Department of Radiation Oncology, Chongqing University Cancer Hospital & Chongqing Cancer Institute & Chongqing Cancer Hospital, Chongqing, China.
Department of Infectious Diseases, Chongqing Public Health Medical Center, Chongqing, China.
Probiotics Antimicrob Proteins. 2024 Aug;16(4):1465-1482. doi: 10.1007/s12602-024-10227-1. Epub 2024 Feb 9.
A dramatic reduction in mortality among people living with HIV (PLWH) has been achieved during the modern antiretroviral therapy (ART) era. However, ART does not restore gut barrier function even after long-term viral suppression, allowing microbial products to enter the systemic blood circulation and induce chronic immune activation. In PLWH, a chronic state of systemic inflammation exists and persists, which increases the risk of development of inflammation-associated non-AIDS comorbidities such as metabolic disorders, cardiovascular diseases, and cancer. Clostridium butyricum is a human butyrate-producing symbiont present in the gut microbiome. Convergent evidence has demonstrated favorable effects of C. butyricum for gastrointestinal health, including maintenance of the structural and functional integrity of the gut barrier, inhibition of pathogenic bacteria within the intestine, and reduction of microbial translocation. Moreover, C. butyricum supplementation has been observed to have a positive effect on various inflammation-related diseases such as diabetes, ulcerative colitis, and cancer, which are also recognized as non-AIDS comorbidities associated with epithelial gut damage. There is currently scant published research in the literature, focusing on the influence of C. butyricum in the gut of PLWH. In this hypothesis review, we speculate the use of C. butyricum as a probiotic oral supplementation may well emerge as a potential future synergistic adjunctive strategy in PLWH, in tandem with ART, to restore and consolidate intestinal barrier integrity, repair the leaky gut, prevent microbial translocation from the gut, and reduce both gut and systemic inflammation, with the ultimate objective of decreasing the risk for development of non-AIDS comorbidities in PLWH.
在现代抗逆转录病毒疗法 (ART) 时代，艾滋病毒感染者 (PLWH) 的死亡率已大幅下降。然而，即使在长期病毒抑制后，ART 也无法恢复肠道屏障功能，允许微生物产物进入全身血液循环并诱导慢性免疫激活。在 PLWH 中，存在并持续存在慢性全身炎症状态，这增加了发生与炎症相关的非艾滋病合并症（如代谢紊乱、心血管疾病和癌症）的风险。丁酸梭菌是一种存在于肠道微生物组中的人类丁酸产生共生体。越来越多的证据表明丁酸梭菌对胃肠道健康有有益影响，包括维持肠道屏障的结构和功能完整性、抑制肠道内的致病菌以及减少微生物易位。此外，已经观察到丁酸梭菌补充对各种与炎症相关的疾病（如糖尿病、溃疡性结肠炎和癌症）有积极影响，这些疾病也被认为是与肠上皮损伤相关的非艾滋病合并症。目前，文献中关于丁酸梭菌在 PLWH 肠道中的影响的研究很少。在本假设综述中，我们推测使用丁酸梭菌作为益生菌口服补充剂可能会成为与 ART 一起恢复和巩固肠道屏障完整性、修复渗漏肠道、防止微生物从肠道易位以及减少肠道和全身炎症的潜在未来协同辅助策略，最终目标是降低 PLWH 中非艾滋病合并症的风险。
