus microbiota.Qhov microbiota tseem nyob ruaj khov yog tias tsis muaj kev hloov pauv hauv cov chaw noj mov. , kab mob pib, lossis noj tshuaj tua kab mob.

Bifidobacteriumand Clostridium kab mob muaj ntau dua nyob rau hauv cov menyuam yaus thiab cov hluas piv rau cov neeg laus, thaum nyob rau hauv cov neeg laus, lawv cov kev sawv cev qis dua 1,13.Cov IM ua haujlwm raws li lub cev ntawm tib neeg lub cev, uas muaj ntau yam kev ua haujlwm tuaj yeem raug kev hloov pauv yog tias tsis noj zaub mov kom raug 14,16,17.Nws lub ntsiab Cov kev ua ub no muaj feem xyuam nrog kev tiv thaiv kab mob, pab hauv plab hnyuv teeb meem, metabolism, kev nqus cov vitamins, kev tiv thaiv kab mob, thiab dehydroxylation ntawm cov kua tsib acid. Thaum muaj kev noj tsis txaus ntawm cov khoom noj niaj hnub niaj hnub ua tiav hauv Western, cov haujlwm no cuam tshuam, txo qis qhov kev siv ntawm lub plab microbiome. Hauv qhov sib piv, cov khoom noj muaj fiber ntau thiab ntuj pab nws txoj kev loj hlob zoo thiab muaj ntau haiv neeg.

IM yog tsim los ntawm tsib yam phyla uas feem ntau colonize txoj hnyuv loj, nrog txog 90% ntawm cov kab mob uas yog cov phyla Firmicutes (Bacillus spp.) thiab Bacteroidetes (Bacteroides spp.). Kuj tseem muaj qhov sawv cev ntawm lwm cov phyla xws li Actinobacteria (Bifidobacterium spp.), Proteobacteria (Escherichia, Helicobacter), thiab Verrucomicrobia (Akkermansia spp.) 1,14,16,25.Nws paub tias qhov profile ntawm IM hauv rog thiab noj qab nyob zoo tus neeg yog divergent. Cov neeg rog rog feem ntau muaj cov kab mob microbiota cuam tshuam nrog kev txo qis hauv Bacteroidetes thiab nce hauv Firmicutes, tab sis qee qhov kev tshawb fawb hauv tib neeg tau pom qhov sib piv, qhia tias FirmicutesBacteroidetes piv yuav nce ntxiv. Tsawg MGR hauv cov neeg rog rog yog txuam nrog cov kab mob metabolic, o, thiab insulin tsis kam16,17. IM tuaj yeem ua rau rog rog hauv qee txoj kev. Nws cov kab mob koom nrog hauv kev tswj hwm thiab muaj peev xwm ua cov khoom noj uas tsis yog digestible polysaccharides los ntawm kev noj zaub mov, cuam tshuam txoj hnyuv nqus ntawm cov saw luv fattyacids (SCFAs).

Ib yam li ntawd, muaj kev tswj hwm tsis ua haujlwm ntawm cov carbohydrate metabolic txoj hauv kev ntawm fructose thiab mannose, galactose, starch, thiab sucrose. Lwm qhov tshwj xeeb yuav yog txoj kev tswj hwm noob nyob qhov twg, raws li cov kab mob uas muaj nyob rau ntawd, muaj kev txhawb nqa ntawm cov ntaub so ntswg inadipose (AT) 12,15. Nyob rau hauv cov ntsiab lus, nyob rau hauv kev rog, tej zaum yuav muaj anincrease los yog txo nyob rau hauv cov kab mob phyla, ua rau ib tug kev hloov nyob rau hauv kev sib raug zoo ntawm Firmicutes thiab Bacteroidetes, ua rau lawv ntau haiv neeg yuav tsum qis dua nyob rau hauv sib piv rau cov tib neeg nyob rau hauv lub hom phiaj qhov hnyav.Raws li Abenavoli li al., tag nrho cov carbohydrate thiab starch. Cov txheej txheem metabolic tau ua kom muaj txiaj ntsig zoo hauv obesemicrobiome.

Tsis tas li ntawd, nyob rau hauv qhov kev soj ntsuam no, ntau cov noob muaj feem xyuam rau lipopolysaccharide (LPS) biosynthesis thiab peptidoglycan biosynthesis tau siab dua, thiab qhov kev tshawb pom no tuaj yeem cuam tshuam rau qib siab ntawm cov kab mob cytokines xws li IL-6 thiab TNF-beta tam sim no hauv kev rog rog1. Thaum kawg, txoj hauv kev hais txog cov amino acid metabolism uas muaj phenylalanine, tyrosine, thiab tryptophan biosynthesis thiab modules ntawm glutamine / glutamate thauj system tau siab dua piv rau cov neeg hauv pawg tswj hwm ntawm cov neeg noj qab haus huv15.Butyrate-ua cov kab mob muaj ntau dua cov neeg tsis rog, sib piv rau cov amino acid glycine, uas txo qis. Kev nce qib glycine muaj feem cuam tshuam nrog kev txhim kho HbA1c, thiab acetyl-glycine tau cuam tshuam nrog kev txo qis ntawm kev tsim DM2. Cov kab mob kab mob Bacteroidesthetaiotaomicron cuam tshuam tus tswv tsev adiposity thiab metabolism, yog li nws depletion yog txuam nrog rog thiab serumamino acid concentration.

