英研究找到抑制艰难梭菌菌群 可避免“粪便移植”尴尬
plospathogens · 2012/10/29
英国桑格研究所等机构研究人员找到了粪便移植疗法背后的有用菌群,将来有望在此基础上开发出使用这些混合菌群的标准疗法,从而为病人消除疾患的同时避免“粪便移植”的尴尬。

医疗中有一些难以避免的尴尬事,比如有时需要让病人摄入别人的粪便来治病。英国一项最新研究找到了这种疗法所使用的菌群,有望为病人消除疾患的同时避免尴尬。

粪便治病的医学称谓是粪便移植,可用于治疗艰难梭菌感染。许多人肠道中都存在艰难梭菌,平时由于肠道中大量细菌互相制约,它不会引发什么问题。但在某些时候,比如患者服用抗生素导致其他细菌大量死亡时,艰难梭菌就会在肠道中过度繁殖,导致腹痛、腹泻等症状。每年仅在美国和欧洲就有10万人死于此种病菌。

由于目前许多抗生素都对付不了艰难梭菌,只好采用粪便移植的方法,即让一名身体健康者提供粪便,经处理后从食道或直肠送入病人肠道系统中。这些粪便提取物中含有正常的肠道菌群,它们可以抑制过度繁殖的艰难梭菌。虽然这种方法确有疗效,但人们显然很难接受这种疗法。

纽约勃兰特医生诊所中,医生正在给患者进行粪便移植。患者看起来很痛苦,但是粪便移植在治愈艰难梭菌方面有着高达91%的成功率。

英国桑格研究所等机构研究人员在新一期《科学公共图书馆病原卷》杂志上报告说,他们用粪便移植的方法治疗了受艰难梭菌感染的实验鼠,然后仔细分析了粪便中起作用的细菌种类,最终确定6种细菌,它们的混合作用可以抑制艰难梭菌。

进行研究的戈登·杜根教授说,这项成果找到了粪便移植疗法背后的有用菌群,将来有望在此基础上开发出使用这些混合菌群的标准疗法,帮助病人避免直接摄入粪便的尴尬。

Targeted Restoration of the Intestinal Microbiota with a Simple, Defined Bacteriotherapy Resolves Relapsing Clostridium difficile Disease in Mice

Trevor D. Lawley, Simon Clare, Alan W. Walker, Mark D. Stares, Thomas R. Connor, Claire Raisen, David Goulding, Roland Rad, Fernanda Schreiber, Cordelia Brandt, Laura J. Deakin, Derek J. Pickard, Sylvia H. Duncan, Harry J. Flint, Taane G. Clark, Julian Parkhill, Gordon Dougan

Relapsing C. difficile disease in humans is linked to a pathological imbalance within the intestinal microbiota, termed dysbiosis, which remains poorly understood. We show that mice infected with epidemic C. difficile (genotype 027/BI) develop highly contagious, chronic intestinal disease and persistent dysbiosis characterized by a distinct, simplified microbiota containing opportunistic pathogens and altered metabolite production. Chronic C. difficile 027/BI infection was refractory to vancomycin treatment leading to relapsing disease. In contrast, treatment of C. difficile 027/BI infected mice with feces from healthy mice rapidly restored a diverse, healthy microbiota and resolved C. difficile disease and contagiousness. We used this model to identify a simple mixture of six phylogenetically diverse intestinal bacteria, including novel species, which can re-establish a health-associated microbiota and clear C. difficile 027/BI infection from mice. Thus, targeting a dysbiotic microbiota with a defined mixture of phylogenetically diverse bacteria can trigger major shifts in the microbial community structure that displaces C. difficile and, as a result, resolves disease and contagiousness. Further, we demonstrate a rational approach to harness the therapeutic potential of health-associated microbial communities to treat C. difficile disease and potentially other forms of intestinal dysbiosis.

文献连接:Targeted Restoration of the Intestinal Microbiota with a Simple, Defined Bacteriotherapy Resolves Relapsing Clostridium difficile Disease in Mice

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