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功能性胃肠病患者和伴有或不伴有自我报告的非乳糜泻小麦敏感性患者的十二指肠黏膜相关微生物组、内脏感觉功能、免疫激活和心理共病。

The duodenal mucosa associated microbiome, visceral sensory function, immune activation and psychological comorbidities in functional gastrointestinal disorders with and without self-reported non-celiac wheat sensitivity.

机构信息

Department of Gastroenterology and Hepatology, Princess Alexandra Hospital, Brisbane, Australia.

Translational Research Institute Queensland, Australia.

出版信息

Gut Microbes. 2022 Jan-Dec;14(1):2132078. doi: 10.1080/19490976.2022.2132078.

DOI:10.1080/19490976.2022.2132078
PMID:36303431
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9621048/
Abstract

Frequently, patients with functional gastrointestinal disorders (FGIDs) report intolerance of wheat products. We compared gastrointestinal symptoms, sensory function, psychiatric comorbidities, gut-homing immune cells, and duodenal mucosa-associated microbiome (d-MAM) in FGID patients and controls with and without self-reported wheat sensitivity (SR-NCWS). We recruited 40 FGID patients and 20 controls referred by GPs for treatment. Gastrointestinal/extraintestinal symptoms, visceral sensory function, psychological comorbidities, and SR-NCWS were assessed in a standardized approach. Peripheral gut homing T-cells (CD4α4β7CCR9/CD8α4β7CCR9) were quantified, and the d-MAM was assessed by DNA sequencing for 46 subjects. Factors of bacterial genera were extracted utilizing factor analysis with varimax rotation and factors univariately associated with FGID or SR-NCWS included in a subsequent multivariate analysis of variance to identify statistically independent discriminators. Anxiety scores (p < .05) and increased symptom responses to a nutrient challenge (p < .05) were univariately associated with FGID. Gut homing T-cells were increased in FGID patients with SR-NCWS compared to other groups (p all <0.05). MANOVA revealed that anxiety (p = .03), visceral sensory function (p = 0.007), and a d-MAM factor comprise members of the , and lineages were significantly (p = .001) associated with FGID, while gut homing CD4α4 β7CCR9 T-cells were associated (p = .002) with SR-NCWS. Compared to controls, patients with and without SR-NCWS show that there are shifts in the amplicon sequence variants within specific bacterial genera between the FGID subgroups (particularly and ) as well as distinct bacterial taxa discriminatory for the two different FGID subtypes. Compared to controls, both FGID patients with and without SR-NCWS have an increased symptom response to a standardized nutrient challenge and increased anxiety scores. The FGID patients with SR-NCWS - as compared to FGID without SR-NCWS (and controls without SR-NCWS) - have increased gut homing T-cells. The d-MAM profiles suggest species and strain-based variations between the two FGID subtypes and in comparison to controls.

摘要

常伴有功能性胃肠疾病（FGIDs）的患者报告对小麦产品不耐受。我们比较了 FGIDs 患者和对照者中有和无自我报告的小麦敏感（SR-NCWS）者的胃肠症状、感觉功能、精神共病、肠道归巢免疫细胞和十二指肠黏膜相关微生物组（d-MAM）。我们招募了 40 名 FGIDs 患者和 20 名由全科医生推荐接受治疗的对照者。通过标准化方法评估胃肠/肠外症状、内脏感觉功能、心理共病和 SR-NCWS。定量外周肠道归巢 T 细胞（CD4α4β7CCR9/CD8α4β7CCR9），对 46 例患者的 d-MAM 进行 DNA 测序评估。利用最大方差旋转的因子分析提取细菌属的因子，并将与 FGID 或 SR-NCWS 相关的因子纳入后续的方差分析多元回归，以确定具有统计学意义的独立判别因子。焦虑评分（p<0.05）和对营养挑战的症状反应增加（p<0.05）与 FGIDs 呈单变量相关。与其他组相比，伴有 SR-NCWS 的 FGIDs 患者的肠道归巢 T 细胞增加（p 均<0.05）。MANOVA 显示，焦虑（p=0.03）、内脏感觉功能（p=0.007）和一个 d-MAM 因子由 、 和 属的成员组成，与 FGID 显著相关（p=0.001），而肠道归巢 CD4α4β7CCR9 T 细胞与 SR-NCWS 相关（p=0.002）。与对照组相比，伴有和不伴有 SR-NCWS 的 FGID 患者显示出 FGID 亚组之间特定细菌属的扩增子序列变异以及区分两种不同 FGID 亚型的细菌分类群存在差异。与对照组相比，伴有和不伴有 SR-NCWS 的 FGID 患者对标准化营养挑战的症状反应增加，焦虑评分增加。与无 SR-NCWS 的 FGIDs 患者（和无 SR-NCWS 的对照组）相比，伴有 SR-NCWS 的 FGIDs 患者的肠道归巢 T 细胞增加。d-MAM 谱表明两种 FGIDs 亚型之间以及与对照组相比存在物种和菌株的差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcb9/9621048/4146fb7c6795/KGMI_A_2132078_F0007_OC.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcb9/9621048/15e025939803/KGMI_A_2132078_F0005_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcb9/9621048/0f4111cb9394/KGMI_A_2132078_F0006_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcb9/9621048/4146fb7c6795/KGMI_A_2132078_F0007_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcb9/9621048/ebb52f4bb5df/KGMI_A_2132078_F0001_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcb9/9621048/c8515e9c4b3f/KGMI_A_2132078_F0002_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcb9/9621048/65d94e1d5bdb/KGMI_A_2132078_F0003_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcb9/9621048/29f6caf5ccf8/KGMI_A_2132078_F0004_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcb9/9621048/15e025939803/KGMI_A_2132078_F0005_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcb9/9621048/0f4111cb9394/KGMI_A_2132078_F0006_OC.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dcb9/9621048/4146fb7c6795/KGMI_A_2132078_F0007_OC.jpg

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[3]
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Gut Microbes. 2025-12

[4]
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[5]
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[6]
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[7]
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[8]
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本文引用的文献

[1]
Current and Future Approaches for Diagnosing Small Intestinal Dysbiosis in Patients With Symptoms of Functional Dyspepsia.

Front Neurosci. 2022-5-6

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Dig Dis Sci. 2022-6

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Dig Dis Sci. 2022-1

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BMC Gastroenterol. 2021-1-6

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