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轮状病毒肠炎患儿联合锌制剂与常规治疗后肠道微生物组变化的特征。

Characterization of changes in the intestinal microbiome following combination therapy with zinc preparation and conventional treatment for children with rotavirus enteritis.

机构信息

Department of Clinical Laboratory, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.

Department of Gastroenterology, The First People's Hospital of Yunnan Province, The Affiliated Hospital of Kunming University of Science and Technology, Kunming, China.

出版信息

Front Cell Infect Microbiol. 2023 Sep 29;13:1153701. doi: 10.3389/fcimb.2023.1153701. eCollection 2023.

Abstract

BACKGROUND

Rotavirus (RV) is one of the most common pathogens causing diarrhea in infants and young children worldwide. Routinely, antiviral therapy, intestinal mucosa protection, and fluid supplementation are used in clinic, however this is not efficacious in some severe cases. Zinc supplementation has previously been shown to improve resolution of symptoms from infectious diarrhea.

METHODS

In this study differences in response rate, duration of hyperthermia, vomiting, and diarrhea, and the persistence time of cough and lung rales in groups were compared. 16SrDNA gene sequencing technology was used to analyze and compare changes in the intestinal microflora of children with RV enteritis who received the conventional treatment with or without the zinc preparation. In addition, the correlations between the differential bacterial species and the related inflammatory factors were determined.

RESULTS

Conventional therapy combined with the zinc preparation significantly shortened the duration of hyperthermia, vomiting, and diarrhea compared with the conventional treatment alone. In addition, the time to symptom relief showed that the absorption time of cough and lung rales was significantly shorter in the combination treatment group than that in the conventional treatment group in the children with pneumonia. Further, compared with the conventional treatment, the combined treatment significantly increased the diversity and abundances of florae as compared with the conventional treatment. This combination therapy containing zinc preparation markedly increased the abundances of Faecalibacterium, Bacteroidales, Ruminoccoccoccus, and Lachnospiraceae at the genus level. The LEfSe analysis suggested that were most significantly altered after the combination therapy. In addition, a correlation analysis revealed significantly negative correlations between the inflammatory factors especially IL-6, TNF-a, CRP and some intestinal florae such as , and

CONCLUSION

Compared with the conventional therapy alone, the combined therapy with the zinc preparation significantly improves symptoms caused by RV. The combination therapy containing the zinc preparation significantly increases the diversity and abundances of some beneficial groups of bacteria. Further, The presence of these groups was further negatively correlated with relevant inflammatory factors. More importantly, this combination therapy containing the zinc preparation provides a reference for the clinical management of children with RV enteritis.

摘要

背景

轮状病毒(RV)是导致全球婴幼儿腹泻的最常见病原体之一。临床上通常采用抗病毒治疗、肠黏膜保护和补液等方法,但在一些重症病例中效果不佳。补锌治疗已被证明可改善感染性腹泻的症状缓解。

方法

本研究比较了常规治疗加锌制剂与单纯常规治疗在患儿中的反应率、发热、呕吐、腹泻持续时间、咳嗽和肺部啰音持续时间的差异。采用 16SrDNA 基因测序技术分析比较了常规治疗加锌制剂与单纯常规治疗的轮状病毒肠炎患儿肠道微生态的变化,并确定了差异细菌种类与相关炎症因子的相关性。

结果

常规治疗加锌制剂组与单纯常规治疗组相比,发热、呕吐、腹泻持续时间明显缩短。此外,在肺炎患儿中,联合治疗组咳嗽和肺部啰音的缓解时间明显短于常规治疗组。与常规治疗相比,联合治疗组的菌群多样性和丰度明显增加。与常规治疗相比,联合治疗组显著增加了 Faecalibacterium、Bacteroidales、Ruminoccoccoccus 和 Lachnospiraceae 等属的丰度。LEfSe 分析表明,联合治疗后发生了最显著的变化。此外,相关性分析显示,炎症因子,特别是白细胞介素 6、肿瘤坏死因子-α和 C 反应蛋白与某些肠道菌群如 呈显著负相关。

结论

与单纯常规治疗相比,联合锌制剂治疗可显著改善 RV 引起的症状。联合锌制剂治疗可显著增加某些有益菌的多样性和丰度。此外,这些菌群的存在与相关炎症因子呈负相关。更重要的是,这种含锌制剂的联合治疗为儿童轮状病毒肠炎的临床治疗提供了参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edbc/10570505/815f911187ec/fcimb-13-1153701-g001.jpg

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