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洗菌移植降低高血压患者的血压。

Washed Microbiota Transplantation Lowers Blood Pressure in Patients With Hypertension.

机构信息

Department of Gastroenterology, Research Center for Engineering Techniques of Microbiota-Targeted Therapies of Guangdong Province, The First Affiliated Hospital of Guangdong Pharmaceutical University, Guangzhou, China.

Guangdong Provincial Key Laboratory of Microbial Safety and Health, State Key Laboratory of Applied Microbiology Southern China, Institute of Microbiology, Guangdong Academy of Sciences, Guangzhou, China.

出版信息

Front Cell Infect Microbiol. 2021 Aug 11;11:679624. doi: 10.3389/fcimb.2021.679624. eCollection 2021.

Abstract

BACKGROUND

Although transplantation of the fecal microbiota from normotensive donors has been shown to have an antihypertensive effect in hypertensive animal models, its effect on blood pressure in patients with hypertension is unclear. This study aimed to assess the effect of washed microbiota transplantation (WMT) from normotensive donors on blood pressure regulation in hypertensive patients.

METHODS

The clinical data of consecutive patients treated with washed microbiota transplantation (WMT) were collected retrospectively. The blood pressures of hypertensive patients before and after WMT were compared. The factors influencing the antihypertensive effect of WMT in hypertensive patients and fecal microbial composition of donors and hypertensive patients were also analyzed.

RESULTS

WMT exhibited an antihypertensive effect on blood pressure: the blood pressure at hospital discharge was significantly lower than that at hospital admission (change in systolic blood pressure: -5.09 ± 15.51, P = 0.009; change in diastolic blood pressure: -7.74 ± 10.42, P < 0.001). Hypertensive patients who underwent WMT the lower gastrointestinal tract (β = -8.308, standard error = 3.856, P = 0.036) and those not taking antihypertensive drugs (β = -8.969, standard error = 4.256, P = 0.040) had a greater decrease in systolic blood pressure, and hypertensive patients not taking antihypertensive drugs also had a greater decrease in diastolic blood pressure (β = -8.637, standard error = 2.861, P = 0.004). After WMT, the Shannon Diversity Index was higher in six of eight hypertensive patients and the microbial composition of post-WMT samples tended to be closer to that of donor samples.

CONCLUSION

WMT had a blood pressure-lowering effect in hypertensive patients, especially in those who underwent WMT the lower gastrointestinal tract and in those not taking antihypertensive drugs. Therefore, modulation of the gut microbiota by WMT may offer a novel approach for hypertension treatment.

摘要

背景

尽管来自正常血压供体的粪便微生物群移植已被证明在高血压动物模型中具有降压作用,但它对高血压患者的血压影响尚不清楚。本研究旨在评估来自正常血压供体的经洗涤的微生物群移植(WMT)对高血压患者血压调节的影响。

方法

回顾性收集连续接受经洗涤的微生物群移植(WMT)治疗的患者的临床数据。比较高血压患者 WMT 前后的血压。还分析了影响高血压患者 WMT 降压效果的因素以及供体和高血压患者粪便微生物组成。

结果

WMT 对血压有降压作用:出院时的血压明显低于入院时的血压(收缩压变化:-5.09 ± 15.51,P = 0.009;舒张压变化:-7.74 ± 10.42,P < 0.001)。接受 WMT 的下消化道(β = -8.308,标准误差 = 3.856,P = 0.036)和未服用降压药的高血压患者(β = -8.969,标准误差 = 4.256,P = 0.040)的收缩压下降幅度更大,未服用降压药的高血压患者的舒张压下降幅度也更大(β = -8.637,标准误差 = 2.861,P = 0.004)。WMT 后,8 例高血压患者中有 6 例的 Shannon 多样性指数升高,且 post-WMT 样本的微生物组成趋于更接近供体样本。

结论

WMT 可降低高血压患者的血压,尤其是在下消化道接受 WMT 和未服用降压药的患者中。因此,WMT 调节肠道微生物群可能为高血压治疗提供一种新方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9e3e/8385408/ddb5dc7bf79b/fcimb-11-679624-g001.jpg

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