1 Department of Gastroenterology and Hepatology, Medical University of Graz, Auenbruggerplatz 15, 8036 Graz, Austria.
2 Center for Biomarker Research in Medicine (CBmed), Stiftingtalstrasse 5, 8010 Graz, Austria.
Benef Microbes. 2019 Apr 19;10(3):265-278. doi: 10.3920/BM2018.0067. Epub 2019 Jan 29.
The gut is hypothesised to play an important role in the development and progression of sepsis. It is however unknown whether the gut microbiome and the gut barrier function is already altered early in sepsis development and whether it is possible to modulate the microbiome in early sepsis. Therefore, a randomised, double blind, placebo-controlled pilot study to examine the alterations of the microbiome and the gut barrier in early sepsis and the influence of a concomitant probiotic intervention on dysbiosis at this early stage of the disease was conducted. Patients with early sepsis, defined as fulfilling the sepsis definition from the 2012 Surviving Sepsis Campaign guidelines but without signs of organ failure, received multispecies probiotic (Winclove 607 based on Omnibiotic® 10 AAD) for 28 days. Gut microbiome composition, function, gut barrier and bacterial translocation were studied. Patients with early sepsis had a significantly lower structural and functional alpha diversity, clustered differently and showed structural alterations on all taxonomic levels. Gut permeability was unaltered but endotoxin, endotoxin binding proteins and peptidoglycans were elevated in early sepsis patients compared to controls. Probiotic intervention successfully increased probiotic strains in stool and led to an improvement of functional diversity. Microbiome composition and function are altered in early sepsis. Probiotic intervention successfully modulates the microbiome and is therefore a promising tool for early intervention in sepsis.
肠道被认为在脓毒症的发生和发展中起重要作用。然而，尚不清楚肠道微生物组和肠道屏障功能是否在脓毒症早期就已经发生改变，以及是否有可能在早期脓毒症时调节微生物组。因此，进行了一项随机、双盲、安慰剂对照的初步研究，以检查早期脓毒症中微生物组和肠道屏障的改变，以及同时进行益生菌干预对疾病早期失调的影响。早期脓毒症患者定义为符合 2012 年脓毒症存活运动指南的脓毒症定义，但没有器官衰竭的迹象，接受了多菌种益生菌（基于 Omnibiotic® 10 AAD 的 Winclove 607）治疗 28 天。研究了肠道微生物组组成、功能、肠道屏障和细菌易位。与对照组相比，早期脓毒症患者的结构和功能 alpha 多样性显著降低，聚类不同，所有分类水平均显示出结构改变。肠道通透性未改变，但内毒素、内毒素结合蛋白和肽聚糖在早期脓毒症患者中升高。益生菌干预成功地增加了粪便中的益生菌株，并改善了功能多样性。早期脓毒症中微生物组组成和功能发生改变。益生菌干预成功地调节了微生物组，因此是脓毒症早期干预的有前途的工具。