Thaum muab piv rau cov tib neeg noj qab haus huv thiab rog, ib tus tuaj yeem nco txog qhov sib txawv ntawm cov metabolites tau los ntawm cov kab mob hauv plab, xws li kev tsim cov tshuaj tsw qab amino acids (AAA) thiab branched-chainamino acids (BCAA). Hauv microbiota ntawm cov tib neeg rog rog, cov ntshav concentration ntawm phenylalanine, tyrosine, leucine, isoleucine, thiab valine yog qhov tseem ceeb siab dua 15.Nyob rau hauv cov ntsiab lus, microbial by-products (SCFAs) yog tsim nyob rau hauv lub plab thiab hla lub plab hnyuv teeb meem, mus txog ntawm cov ntshav ncig mus txog rau lawv mus txog lub hlwb. Cov byproducts tswj hla cov ntshav-hlwb teeb meem kom txog rau thaum lawv mus txog lub hypothalamus, lub chaw tswj kev qab los noj mov thiab cov txheej txheem metabolic. Yog li ntawd, cov kab mob Enterococcus, piv txwv li, thaum fermenting noj fiber ntau, ua rau qee yam SCFAs uas cuam tshuam ncaj qha rau qhov txo qis hauv qab los noj mov. Yog li, kev sib txuas lus ncaj qha yog tsim los ntawm lub plab thiab lub hlwb.

Kev rog rog yog qib qis tab sis tus kab mob mob ntev nrog AT puas. Inflammation koom ncaj qha rau hauv txoj kev loj hlob ntawm cov teeb meem vim qhov loj ntawm adipocytesinfluences zus tau tej cov inflammatory cytokines andchemokines, uas recruit pro-inflammatory hlwb nyob rau hauv lubAT.

Yog li, hauv kev rog rog hnyav, qhov muaj feem ntau (75% ntawm cov neeg mob) txo qis fecal microbiota thiab MGR tshwm sim 6,7.Ib qho tseem ceeb hauv kev hloov kho MGR, thiab ib qho uas tuaj yeem ua rau muaj ntau haiv neeg, yog kev noj zaub mov ntawm tus neeg. Hauv kev rog rog, txoj hnyuv yog tus cwj pwm los ntawm ntau dua permeability, ua kom cov kab mob kis tau los ntawm txoj hnyuv thiab poob rau hauv cov hlab ntsha, thiab qhov no yuav cuam tshuam rau hauv plab hnyuv dysbiosis, permeability, o, thiab rog. Yog li, cov kev tshawb fawb qhia tias plab hnyuv dysbiosis tau txheeb xyuas qhov hnyav thiab. kev rog dhau, uas ua rau muaj kev cuam tshuam ntau ntxiv hauv lub cev qhov hnyav (BMI); qhov mob zuj zus tuaj yog txuam nrog kev hloov pauv hauv cov metabolism, xws li insulin tsis kam, qis qis qis, thiab hypertrophy ntawm adipocytes6-8,12.Abenavoli li al. Ua ib qho kev soj ntsuam nrog cov nas nyob rau hauv uas ob lub tswv yim uas cov microbiota tuaj yeem ua rau pom kev rog dhau:

1. Kev tswj hwm lub zog thiab lub peev xwm los ua cov txheej txheem nondigestibledietary polysaccharides, ua rau muaj zog plab hnyuv nqus ntawm SCFAs thiab

2. los ntawm kev tswj cov noob, txhawb kom muaj roj cia hauv AT

Los ntawm qhov no, nws tau pom tias microbiota ntawm obeseindividuals muaj txiaj ntsig zoo dua hauv kev rho tawm ntawm lub zog los ntawm cov zaub mov thaum piv rau cov neeg tsis noj nqaij1. Tsis tas li ntawd, kev tshuaj xyuas ntawm qhov muaj pes tsawg leeg thiab qhov nyuaj ntawm lub plab microbiotais tseem ceeb rau kev koom nrog IM kos npe nrog cov kab mob hauv tsev. Ob txoj hauv kev tseem ceeb yog kev txheeb xyuas metagenomic ntawm randomDNA fragment sequencing (Shotgun) thiab 16S ribosomal RNAgene amplicon sequencing16. Tsis tas li ntawd, los ntawm kev tshuaj xyuas ntawm fecal microbiome ntawm 1,126 ntxaib khub, kev sib raug zoo ntawm microbiota thiab cov khoom qub txeeg qub teg ntawm IM tau soj ntsuam. Cov menyuam ntxaib tau sib raug zoo dua li ntawm fraternaltwins thiab tau pom hauv lwm cov txheeb ze ze.

