7 alpha-dehydroxylating bacteria enhance deoxycholic acid input and cholesterol saturation of bile in patients with gallstones
7 alpha-dehydroxylating bacteria enhance deoxycholic acid input and cholesterol saturation of bile in patients with gallstones
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DOI：
10.1016/s0016-5085(96)70024-0
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发表时间：
1996-12-01
期刊：
影响因子：
29.4
通讯作者：
Hylemon, PB
中科院分区：
文献类型：
--
作者：
Berr, F;KullakUblick, GA;Hylemon, PB
背景和目的：胆汁酸池中脱氧胆酸（DCA）过多且胆汁中胆固醇过饱和在胆胆固醇结石（CG）患者中很常见，本研究检查了这是否是由肠道细菌增强胆酸（CA）转化为DCA引起的，方法：10名具有DCA过量CG的患者（DCA/CA池比率，> 1.5）和10名低DCA患者（比率，（1.0））比较了 CA 和 DCA 动力学、75-Se-同牛磺胆酸 (75-SeHCAT) 的回肠吸收以及粪便微生物区系的 CA-7 α-脱羟基活性；在 7 名患者中研究了氨苄西林治疗对 DCA 过量的影响，结果：DCA 过量和低 DCA 患者的 CA 池大小（平均值为 5.8 对 34）和 DCA 存在差异 (P < 0.01) (28 vs. 11 mu mol/kg) 和 DCA 输入量 (8.8 vs. 3.5 mu mol.kg(-1).day(-1))，虽然 75-SeHCAT 排泄量相似，但 DCA 过量患者的 CA-7 α 脱羟基活性和粪便 7 α 脱羟基细菌水平分别高出 3 倍和 1000 倍 (P < 0.01)。氨苄青霉素治疗可降低 (P < 0.02) CA-7 α-脱羟基活性和 DCA 池大小，将 CA 池扩大至正常大小，并降低胆汁胆固醇饱和度。 结论：肠道菌群 CA-7 α-脱羟基活性增加可能是这些患者 CG 形成或生长的重要因素。
Background & Aims: Excessive deoxycholic acid (DCA) in the bile acid pool with cholesterol supersaturation of bile is prevalent in patients with cholesterol gallstones (CGs), This study examined whether this is caused by enhanced conversion of cholic acid (CA) to DCA by intestinal bacteria, Methods: Ten patients with CGs with DCA excess (DCA/CA pool ratio, >1.5) and 10 patients with low DCA (ratio, (1.0) were compared for CA and DCA kinetics, ileal absorption of 75-Se-hometaurocholic acid (75-SeHCAT), and CA-7 alpha-dehydroxylation activity of the fecal microflora; the effects of ampicillin treatment on DCA excess were studied in 7 patients, Results: Patients with DCA excess and low DCA differed (P < 0.01) in the pool size of CA (mean, 5.8 vs. 34) and DCA (28 vs. 11 mu mol/kg) and DCA input (8.8 vs, 3.5 mu mol . kg(-1). day(-1)), Whereas 75-SeHCAT excretion was similar, CA-7 alpha-dehydroxylation activity and levels of fecal 7 alpha-dehydroxylating bacteria were 3-fold and 1000-fold higher (P < 0.01) in patients with DCA excess, respectively. Ampicillin treatment decreased (P < 0.02) CA-7 alpha-dehydroxylation activity and DCA pool size, expanded the CA pool to normal size, and lowered cholesterol saturation of bile. Conclusions: Increased CA-7 alpha-dehydroxylation activity of the intestinal microflora may be an important factor for CG formation or growth in these patients.