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肠-外周神经系统轴对糖尿病周围神经病变发展的影响。

Impact of gut-peripheral nervous system axis on the development of diabetic neuropathy.

机构信息

Fundação Oswaldo Cruz-Fiocruz, Instituto Oswaldo Cruz, Rio de Janeiro, RJ, Brasil.

Cedars-Sinai Medical Center, Medicine Department, Los Angeles, CA, United States of America.

出版信息

Mem Inst Oswaldo Cruz. 2023 Mar 20;118:e220197. doi: 10.1590/0074-02760220197. eCollection 2023.

Abstract

Diabetes is a chronic metabolic disease caused by a reduction in the production and/or action of insulin, with consequent development of hyperglycemia. Diabetic patients, especially those who develop neuropathy, presented dysbiosis, with an increase in the proportion of pathogenic bacteria and a decrease in the butyrate-producing bacteria. Due to this dysbiosis, diabetic patients presented a weakness of the intestinal permeability barrier and high bacterial product translocation to the bloodstream, in parallel to a high circulating levels of pro-inflammatory cytokines such as TNF-α. In this context, we propose here that dysbiosis-induced increased systemic levels of bacterial products, like lipopolysaccharide (LPS), leads to an increase in the production of pro-inflammatory cytokines, including TNF-α, by Schwann cells and spinal cord of diabetics, being crucial for the development of neuropathy.

摘要

糖尿病是一种由胰岛素产生和/或作用减少引起的慢性代谢性疾病,导致高血糖的发生。糖尿病患者,尤其是那些发生神经病变的患者,表现出肠道菌群失调,致病菌比例增加,产丁酸细菌减少。由于这种肠道菌群失调,糖尿病患者的肠道通透性屏障减弱,细菌产物大量转移到血液中,同时循环中促炎细胞因子如 TNF-α 的水平升高。在这种情况下,我们在这里提出,由菌群失调引起的全身性细菌产物(如脂多糖 [LPS])水平升高,导致施万细胞和糖尿病患者脊髓中促炎细胞因子(包括 TNF-α)的产生增加,这对神经病变的发展至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6e0/10027071/57493ed4e728/1678-8060-mioc-118-e220197-gf1.jpg

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