Department of Biological Chemistry and Molecular Pharmacology, Blavatnik Institute, Harvard Medical School, Boston, MA 02115, USA.
Laboratory for Surgical and Metabolic Research, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
Cell Host Microbe. 2021 Mar 10;29(3):408-424.e7. doi: 10.1016/j.chom.2020.12.004. Epub 2021 Jan 11.
Bariatric surgery is the most effective treatment for type 2 diabetes and is associated with changes in gut metabolites. Previous work uncovered a gut-restricted TGR5 agonist with anti-diabetic properties-cholic acid-7-sulfate (CA7S)-that is elevated following sleeve gastrectomy (SG). Here, we elucidate a microbiome-dependent pathway by which SG increases CA7S production. We show that a microbial metabolite, lithocholic acid (LCA), is increased in murine portal veins post-SG and by activating the vitamin D receptor, induces hepatic mSult2A1/hSULT2A expression to drive CA7S production. An SG-induced shift in the microbiome increases gut expression of the bile acid transporters Asbt and Ostα, which in turn facilitate selective transport of LCA across the gut epithelium. Cecal microbiota transplant from SG animals is sufficient to recreate the pathway in germ-free (GF) animals. Activation of this gut-liver pathway leads to CA7S synthesis and GLP-1 secretion, causally connecting a microbial metabolite with the improvement of diabetic phenotypes.
减重手术是治疗 2 型糖尿病最有效的方法,它与肠道代谢物的变化有关。之前的研究发现了一种具有抗糖尿病特性的肠道限制型 TGR5 激动剂——胆酸-7-硫酸盐(CA7S),它在袖状胃切除术(SG)后升高。在这里,我们阐明了一种微生物组依赖的途径,通过该途径,SG 增加 CA7S 的产生。我们表明,一种微生物代谢物,石胆酸(LCA),在 SG 后在小鼠门静脉中增加,并且通过激活维生素 D 受体,诱导肝 mSult2A1/hSULT2A 表达以驱动 CA7S 的产生。SG 诱导的微生物组的转变增加了肠道胆汁酸转运体 Asbt 和 Ostα 的表达,这反过来又促进了 LCA 穿过肠道上皮的选择性转运。来自 SG 动物的盲肠微生物群移植足以在无菌(GF)动物中重现该途径。该肠道-肝脏途径的激活导致 CA7S 的合成和 GLP-1 的分泌,将微生物代谢物与改善糖尿病表型联系起来。
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