Mucosal flora in inflammatory bowel disease
Mucosal flora in inflammatory bowel disease
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DOI：
10.1053/gast.2002.30294
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发表时间：
2002-01-01
期刊：
影响因子：
29.4
通讯作者：
Lochs, H
中科院分区：
文献类型：
--
作者：
Swidsinski, A;Ladhoff, A;Lochs, H
背景与目的：直接与肠粘膜相互作用的微生物被粪便菌群遮蔽，且特征不佳。方法：对305例肠炎患者和40例正常对照的肠镜活检标本进行肠道菌群检测。通过定量聚合酶链式反应、随后的克隆和测序、荧光原位杂交和电子显微镜对微生物培养物进行验证。结果：我们在肠炎患者中发现了高浓度的粘膜细菌，但在对照组中没有发现。无论是发炎的结肠还是非发炎的结肠，粘膜细菌的浓度都随着疾病的严重程度而递增。在>；10,000 cfu/Mul的患者中，一条厚厚的细菌带附着在完整的黏膜上，没有移位的迹象，炎症性肠病(IBD)患者和粘膜细菌浓度>；50,000 cfu/mul的患者在固有层旁边的孤立肠细胞内有多个多态细菌的特征包涵体，没有或没有与粪便流接触。经鉴定的细菌来自粪便。结论：我们的发现表明IBD黏膜菌群的改变不是继发于炎症，而是特定宿主反应的结果。我们假设，健康的粘膜能够抑制粪便细菌，这一功能在IBD患者中受到严重干扰。
Background & Aims: Microorganisms that directly interact with the intestinal mucosa are obscured by fecal flora and poorly characterized. Methods: We investigated the mucosal flora of washed colonoscopic biopsies of 305 patients with bowel inflammation and 40 controls. The microbial cultures were validated by quantitative polymerase chain reaction with subsequent cloning and sequencing, fluorescence in-situ hybridization, and electron microscopy. Results: We found high concentrations of mucosal bacteria in patients with bowel inflammation, but not in controls. The concentrations of mucosal bacteria increased progressively with the severity of disease, both in inflamed and non-inflamed colon. In patients with >10,000 cfu/muL, a thick bacterial band was attached to the intact mucosa without signs of translocation, Patients with inflammatory bowel disease (IBD) and concentrations of mucosal bacteria >50,000 cfu/muL had characteristic inclusions of multiple polymorphic bacteria within solitary enterocytes located next to the lamina propria, without or having no contact with the fecal stream. The identified bacteria were of fecal origin. Conclusions: Our findings suggest that the changes in the mucosal flora in IBD are not secondary to inflammation, but a result of a specific host response. We hypothesize that the healthy mucosa is capable of holding back fecal bacteria and that this function is profoundly disturbed in patients with IBD.