Themicroorganisms lawv tus kheej pab txhawb rau shaping muaj pes tsawg leeg los ntawm kev tso tawm ntawm peptides thiab tswj molecules uas cuam tshuam cov metabolic profile ntawm tus tswv tsev. Txhawm rau txheeb xyuas qhov cuam tshuam ntawm cov noob caj noob ces thiab ntsuas kev sib raug zoo ntawm microbial cuam tshuam nrog cov txheej txheem metabolic, microbiota ntawm cov neeg mob Crohn's disease (CD) tau kawm hauv cov txheeb ze (niam txiv, ntxaib, thiab cov kwv tij tsis yog ntxaib) siv DNA ntiv tes. Dysbiosis tau tshwm sim hauv cov neeg mob ntxaib nrog CD thiab tsis tuaj ntawm cov txheeb ze yam tsis muaj tus kab mob, txawm tias lawv cov cuab yeej cuab tam caj ces tau sib koom. Raws li qhov tshwm sim, nws tau pom tias plab hnyuv colonization los ntawm microbiotaresults hauv kev hloov pauv hauv cov hnyuv.

Ntuj Herbal Tshuaj Rau Relieving cem quav-Cistanche

Cistanche yog ib tug genus ntawm parasitic nroj tsuag uas belongs rau tsev neeg Orobanchaceae. Cov nroj tsuag no paub txog lawv cov khoom siv tshuaj thiab tau siv hauv Cov Tshuaj Suav Tshuaj (TCM) rau ntau pua xyoo. Cov hom Cistanche feem ntau pom muaj nyob hauv thaj av qhuav thiab suab puam ntawm Tuam Tshoj, Mongolia, thiab lwm qhov chaw ntawm Central Asia. Cistanche nroj tsuag yog tus cwj pwm los ntawm lawv cov nqaij tawv, yellowish stems thiab muaj nuj nqis heev rau lawv cov txiaj ntsig kev noj qab haus huv. Hauv TCM, Cistanche ntseeg tau tias muaj cov khoom siv tonic thiab feem ntau yog siv los kho lub raum, txhim kho qhov tseem ceeb, thiab txhawb kev ua haujlwm ntawm kev sib deev. Nws kuj yog siv los daws cov teeb meem ntsig txog kev laus, qaug zog, thiab kev noj qab haus huv tag nrho. Thaum Cistanche muaj keeb kwm ntev ntawm kev siv tshuaj ib txwm siv, kev tshawb fawb tshawb fawb txog nws txoj kev ua tau zoo thiab kev nyab xeeb yog tsis tu ncua thiab txwv. Txawm li cas los xij, nws paub tias muaj ntau yam bioactive tebchaw xws li phenylethanoid glycosides, iridoids, lignans, thiab polysaccharides, uas tuaj yeem ua rau nws cov teebmeem tshuaj.

Wecistanche's cistanche hmoov, cistanche ntsiav tshuaj, cistanche tsiav tshuaj, thiab lwm yam khoom yog tsim los siv suab puam cistanche raws li raw cov ntaub ntawv, tag nrho cov uas muaj ib tug zoo ntxim rau relieving cem quav. Cov txheej txheem tshwj xeeb yog raws li hauv qab no: Cistanche ntseeg tau tias muaj cov txiaj ntsig zoo rau kev tshem tawm cem quav raws li nws cov kev siv ib txwm siv thiab qee cov tshuaj uas nws muaj. Txawm hais tias kev tshawb fawb tshawb fawb tshwj xeeb ntawm Cistanche qhov cuam tshuam rau cem quav yog txwv, nws tau xav tias muaj ntau lub tswv yim uas yuav ua rau nws muaj peev xwm txo tau cem quav. Laxative nyhuv: Cistanche tau ntev tau siv nyob rau hauv Tsoos Suav Tshuaj raws li ib tug tshuaj rau cem quav. Nws ntseeg tau tias muaj cov nyhuv laxative me me, uas tuaj yeem pab txhawb kev zom zaub mov thiab ua rau cem quav. Cov nyhuv no tuaj yeem raug ntaus nqi rau ntau lub tebchaw nyob hauv Cistanche, xws li phenylethanoid glycosides thiab polysaccharides. Moistening cov hnyuv: Raws li kev siv ib txwm siv, Cistanche suav hais tias muaj cov khoom siv moisturizing, tshwj xeeb yog tsom rau cov hnyuv. Txhawb nqa dej thiab lubrication ntawm cov hnyuv yuav pab tau cov cuab yeej soften thiab yooj yim dua, yog li no relieving cem quav. Anti-inflammatory Effect: cem quav tej zaum yuav txuam nrog o nyob rau hauv lub plab zom mov. Cistanche muaj qee qhov sib txuas, suav nrog phenylethanoid glycosides thiab lignans, uas ntseeg tau tias muaj cov tshuaj tiv thaiv kab mob. Los ntawm kev txo cov kab mob hauv cov hnyuv, nws tuaj yeem pab txhim kho kev zom zaub mov tsis tu ncua thiab txo qhov cem quav.