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人类实验性肠产毒性大肠杆菌感染期间的炎症、犬尿氨酸和黏膜损伤。

Inflammation, the kynurenines, and mucosal injury during human experimental enterotoxigenic Escherichia coli infection.

机构信息

Department of Clinical Science, Faculty of Medicine, University of Bergen, Bergen, Norway.

National Centre for Ultrasound in Gastroenterology, Haukeland University Hospital, Bergen, Norway.

出版信息

Med Microbiol Immunol. 2024 Mar 2;213(1):2. doi: 10.1007/s00430-024-00786-z.

Abstract

Enterotoxigenic Escherichia coli (ETEC) is an important cause of diarrhea in children and travelers, especially in low- and middle-income countries. ETEC is a non-invasive gut pathogen colonizing the small intestinal wall before secreting diarrhea-inducing enterotoxins. We sought to investigate the impact of ETEC infection on local and systemic host defenses by examining plasma markers of inflammation and mucosal injury as well as kynurenine pathway metabolites. Plasma samples from 21 volunteers experimentally infected with ETEC were collected before and 1, 2, 3, and 7 days after ingesting the ETEC dose, and grouped based on the level of intestinal ETEC proliferation: 14 volunteers experienced substantial proliferation (SP) and 7 had low proliferation (LP). Plasma markers of inflammation, kynurenine pathway metabolites, and related cofactors (vitamins B2 and B6) were quantified using targeted mass spectrometry, whereas ELISA was used to quantify the mucosal injury markers, regenerating islet-derived protein 3A (Reg3a), and intestinal fatty acid-binding protein 2 (iFABP). We observed increased concentrations of plasma C-reactive protein (CRP), serum amyloid A (SAA), neopterin, kynurenine/tryptophan ratio (KTR), and Reg3a in the SP group following dose ingestion. Vitamin B6 forms, pyridoxal 5'-phosphate and pyridoxal, decreased over time in the SP group. CRP, SAA, and pyridoxic acid ratio correlated with ETEC proliferation levels. The changes following experimental ETEC infection indicate that ETEC, despite causing a non-invasive infection, induces systemic inflammation and mucosal injury when proliferating substantially, even in cases without diarrhea. It is conceivable that ETEC infections, especially when repeated, contribute to negative health impacts on children in ETEC endemic areas.

摘要

肠产毒性大肠杆菌(ETEC)是儿童和旅行者腹泻的重要病因,尤其在中低收入国家。ETEC 是一种非侵入性肠道病原体,定植于小肠壁,然后分泌致腹泻肠毒素。我们通过检测炎症和黏膜损伤的血浆标志物以及犬尿氨酸途径代谢物,研究了 ETEC 感染对局部和全身宿主防御的影响。21 名志愿者经实验性 ETEC 感染,在摄入 ETEC 剂量后 1、2、3 和 7 天前及后采集血浆样本,根据肠道 ETEC 增殖水平分组:14 名志愿者出现大量增殖(SP),7 名志愿者增殖水平低(LP)。采用靶向质谱法定量检测血浆炎症标志物、犬尿氨酸途径代谢物及其相关辅助因子(维生素 B2 和 B6),ELISA 法用于定量检测黏膜损伤标志物、再生胰岛衍生蛋白 3A(Reg3a)和肠脂肪酸结合蛋白 2(iFABP)。我们观察到,在摄入 ETEC 剂量后,SP 组血浆 C 反应蛋白(CRP)、血清淀粉样蛋白 A(SAA)、新蝶呤、犬尿氨酸/色氨酸比值(KTR)和 Reg3a 浓度升高。SP 组维生素 B6 形式(吡哆醛 5'-磷酸和吡哆醛)随时间推移而降低。CRP、SAA 和吡哆酸比值与 ETEC 增殖水平相关。实验性 ETEC 感染后的变化表明,ETEC 尽管引起非侵入性感染,但在大量增殖时,即使在没有腹泻的情况下,也会引起全身炎症和黏膜损伤。可以想象,ETEC 感染,特别是重复感染,会对 ETEC 流行地区的儿童健康产生负面影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5e9/10908629/752c7dc32a17/430_2024_786_Fig1_HTML.jpg

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