溃疡性结肠炎患者肠道细菌-法尼酯X受体轴的 表达及临床意义

Expression and clinical significance of intestinal bacteria-FXR axis in patients with ulcerative colitis

目的研究溃疡性结肠炎(UC)患者肠道细菌-法尼酯X受体(FXR)轴的表达及临床意义。方法选取本院2019年1月至2021年1月行肠镜检查和病理活检确诊的UC患者56例作为研究对象(UC组),另选取同期健康体检志愿者62名作为健康对照(健康对照组)。取UC患者和健康志愿者新鲜粪便标本,行镜检和培养鉴定;实时荧光定量聚合酶链反应(qRT-PCR)法分析各细菌数量;酶联免疫吸附法(ELISA)测定各肠黏膜组织FXR、白细胞介素(IL)-17、IL-23水平;对UC患者行Mayo评分和Baron分级;Spearman分析各细菌数量、FXR水平与IL-17水平、IL-23水平、Mayo评分、Baron分级的相关性。结果与健康对照组相比,UC组患者杆菌(大肠杆菌、拟杆菌、双歧杆菌、乳酸杆菌)数量、FXR水平明显降低,球菌(肠球菌)数量、IL-17水平、IL-23水平、Mayo评分、Baron分级明显升高(P<0.05);细菌失调比例比较发现,与健康对照组相比,UC组患者肠道正常细菌比例明显降低(P<0.05),Ⅰ、Ⅱ、Ⅲ级失调比例升高(P<0.05)。Spearman分析显示,UC患者肠道大肠杆菌、拟杆菌、双歧杆菌、乳酸杆菌和黏膜组织中FXR水平与IL-17水平、IL-23水平、Mayo评分、Baron分级呈负相关(均P<0.01),肠球菌与IL-17水平、IL-23水平、Mayo评分、Baron分级呈正相关(均P<0.01)。结论UC患者肠道细菌失调,FXR呈低表达,与IL-17水平、IL-23水平、Mayo评分、Baron分级相关。

Objective To explore the expression and clinical significance of intestinal bacteria-farneside X receptor(FXR)axis in patients with ulcerative colitis(UC).Methods Fifty-six UC patients diagnosed by enteroscopy and pathological biopsy in our hospital from January 2019 to January 2021 were selected as the study subjects(UC group),and 62 healthy physical examination volunteers at the same time were selected as the healthy control(healthy control group).Fresh fecal samples of UC patients and healthy volunteers were collected for microscopic examination and culture identification.The number of bacteria was analyzed by real-time fluorescent quantitative PCR(qRT-PCR),and enzyme linked immunosorbent assay(ELISA)was used to detect the levels of FXR,interleukin(IL)-17 and IL-23 in intestinal mucosa.The patients with UC were evaluated by Mayo score and Baron grade.Spearman was used to analyze the correlations between the number of bacteria,the levels of FXR and IL-17,IL-23,Mayo score,Baron grade.Results Compared with control group,the number of bacilli(E.coli,Bacteroides,Bifidobacterium,Lactobacillus)and the level of FXR reduced significantly,while the number of coccus(Enterococcus),levels of IL-17 and IL-23,Mayo score and Baron grade increased significantly in UC group(P<0.05).The comparison of the proportion of bacterial disorders showed that,compared with control group,the proportion of bacteria decreased significantly,and the proportions of gradeⅠ,ⅡandⅢmaladjustment increased significantly in UC group(P<0.05).Spearman′s analysis showed that FXR levels in E.coli,Bacteroides,bifidobacteria,lactobacilli and mucosa of UC patients were negatively correlated with levels of IL-17,IL-23,Mayo score and Baron grade(all P<0.01),and enterococcus was positively correlated with the levels of IL-17,IL-23,Mayo score and Baron grade(P<0.01).Conclusion For UC patients,the intestinal bacteria were maladjusted and the expression of FXR declined,which were correlated with levels of IL-17 and IL-23,Mayo score and Baron grade.