鼠李糖乳杆菌 GG 补充剂对 HIV 感染个体肠道炎症的影响：基于 PET/MRI 扫描和肠道微生物组成的评估。

Effect of Lactobacillus rhamnosus GG Supplementation on Intestinal Inflammation Assessed by PET/MRI Scans and Gut Microbiota Composition in HIV-Infected Individuals.

机构信息

Viro-immunolgy Research Unit, Department of Infectious Diseases, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.

Research Institute of Internal Medicine, Oslo University Hospital Rikshospitalet, Oslo, Norway.

出版信息

J Acquir Immune Defic Syndr. 2018 Aug 1;78(4):450-457. doi: 10.1097/QAI.0000000000001693.

DOI:10.1097/QAI.0000000000001693

PMID:29874201

Abstract

BACKGROUND

Alterations in the gut microbiome have been associated with inflammation and increased cardiovascular risk in HIV-infected individuals. The aim of this study was to investigate the effects of the probiotic strain Lactobacillus rhamnosus GG (LGG) on intestinal inflammation, gut microbiota composition, and systemic markers of microbial translocation and inflammation in HIV-infected individuals.

METHODS

This prospective, clinical interventional trial included 45 individuals [15 combination antiretroviral treatment (cART) naive and 30 cART treated] who ingested LGG twice daily at a dosage of 6 × 109 colony-forming units per capsule for a period of 8 weeks. Intestinal inflammation was assessed using F-2-fluoro-2-deoxy-D-glucose positron emission tomography/magnetic resonance imaging (F-FDG PET/MRI) scans in 15 individuals. Gut microbiota composition (V3-V4 region of the 16s rRNA gene) and markers of microbial translocation and inflammation (lipopolysaccharide, sCD14, sCD163, sCD25, high-sensitive CRP, IL-6, and tumor necrosis factor-alpha) were analyzed at baseline and after intervention.

RESULTS

At baseline, evidence of intestinal inflammation was found in 75% of the participants, with no significant differences between cART-naive and cART-treated individuals. After LGG supplementation, a decrease in intestinal inflammation was detected on PET/MRI (-0.3 mean difference in the combined activity grade score from 6 regions, P = 0.006), along with a reduction of Enterobacteriaceae (P = 0.018) and Erysipelotrichaceae (P = 0.037) in the gut microbiome, with reduced Enterobacteriaceae among individuals with decreased F-FDG uptake on PET/MRI (P = 0.048). No changes were observed for soluble markers of microbial translocation and inflammation.

CONCLUSIONS

A decrease in intestinal inflammation was found in HIV-infected individuals after ingestion of LGG along with a reduced abundance of Enterobacteriaceae, which may explain the local anti-inflammatory effect in the gut.

摘要

背景

肠道微生物组的改变与 HIV 感染者的炎症和心血管风险增加有关。本研究旨在探讨益生菌菌株鼠李糖乳杆菌 GG（LGG）对 HIV 感染者肠道炎症、肠道微生物群组成以及系统微生物易位和炎症标志物的影响。

方法

这项前瞻性、临床干预性试验纳入了 45 名个体[15 名联合抗逆转录病毒治疗（cART）初治和 30 名 cART 治疗]，他们每天两次摄入 LGG，剂量为每胶囊 6×10^9 个菌落形成单位，持续 8 周。15 名个体接受 F-2-氟-2-脱氧-D-葡萄糖正电子发射断层扫描/磁共振成像（F-FDG PET/MRI）扫描评估肠道炎症。在基线和干预后分析肠道微生物群组成（16s rRNA 基因 V3-V4 区）和微生物易位和炎症标志物（脂多糖、sCD14、sCD163、sCD25、高敏 CRP、IL-6 和肿瘤坏死因子-α）。

结果

在基线时，75%的参与者存在肠道炎症证据，cART 初治和 cART 治疗个体之间无显著差异。在 LGG 补充后，PET/MRI 上检测到肠道炎症减轻（从 6 个区域的综合活性评分中降低 0.3 个平均差异，P=0.006），肠道微生物群中肠杆菌科（P=0.018）和真杆菌科（P=0.037）减少，PET/MRI 上 F-FDG 摄取减少的个体中肠杆菌科减少（P=0.048）。可溶性微生物易位和炎症标志物无变化。