| 赵明理,曹建西.重症肌无力病人肠道微生物群的变化[J].安徽医药,2024,28(8):1552-1557. |
| 重症肌无力病人肠道微生物群的变化 |
| Changes of intestinal microbiota in patients with myasthenia gravis |
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| DOI：10.3969/j.issn.1009-6469.2024.08.014 |
| 中文关键词: 重症肌无力 菌群 免疫功能 志贺菌属 短链脂肪酸 |
| 英文关键词: Myasthenia gravis Microbiota Immune function Prevotella Short chain fatty acids |
| 基金项目:河南省教育厅高等学校重点科研项目( 20B360006)；河南省中医药科学研究专项课题( 2023ZY1006) |
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| 中文摘要: |
| 目的探究重症肌无力( MG)病人和健康人群肠道微生物群的差异，以期为 MG的诊断和治疗寻求新的途径。方法选择 2021年 8月至 2022年 12月河南中医药大学第一附属医院 MG病人 20例，健康志愿者 10例，使用酶联免疫吸附(ELISA)测定 MG病人和健康志愿者血清中细胞因子水平；通过 Illumina MiSeq高通量测序仪检测 MG病人和健康志愿者肠道微生物群多样性和结构的差异；通过 OmicShare工具分析肠道微生物群与细胞因子［白细胞介素( IL)-6，IL-17，IL-22，IL-21，转化生长因子(TGF)-β，抗乙酰胆碱受体抗体( AChR)、人骨骼肌受体酪氨酸激酶抗体( MuSK)和人抗连接蛋白抗体( Titin)］之间的相关性。结果 MG病人血液中 IL-6，IL-17，IL-22，IL-21和 TGF-β水平分别为( 5.46±0.31)、(16.07±0.24)、(16.81±0.31)、(24.92±0.45)和(16 613.00±247.80)ng/L，高于健康志愿者的( 1.94±0.19)、(5.20±0.21)、(10.92±0.23)、(12.92±0.21)和( 14 462.00±140.70)ng/L，差异有统计学意义( P<0.01)；而且， MG病人血液中的 AChR、Musk和 Titin抗体水平分别为( 5.54±1.57)、(0.17±0.03)和( 1.47± 0.28)nmol/L，均高于健康志愿者的( 0.75±0.20)、(0.03±0.02)和( 0.19±0.04)nmol/L(P<0.05或 P<0.01)。此外， MG病人肠道微生物的结构发生了较大改变，在门水平上， MG病人的拟杆菌门的相对丰度为( 31.28±4.72)%低于健康志愿者的( 55.61±5.47)%，差异有统计学意义( P<0.01)而增加了变形菌门的相对丰度( 37.46±5.29)%比( 33.24±3.36)%(P<0.01)；在属水平上， MG病人的普雷沃菌属的相对丰度为(0，.14±0.10)%低于健康志愿者的( 24.01±9.90)%(P<0.01)而其志贺菌属的相对丰度为( 12.92± 5.21)%高于健康志愿者的( 0.08±0.04)%(P<0.01)；而且，关联分析结果显示志贺菌属与血，清炎症因子呈显著正相关( P<0.05或 P<0.01)普雷沃菌属和巨单胞菌属与血清炎症因子呈显著负相关( P<0.05或 P<0.01)瘤胃球菌属和真细菌与 AChR，MuSK和 Titin等抗体，水平呈正相关。结论 MG病人和健康志愿者除了血清中细胞因子存在差异，外，肠道微生物群的多样性和结构也存在差异，一方面这些差异的微生物可能作为检测 MG的标志，同时也可以从这些差异的微生物入手寻找治疗 MG的新途径。 |
| 英文摘要: |
| Objective To explore the difference of intestinal microbiota between myasthenia gravis (MG) patients and healthy people, soas to find a new way for the diagnosis and treatment of MG.Methods A total of 20 MG patients and 10 healthy volunteers in the FirstAffiliated Hospital of He'nan University of Traditional Chinese Medicine from August 2021 to December 2022 were selected. The levelof cytokines in the serum of MG patients and healthy volunteers by enzyme-linked immunosorbent assay (ELISA). The differences in di-versity and structure of intestinal microbiota in patients with MG and healthy volunteers were detected by Illumina MiSeq high-through- put sequencer. The correlation between intestinal microbiota and cytokines [Interleukin (IL) -6, IL-17, IL-22, IL-21, transforming growth factor (TGF)-β, anti-acetylcholine receptor antibody (AChR), human skeletal muscle receptor tyrosine kinase antibody (MuSK), and human anti-connectin antibody (Titin)] was analyzed by OmicShare tool.Results The levels of inflammatory factors in blood of pa-tients with MG were (5.46±0.31), (16.07±0.24), (16.81±0.31), (24.92±0.45) and (16 613.00±247.80) ng/L, respectively, which werehigher than those of healthy volunteers [(1.94±0.19), (5.20±0.21), (10.92±0.23), (12.92±0.21) and (14 462.00±140.70) ng/L] (P<0.01).Furthermore, the levels of AChR, Musk and Titin antibodies in the blood of patients with MG were (5.54±1.57), (0.17±0.03) and (1.47±0.28) nmol/L, respectively, which were higher than those of healthy volunteers [(0.75±0.20), (0.03±0.02) and (0.19±0.04) nmol/L] (P<0.05 or P<0.01). In addition, the structure of intestinal microbiota in patients with MG has changed greatly. At the phyla level, the rela-tive abundance of Bacteroides in MG patients was (31.28±4.72)%, which was lower than that in healthy volunteers (55.61±5.47)%, witha statistically significant difference (P<0.01), while the relative abundance of Proteobacteria in MG patients was higher than that in healthy volunteers [(37.46±5.29)% vs. (33.24±3.36)%] (P<0.01). At the genus level, the relative abundance of Prevotella in MG patients (0.14±0.10)% was lower than that in healthy volunteers (24.01±9.90)% (P<0.01), while the relative abundance of Shigella in MG pa- tients (12.92±5.21)% was higher than that in healthy volunteers (0.08±0.04)% (P<0.01). Moreover, correlation analysis showed that Shi- gella was significantly positively correlated with serum inflammatory factors (P<0.05 or P<0.01), Prevotella and Megamonas were signif- icantly negatively correlated with serum inflammatory factors (P<0.05 or P<0.01), and Ruminococcus and Eubacterium were positively correlated with antibody levels of AChR, MuSK and Tinin.Conclusions In addition to the differences in cytokines in blood, there arealso differences in the diversity and structure of intestinal microbiota between patients with MG and healthy volunteers. On the onehand, these differences in microorganisms may be used as a marker to detect MG, but also from these differences in microorganisms to find a new way to treat MG. |
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