Beneficial Effect of Alcohol Withdrawal on Gut Permeability and Microbial Translocation in Patients with Alcohol Use Disorder
Beneficial Effect of Alcohol Withdrawal on Gut Permeability and Microbial Translocation in Patients with Alcohol Use Disorder
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DOI：
10.1111/acer.13527
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发表时间：
2018-01-01
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影响因子：
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通讯作者：
Dunyach-Remy, Catherine
中科院分区：
文献类型：
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作者：
Donnadieu-Rigole, Helene;Pansu, Nathalie;Dunyach-Remy, Catherine
背景人类肠道微生物群在多种疾病中发挥有益或有害的作用。许多因素，包括饮酒，可能会影响其成分并引发细菌移位。过量饮酒会增加肠道通透性和内毒素转移到外周循环中。尽管经常测量血浆内毒素浓度，但从未描述过酒精使用障碍（AUD）受试者戒酒后的定量变化。本研究的目的是测量 AUD 患者的微生物易位 (MT) 和肠道通透性标志物，将这些标志物与健康对照 (HC) 进行比较，并监测戒酒前 6 周期间的标志物。 方法 纳入 65 名因戒酒而住院的 AUD 患者。收集了流行病学、临床、生物学和成瘾学数据。在基线时采集血样，然后在戒酒后 3 周和 6 周采集血样。一百名健康志愿者被用作对照。监测血浆样本中 MT 的三个标志物：使用 ELISA 定量 sCD14 和脂多糖结合蛋白 (LBP)，使用实时聚合酶链式反应定量 16S rDNA。还使用 ELISA 监测连蛋白和肠脂肪酸结合蛋白 (I-FABP) 的血液水平，作为肠道通透性的间接标志物。结果在基线时，AUD 患者的 LBP、16S rDNA、sCD14 和 I-FABP 标志物显着高于 HC 患者。戒酒六周后，血浆 sCD14 和 LBP 水平显着下降。戒酒前的大麻消耗量和体重指数 (BMI) 会影响基线 MT 水平以及 6 周后 MT 标记物的下降。最后，戒酒前后MT和肠道通透性标志物之间不存在相关性。结论戒酒前，AUD患者的MT标志物高于HC患者。禁欲 6 周后，观察到 MT 标记物有所改善。我们的数据表明，MT 及其改善、BMI 和大麻消费之间存在联系。
BackgroundThe human intestinal microbiota exerts beneficial or harmful effects in several disorders. Many factors, including alcohol consumption, may influence its composition and trigger bacterial translocation. Excessive alcohol consumption increases gut permeability and translocation of endotoxin into peripheral circulation. Although plasma endotoxin concentrations have been measured often, quantitative changes following alcohol withdrawal have never been described in subjects with alcohol use disorder (AUD). The aim of this study was to measure microbial translocation (MT) and gut permeability markers in patients with AUD, to compare these markers to healthy controls (HC) and to monitor markers during the first 6weeks of abstinence.MethodsSixty-five patients with AUD and hospitalized for alcohol withdrawal were included. Epidemiological, clinical, biological, and addictological data were gathered. Blood samples were collected at baseline, then 3 and 6weeks after alcohol withdrawal. A hundred healthy volunteers were used as controls. Three markers of MT were monitored in plasma samples: sCD14 and lipopolysaccharide-binding protein (LBP) were quantified using ELISA, and 16S rDNA was quantified using real-time polymerase chain reaction. Zonulin and intestinal fatty acid binding protein (I-FABP) blood levels were also monitored as indirect markers of gut permeability, using ELISA.ResultsAt baseline, LBP, 16S rDNA, sCD14 and I-FABP markers were significantly higher in patients with AUD than in HC. Six weeks after alcohol withdrawal plasma levels of sCD14 and LBP decreased significantly. Cannabis consumption and body mass index (BMI) before alcohol withdrawal influenced baseline MT levels and the decrease in MT markers after 6weeks. Finally, markers of MT and gut permeability did not correlate with each other before and after alcohol withdrawal.ConclusionsBefore alcohol withdrawal, MT markers were higher in patients with AUD than in HC. After 6weeks of abstinence, an improvement in MT markers was observed. Our data suggest that there is a link between MT, its improvement, BMI, and cannabis consumption.