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阿片类药物的使用会增强医院获得性感染的毒力,增加系统细菌传播,并在感染的小鼠模型中加重肠道菌群失调。

Opioid use potentiates the virulence of hospital-acquired infection, increases systemic bacterial dissemination and exacerbates gut dysbiosis in a murine model of infection.

机构信息

Department of Veterinary Population Medicine, University of Minnesota, Minneapolis, MN, USA.

Department of Surgery and Sylvester Cancer Center, Miller School of Medicine, University of Miami, Miami, FL, USA.

出版信息

Gut Microbes. 2020;11(2):172-190. doi: 10.1080/19490976.2019.1629237. Epub 2019 Aug 5.

Abstract

Opioid analgesics are frequently prescribed in the United States and worldwide. However, serious side effects such as addiction, immunosuppression and gastrointestinal symptoms limit their use. It was recently demonstrated that morphine treatment results in a significant disruption in gut barrier function, leading to an increased translocation of gut commensal bacteria. Further studies have indicated distinct alterations in the gut microbiome and metabolome following morphine treatment, contributing to the negative consequences that are associated with opioid use. However, it is unclear how opioids modulate gut homeostasis in the context of a hospital-acquired bacterial infection. is an ideal murine model of human infections with enteropathogenic (EPEC) and enterohemorrhagic (EHEC). In the current study, a mouse model of infection was used to investigate the role of morphine in the modulation of gut homeostasis in the context of a hospital-acquired bacterial infection. Morphine treatment resulted in 1) the promotion of systemic dissemination, 2) an increase in the expression of the virulence factors of colonization in intestinal contents, 3) altered gut microbiome, 4) damaged integrity of gut epithelial barrier function, 5) inhibition of the -induced increase in goblet cells, and 6) dysregulated IL-17A immune response. This study demonstrates and further validates a positive correlation between opioid drug use/abuse and an increased risk of infections, suggesting that the overprescription of opioids may increase the susceptibility to hospital-acquired infection.

摘要

阿片类镇痛药在美国和全球范围内经常被开具。然而,成瘾、免疫抑制和胃肠道症状等严重副作用限制了它们的使用。最近的研究表明,吗啡治疗会导致肠道屏障功能严重紊乱,从而导致肠道共生细菌的易位增加。进一步的研究表明,吗啡治疗后肠道微生物组和代谢组发生明显改变,导致与阿片类药物使用相关的负面后果。然而,目前尚不清楚阿片类药物如何在医院获得性细菌感染的情况下调节肠道内稳态。是一种理想的人类感染肠致病性大肠杆菌(EPEC)和肠出血性大肠杆菌(EHEC)的鼠模型。在本研究中,利用感染的小鼠模型,研究了吗啡在医院获得性细菌感染情况下调节肠道内稳态中的作用。吗啡治疗导致 1)促进细菌全身性传播,2)增加肠道内容物中定植的毒力因子的表达,3)改变肠道微生物组,4)破坏肠道上皮屏障功能的完整性,5)抑制诱导的杯状细胞增加,以及 6)IL-17A 免疫反应失调。这项研究表明并进一步验证了阿片类药物使用/滥用与感染风险增加之间的正相关关系,表明阿片类药物的过度处方可能会增加医院获得性感染的易感性。

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