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阻塞性睡眠呼吸暂停相关性高血压与肠道和神经炎症增加有关。

Obstructive Sleep Apnea-Induced Hypertension Is Associated With Increased Gut and Neuroinflammation.

机构信息

Department of Integrative Physiology Baylor College of Medicine Houston TX USA.

Department of Anesthesiology Baylor College of Medicine Houston TX USA.

出版信息

J Am Heart Assoc. 2023 Jun 6;12(11):e029218. doi: 10.1161/JAHA.122.029218. Epub 2023 Jun 1.

Abstract

Background Obstructive sleep apnea (OSA) is an independent risk factor for the development of hypertension. We have demonstrated that OSA induces gut dysbiosis, and this dysbiotic microbiota contributes to hypertension. However, the mechanisms linking gut dysbiosis to blood pressure regulation remain unclear. Recent studies demonstrate that gut dysbiosis can induce a proinflammatory response of the host resulting in peripheral and neuroinflammation, key factors in the development of hypertension. We hypothesized that OSA induces inflammation in the gut that contributes to neuroinflammation and hypertension. Methods and Results OSA was induced in 8-week-old male rats. After 2 weeks of apneas, lymphocytes were isolated from aorta, brain, cecum, ileum, mesenteric lymph node, and spleen for flow cytometry. To examine the role of interleukin-17a, a monoclonal antibody was administered to neutralize interleukin-17a. Lymphocytes originating from the gut were tracked by labeling with carboxyfluorescein succinimidyl ester dye. OSA led to a significant decrease in T regulatory cells along with an increase in T helper (T) 17 cells in the ileum, cecum, and brain. Interleukin-17a neutralization significantly reduced blood pressure, increased T regulatory cells, and decreased T1 cells in the ileum, cecum, and brain of OSA rats. T1, T2, and T17 cells from the gut were found to migrate to the mesenteric lymph node, spleen, and brain with increased frequency in rats with OSA. Conclusions OSA induces a proinflammatory response in the gut and brain that involves interleukin-17a signaling. Gut dysbiosis may serve as the trigger for gut and neuroinflammation, and treatments to prevent or reverse gut dysbiosis may prove useful in reducing neuroinflammation and hypertension.

摘要

背景

阻塞性睡眠呼吸暂停(OSA)是高血压发展的独立危险因素。我们已经证明,OSA 会导致肠道菌群失调,而这种失调的微生物群有助于高血压的发生。然而,将肠道菌群失调与血压调节联系起来的机制尚不清楚。最近的研究表明,肠道菌群失调会引起宿主的炎症反应,导致外周和神经炎症,这是高血压发展的关键因素。我们假设 OSA 会引起肠道炎症,进而导致神经炎症和高血压。

方法和结果

在 8 周龄雄性大鼠中诱导 OSA。在出现呼吸暂停 2 周后,从主动脉、大脑、盲肠、回肠、肠系膜淋巴结和脾脏分离淋巴细胞进行流式细胞术分析。为了研究白细胞介素-17a 的作用,用单克隆抗体中和白细胞介素-17a。用羧基荧光素琥珀酰亚胺酯染料标记来跟踪来源于肠道的淋巴细胞。OSA 导致回肠、盲肠和大脑中的调节性 T 细胞显著减少,而辅助性 T(Th)17 细胞增加。白细胞介素-17a 中和显著降低了 OSA 大鼠的血压,增加了回肠、盲肠和大脑中的调节性 T 细胞,减少了 Th1 细胞。从 OSA 大鼠的肠道中分离出来的 Th1、Th2 和 Th17 细胞在肠系膜淋巴结、脾脏和大脑中的迁移频率增加。

结论

OSA 会引起肠道和大脑的炎症反应,涉及白细胞介素-17a 信号通路。肠道菌群失调可能是肠道和神经炎症的触发因素,预防或逆转肠道菌群失调的治疗方法可能有助于减少神经炎症和高血压。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6f8/10381979/52f3d995e251/JAH3-12-e029218-g001.jpg

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