References

nogr

Экспериментальная и клиническая гастроэнтерология

Experimental and Clinical Gastroenterology

1682-8658

«Global Media Technologies»

nogr-359

Research Article

ЭКСПЕРИМЕНТАЛЬНАЯ ГАСТРОЭНТЕРОЛОГИЯ

EXPERIMENTAL GASTROENTEROLOGY

МИКРОБИОТА КИШЕЧНИКА ПРИ ЯЗВЕННОМ КОЛИТЕ И ЦЕЛИАКИИ

GUT MICROBIOTA IN ULCERATIVE COLITIS AND CELIAC DISEASE

Ситкин

С. И.

Sitkin

S. I.

drsitkin@gmail.com

Вахитов

Т. Я.

Vakhitov

T. Ya.

noemail@neicon.ru

Ткаченко

Е. И.

Tkachenko

E. I.

noemail@neicon.ru

Орешко

Л. С.

Oreshko

L. S.

noemail@neicon.ru

Жигалова

Т. Н.

Zhigalova

T. N.

noemail@neicon.ru

Радченко

В. Г.

Radchenko

V. G.

noemail@neicon.ru

Селиверстов

П. В.

Seliverstov

P. V.

noemail@neicon.ru

Авалуева

Е. Б.

Avalueva

E. B.

noemail@neicon.ru

Суворова

М. А.

Suvorova

M. A.

noemail@neicon.ru

Комличенко

Э. В.

Komlichenko

E. V.

noemail@neicon.ru

СЗГМУ им. И. И. Мечникова, Санкт-Петербург; Гос. НИИ ОЧБ ФМБА РоссииРоссияNorth-Western State Medical University named after I. I. Mechnikov, St. Petersburg; State Research Institute of Highly Pure BiopreparationsRussian Federation

Гос. НИИ ОЧБ ФМБА РоссииРоссияState Research Institute of Highly Pure BiopreparationsRussian Federation

СЗГМУ им. И. И. Мечникова, Санкт-Петербург; Военно-медицинская академия имени С. М. КироваРоссияNorth-Western State Medical University named after I. I. Mechnikov, St. Petersburg; Kirov Military Medical AcademyRussian Federation

СЗГМУ им. И. И. Мечникова, Санкт-ПетербургРоссияNorth-Western State Medical University named after I. I. Mechnikov, St. PetersburgRussian Federation

Институт экспериментальной медициныРоссияInstitute of Experimental MedicineRussian Federation

ПСПбГМУ им. акад. И. П. ПавловаРоссияPavlov First Saint Petersburg State Medical UniversityRussian Federation

2017

20012017

01830

2017

Ситкин С.И., Вахитов Т.Я., Ткаченко Е.И., Орешко Л.С., Жигалова Т.Н., Радченко В.Г., Селиверстов П.В., Авалуева Е.Б., Суворова М.А., Комличенко Э.В.

Sitkin S.I., Vakhitov T.Y., Tkachenko E.I., Oreshko L.S., Zhigalova T.N., Radchenko V.G., Seliverstov P.V., Avalueva E.B., Suvorova M.A., Komlichenko E.V.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.nogr.org/jour/article/view/359

