Mesalazine (5-aminosalicylic acid) alters faecal bacterial profiles, but not mucosal proteolytic activity in diarrhoea-predominant irritable bowel syndrome
Mesalazine (5-aminosalicylic acid) alters faecal bacterial profiles, but not mucosal proteolytic activity in diarrhoea-predominant irritable bowel syndrome
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DOI：
10.1111/j.1365-2036.2011.04732.x
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发表时间：
2011-08-01
影响因子：
7.6
通讯作者：
Rioux, K. P.
中科院分区：
文献类型：
--
作者：
Andrews, C. N.;Griffiths, T. A.;Rioux, K. P.
目的探讨美沙拉秦（5-氨基水杨酸或5-氨基水杨酸）对肠易激综合征（IBS）患者肠道菌群的影响及其与治疗效果的关系。患者接受口服美沙拉秦（1.5 g b.d.）持续4周，然后是4周的洗脱期。在美沙拉秦治疗前、治疗中和治疗后，对粪便细菌群落和IBS症状的分子特征进行了评估。评估结肠粘膜活检的蛋白水解活性。美沙拉秦对粪便微生物群，粘膜蛋白水解活性和IBS症状的定性和定量的影响进行了assessed.ResultsFaecal细菌减少了46%的美沙拉秦治疗（P = 0.014），但恢复到基线期间冲洗。厚壁菌门和拟杆菌门代表了95%的确定的细菌类型，与无应答者[中位数5%（11）下降，P = 0.088]相比，在第4周时，有症状应答者中厚壁菌门的比例有增加的趋势[中位数（IQR）增加14%（49）]。直肠乙状结肠粘膜蛋白水解活性在基线和治疗之间没有变化[中位数23.2（17.9）vs. 19.5（46.7）mU活性/mg组织，P = 0.433]。8 12（67%）的患者积极回应美沙拉秦的基础上，全球救济问卷调查，与不适和增加排便satisfaction.ConclusionsMesalazine治疗的天数显着减少与减少粪便细菌丰度和重新平衡的微生物群的主要成分。需要进一步研究5-氨基水杨酸在肠易激综合征中的细菌学和抗炎特性。
BackgroundImbalances in gut luminal bacteria may contribute to the pathogenesis of irritable bowel syndrome (IBS).AimTo explore select bacteriological and anti-inflammatory effects of mesalazine (mesalamine; 5-aminosalicylic acid or 5ASA) and their relation to potential therapeutic effects in IBS.MethodsProspective pilot study of 12 women with diarrhoea-predominant IBS. Patients received oral mesalazine (1.5 g b.d.) for 4 weeks followed by a 4-week washout phase. Molecular profiling of stool bacterial communities and IBS symptoms were assessed before, during and after mesalazine treatment. Colonic mucosal biopsies were assessed for proteolytic activity. Qualitative and quantitative effects of mesalazine on stool microbiota, mucosal proteolytic activity and IBS symptoms were assessed.ResultsFaecal bacteria decreased by 46% on mesalazine treatment (P = 0.014), but returned to baseline during washout. Firmicutes and Bacteroidetes represented 95% of identified phylotypes, with a trend towards an increase in the proportion of Firmicutes at week 4 in symptomatic responders [median (IQR) 14% (49) increase] compared with nonresponders [median 5% (11) decrease, P = 0.088]. Rectosigmoid mucosal proteolytic activity did not change between baseline and treatment [median 23.2 (17.9) vs. 19.5 (46.7) mU activity/mg tissue, P = 0.433]. Eight of 12 (67%) patients responded favourably to mesalazine based on a global relief questionnaire, with significant decreases in days with discomfort and increases in bowel movement satisfaction.ConclusionsMesalazine treatment is associated with a decrease in faecal bacteria abundance and rebalancing of the major constituents of the microbiota. Further study of the bacteriological and anti-inflammatory properties of mesalazine in IBS is warranted.