镰状细胞血管阻塞性危机：这是一种直觉。
Sickle cell vaso-occlusive crisis: it's a gut feeling.
作者信息
Lim Seah H, Fast Loren, Morris Alison
机构信息
Division of Hematology and Oncology, Rhode Island Hospital/Brown University Warren Alpert Medical School, Room 140 APC Building, 593 Eddy Street, Providence, RI, USA.
Division of Pulmonary, Allergy, and Critical Care Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
出版信息
J Transl Med. 2016 Dec 1;14(1):334. doi: 10.1186/s12967-016-1092-5.
Insights in the pathogenesis of vaso-occlusive crisis in patients with sickle cell disease have changed significantly in the last decade. Various laboratory and clinical evidence have provided support to the pivotal role of activated neutrophils in this process. A recent study in murine sickle cell disease indicated that the intestinal microbiota is responsible for regulating the number of aged neutrophils, a subset of neutrophils that are overly activated. Reduction of these neutrophils in vivo protected the mice from fatal TNFα-induced vaso-occlusive crisis. In this paper, we discuss the reasons why patients with sickle cell disease may have an abnormal intestinal microbiota and how this could contribute to the development of vaso-occlusive crisis. We also highlight the recent interest in studying the intestinal microbiota of patients with sickle cell disease and suggest that the next therapeutic approach for these patients may well be in the manipulation of the intestinal microbiota to restore the individual's microbial landscape.
在过去十年中，对镰状细胞病患者血管闭塞性危机发病机制的认识发生了显著变化。各种实验室和临床证据支持了活化中性粒细胞在这一过程中的关键作用。最近一项针对小鼠镰状细胞病的研究表明，肠道微生物群负责调节衰老中性粒细胞的数量，衰老中性粒细胞是过度活化的中性粒细胞亚群。体内减少这些中性粒细胞可保护小鼠免受致命的肿瘤坏死因子α诱导的血管闭塞性危机。在本文中，我们讨论了镰状细胞病患者肠道微生物群可能异常的原因，以及这如何导致血管闭塞性危机的发生。我们还强调了最近对研究镰状细胞病患者肠道微生物群的兴趣，并建议对这些患者的下一种治疗方法很可能是通过操纵肠道微生物群来恢复个体的微生物格局。
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