Цель исследования: изучить количественный состав некоторых представителей симбиотической микробиоты толстой кишки и выявить особенности дисбиоза кишечника у пациентов с язвенным колитом и целиакией. Материалы и методы: В исследование было включено 40 пациентов с активным язвенным колитом (легкая и среднетяжелая атаки), получающих терапию препаратами месалазина, 43 пациента с целиакией, находящихся на безглютеновой диете, и 42 практически здоровых добровольца. Для количественного определения микроорганизмов ДНК, выделенную из образцов кала, подвергали полимеразной цепной реакции (ПЦР) в режиме реального времени. Результаты: У пациентов с язвенным колитом, как и у больных целиакией, количество Faecalibacterium prausnitzii было значимо меньше, чем у здоровых лиц (p = 0,043 и p = 0,036 соответственно). Общее количество бутират-продуцирующих бактерий, имеющих ген бутирил-КоA: ацетат-КоA-трансферазы (but), было снижено (по сравнению со здоровыми добровольцами) только у пациентов с язвенным колитом (p = 0,048). Несмотря на то, что общее количество бактероидов между группами пациентов не различалось, Bacteroides thetaiotaomicron существенно реже встречался у пациентов с язвенным колитом, чем у здоровых лиц (p = 0,016). Отсутствие Bacteroides thetaiotaomicron в кале или его уровень ниже порога обнаружения были значимо связаны с язвенным колитом (ОШ = 6,30; 95% ДИ: 1,33 - 29,95). У пациентов с целиакией уровень Bifidobacterium spp. был значимо снижен по сравнению как со здоровыми добровольцами, так и с больными язвенным колитом (p = 0,022 и p = 0,046 соответственно). Как при язвенном колите, так и при целиакии таксономический дисбиоз характеризовался повышенным отношением Bacteroides fragilis spp. к Faecalibacterium prausnitzii по сравнению со здоровыми лицами (p < 0,05 в обоих случаях). Выводы: Повышенное отношение Bacteroides fragilis к Faecalibacterium prausnitzii может рассматриваться в качестве потенциального биомаркера дисбиоза кишечника провоспалительного типа. Уменьшение численности бутират-продуцирующих бактерий подтверждает целесообразность восполнения дефицита масляной кислоты при обоих заболеваниях путем дополнительного назначения препаратов масляной кислоты, пробиотиков на основе бутират-продуцирующих бактерий, бутирогенных пребиотиков и метабиотиков. Bacteroides thetaiotaomicron может играть защитную роль в организме человека, возможно, предохраняя его от развития воспалительных заболеваний кишечника. Снижение уровня Bifidobacterium spp. у пациентов с целиакией может свидетельствовать о защитной функции некоторых видов бифидобактерий и целесообразности применения пробиотиков на основе бифидобактерий и пребиотиков инулинового типа.

Aim: to investigate of fecal microbiota composition and to specify the features of intestinal dysbiosis in patients with ulcerative colitis (UC) and celiac disease (CD). Methods: Fresh fecal samples were collected from 40 mild-to-moderate active UC patients on mesalazine treatment, 43 CD patients on a gluten-free diet and 42 healthy controls (HC). The quantitative real-time polymerase chain reaction (qRT-PCR) was used for fecal microbiota assessment. Results: UC and CD patients had lower Faecalibacterium prausnitzii counts than HC (p = 0.043 and p = 0.036, respectively). Butyrate-producing bacteria (primers for Butyryl-CoA: acetate CoA transferase gene were used) were depleted in UC patients compared to HC (p = 0.048). Surprisingly, Bacteroides thetaiotaomicron was detected less frequently in UC patients than in HC (p = 0.016). The absence of Bacteroides thetaiotaomicron in feces or its levels below the limit of detection were significantly associated with ulcerative colitis (OR = 6.30; 95% CI: 1.33 - 29.95). CD patients had lower Bifidobacterium spp. counts than HC or UC (p = 0.022 and p = 0.046, respectively). Taxonomic dysbiosis in both UC and CD was characterized by a higher Bacteroides fragilis/Faecalibacterium prausnitzii ratio compared to HC (p < 0.05 in both cases). Conclusions: An increased B. fragilis/F. prausnitzii ratio can serve as available biomarker for intestinal proinflammatory dysbiosis in both UC and CD. Low counts of Faecalibacterium prausnitzii (in both UC and CD) and total butyrate-producing bacteria (in UC) suggest the desirability of co-treatment with oral butyrate or butyrate-enhancing agents (probiotics, prebiotics, metabiotics) in both UC and CD. Not only butyrate-producing bacteria but possibly also Bacteroides thetaiotaomicron protects against ulcerative colitis. Treatment that increases colonic bifidobacteria (e. g. some Bifidobacterium probiotics or inulin-type prebiotics) can be considered in CD.

бутиратдисбиоз толстой кишкимикробиота кишечникацелиакияязвенный колит

Bacteroides thetaiotaomicronBifidobacteriumFaecalibacterium prausnitziiBacteroides thetaiotaomicronBifidobacteriumbutyrateceliac diseasedysbiosisFaecalibacterium prausnitziigut microbiotaulcerative colitis

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The authors declare that there are no conflicts of interest present.