Department of Medicine, Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Department of Surgery, Mayo Clinic, Rochester, MN, USA.
Sci Transl Med. 2018 Oct 24;10(464). doi: 10.1126/scitranslmed.aam7019.
The gut microbiota plays a critical role in pathogen defense. Studies using antibiotic-treated mice reveal mechanisms that increase susceptibility to infection (CDI), but risk factors associated with CDI in humans extend beyond antibiotic use. Here, we studied the dysbiotic gut microbiota of a subset of patients with diarrhea and modeled the gut microbiota of these patients by fecal transplantation into germ-free mice. When challenged with , the germ-free mice transplanted with fecal samples from patients with dysbiotic microbial communities showed increased gut amino acid concentrations and greater susceptibility to CDI. A mutant that was unable to use proline as an energy source was unable to robustly infect germ-free mice transplanted with a dysbiotic or healthy human gut microbiota. Prophylactic dietary intervention using a low-proline or low-protein diet in germ-free mice colonized by a dysbiotic human gut microbiota resulted in decreased expansion of wild-type after challenge, suggesting that amino acid availability might be important for CDI. Furthermore, a prophylactic fecal microbiota transplant in mice with dysbiosis reduced proline availability and protected the mice from CDI. Last, we identified clinical risk factors that could potentially predict gut microbial dysbiosis and thus greater susceptibility to CDI in a retrospective cohort of patients with diarrhea. Identifying at-risk individuals and reducing their susceptibility to CDI through gut microbiota-targeted therapies could be a new approach to preventing infection in susceptible patients.
肠道微生物群在病原体防御中起着关键作用。使用抗生素处理的小鼠研究揭示了增加易感性的机制(CDI),但与人类 CDI 相关的风险因素超出了抗生素的使用范围。在这里,我们研究了一组腹泻患者的肠道微生物群失调,并通过粪便移植将这些患者的肠道微生物群模型化到无菌小鼠中。当受到挑战时,移植了来自微生物群落失调患者粪便样本的无菌小鼠显示出肠道氨基酸浓度增加,并且更容易发生 CDI。一种无法将脯氨酸用作能源的突变体无法有效地感染移植了失调或健康人类肠道微生物群的无菌小鼠。用低脯氨酸或低蛋白饮食对定植了失调的人类肠道微生物群的无菌小鼠进行预防性饮食干预,导致在受到挑战后野生型的扩张减少,这表明氨基酸的可用性可能对 CDI 很重要。此外,在患有肠道微生态失调的小鼠中进行预防性粪便微生物群移植可减少脯氨酸的可用性并保护小鼠免受 CDI 的侵害。最后,我们确定了临床风险因素,这些因素可能潜在地预测肠道微生物群失调,从而增加腹泻患者发生 CDI 的易感性。通过针对肠道微生物群的治疗来确定易受感染的个体并降低其对 CDI 的易感性,可能是预防易感患者感染的一种新方法。
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