Changes of gut bacteria and immune parameters in liver transplant recipients
Changes of gut bacteria and immune parameters in liver transplant recipients
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DOI：
10.1016/s1499-3872(11)60124-0
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发表时间：
2012-02-01
影响因子：
3.3
通讯作者：
Li, Lan-Juan
中科院分区：
文献类型：
--
作者：
Wu, Zhong-Wen;Ling, Zong-Xin;Li, Lan-Juan
背景：肝移植是终末期肝病患者最有效的治疗选择之一，肠道微生物区系积极参与移植前和移植后患者的潜在感染。方法：收集2004-11/2008-05中国收治的健康志愿者28例、肝硬变患者51例、肝移植患者111例的新鲜粪便和血液标本。分别采用实时定量聚合酶链式反应、显色凝胶变形法、夹心式酶联免疫吸附试验和放射免疫法检测肠道细菌、血浆内毒素、血清细胞因子(肿瘤坏死因子α和白介素6)和粪便分泌型免疫球蛋白A(SIgA)。肝移植受者的感染率较低，而肠杆菌科细菌和肠球菌的感染率较低。显著高于对照组(P<；0.05)。肝移植后，除肠球菌外，其余细菌均有随时间恢复正常的趋势。肝硬变患者血浆内毒素、白介素6和粪便sIgA显著升高，而肝移植受者无明显变化。肝硬变患者血浆内毒素和白介素6与所有真细菌和类杆菌-普雷沃特氏菌均呈负相关，而肿瘤坏死因子α与这6种肠道细菌无明显相关性。结论：我们的研究表明，无论是肝硬变还是肝移植患者，肠道细菌数量都发生了显著变化，而肝硬变患者血浆内毒素和白介素6水平显著升高，与肠道菌群显著相关。有趣的是，我们的数据显示，肝移植受者的肠道细菌有恢复到正常水平的趋势。(肝胆胰脏疾病2012；11：40-50)
BACKGROUND: Liver transplantation is one of the most effective therapeutic options for patients with end-stage liver diseases, and gut microbiota is actively involved in potential infections in pretransplant and posttransplant patients. However, the diversity of gut microbiota and its relationship with the immune parameter of liver transplantation recipients are not well understood.METHODS: We collected fresh feces and blood samples from 190 participants in China from November 2004 to May 2008, including 28 healthy volunteers, 51 cirrhotic patients and 111 liver-transplanted patients. Six interesting gut bacteria, plasma endotoxin, serum cytokines (i.e., tumor necrosis factor alpha and interleukin-6) and fecal secretory IgA (SIgA) were investigated by real-time quantitative PCR, chromogenic limulus amoebocyte assay, sandwich-type enzyme-linked immunosorbent assay and radioimmunoassay, respectively.RESULTS: All Eubacteria, Bifidobacterium spp., Faecalibacterium prausnitzii and Lactobacillus spp. were significantly lower in the liver transplantation recipients while Enterobacteriaceae and Enterococcus spp. were significantly higher (P < 0.05). Except for Enterococcus spp., other bacteria showed a tendency to restore to normal level along with the time after liver transplantation. Plasma endotoxin, interleukin-6 and fecal SIgA in cirrhotic patients increased significantly, but not in liver transplantation recipients. Plasma endotoxin and interleukin-6 were negatively correlated with all Eubacteria and the Bacteroides-Prevotella group, while tumor necrosis factor alpha was not significantly correlated with these six gut bacteria in cirrhotic patients.CONCLUSIONS: Our study demonstrates that abundant gut bacteria were altered significantly in both cirrhotic and liver transplantation patients, while plasma endotoxin and interleukin-6 increased remarkably in cirrhotic patients, showing significant correlations with gut microbiota. Interestingly, our data show a tendency for these gut bacteria to restore to normal levels in liver transplantation recipients. (Hepatobiliary Pancreat Dis Int 2012;11:40-50)