肺结核与肠道菌群相关性的研究进展

doi:10.3969/j.issn.1000-6621.2021.11.017

摘要/Abstract

摘要：

随着微生物检测技术的发展,研究发现肠道菌群与人类疾病存在着密切的关系。目前已经有多项研究表明肺结核患者肠道菌群失调,而且机体肠道菌群失调可能会明显地增加肺结核的患病率,两者之间通过菌群代谢和机体的免疫反应等直接或间接地相互影响。作者对肺结核与肠道菌群的关联、两者之间作用的可能机制,以及是否可以通过调节肠道菌群预防和辅助治疗肺结核进行综述。

关键词: 结核,肺, 肠杆菌科, 代谢, 免疫调节, 有益菌种

Abstract:

With the development of microbial detection technology, studies have found that there is a close relationship between intestinal flora and human diseases. At present, many studies have shown that the imbalance of intestinal flora exists in patients with pulmonary tuberculosis which may significantly increase the prevalence of pulmonary tuberculosis. They interact directly or indirectly through the metabolism of bacteria and the immune response of the body. The author reviews the relationship between pulmonary tuberculosis and intestinal flora, the possible mechanism of the interaction between them, and whether it is possible to prevent and treat pulmonary tuberculosis by regulating intestinal microflora.

Key words: Tuberculosis,pulmonary, Enterobacteriaceae, Metabolism, Immunomodulation, Beneficial bacteria

李康, 柴英辉, 白光亮, 邓先平, 雷红. 肺结核与肠道菌群相关性的研究进展[J]. 中国防痨杂志, 2021, 43(11): 1210-1215. doi: 10.3969/j.issn.1000-6621.2021.11.017

LI Kang, CHAI Ying-hui, BAI Guang-liang, DENG Xian-ping, LEI Hong. Research progress of correlation between pulmonary tuberculosis and intestinal flora[J]. Chinese Journal of Antituberculosis, 2021, 43(11): 1210-1215. doi: 10.3969/j.issn.1000-6621.2021.11.017

参考文献 50

[1]	Floyd K, Glaziou P, Houben RMGJ, et al. Global tuberculosis targets and milestones set for 2016—2035: definition and rationale. Int J Tuberc Lung Dis, 2018, 22(7):723-730. doi: 10.5588/ijtld. 17.0835. doi: 10.5588/ijtld. 17.0835
[2]	Druszczyńska M, Kowalewicz-Kulbat M, Fol M, et al. Latent M.tuberculosis infection-pathogenesis, diagnosis, treatment and prevention strategies. Pol J Microbiol, 2012, 61(1):3-10. doi: 10.33073/pjm-2012-001. doi: 10.33073/pjm-2012-001
[3]	孔维宾, 韩丹, 李梦秋, 等. 肺结核患者家属结核分枝杆菌潜伏感染状况及危险因素分析. 河南预防医学杂志, 2021, 32(1):10-12,16. doi: 10.13515/j.cnki.hnjpm.1006-8414.2021.01.003. doi: 10.13515/j.cnki.hnjpm.1006-8414.2021.01.003
[4]	Blum HE. The human microbiome. Adv Med Sci, 2017, 62(2):414-420. doi: 10.1016/j.advms.2017.04.005. doi: 10.1016/j.advms.2017.04.005
[5]	Budden KF, Gellatly SL, Wood DL, et al. Emerging pathogenic links between microbiota and the gut-lung axis. Nat Rev Microbiol, 2017, 15(1):55-63. doi: 10.1038/nrmicro.2016.142. doi: 10.1038/nrmicro.2016.142
[6]	Hsu BB, Plant IN, Lyon L, et al. In situ reprogramming of gut bacteria by oral delivery. Nat Commun, 2020, 11(1):5030. doi: 10.1038/s41467-020-18614-2. doi: 10.1038/s41467-020-18614-2
[7]	Chassaing B, Raja SM, Lewis JD, et al. Colonic Microbiota Encroachment Correlates With Dysglycemia in Humans. Cell Mol Gastroenterol Hepatol, 2017, 4(2):205-221. doi: 10.1016/j.jcmgh. 2017.04.001. doi: 10.1016/j.jcmgh. 2017.04.001
[8]	陈硕, 聂汉祥, 刘琳琳, 等. 肠道菌群与支气管哮喘. 国际呼吸杂志, 2018, 38(2):129-132. doi: 10.3760/cma.j.issn.1673-436X.2018.02.011. doi: 10.3760/cma.j.issn.1673-436X.2018.02.011
[9]	Mukherjee S, Joardar N, Sengupta S, et al. Gut microbes as future therapeutics in treating inflammatory and infectious diseases: Lessons from recent findings. J Nutr Biochem, 2018, 61:111-128. doi: 10.1016/j.jnutbio.2018.07.010. doi: 10.1016/j.jnutbio.2018.07.010
[10]	Schuijt TJ, Lankelma JM, Scicluna BP, et al. The gut microbiota plays a protective role in the host defence against pneumococcal pneumonia. Gut, 2016, 65(4):575-583. doi: 10.1136/gutjnl-2015-309728. doi: 10.1136/gutjnl-2015-309728
[11]	Azad MB, Konya T, Persaud RR, et al. Impact of maternal intrapartum antibiotics, method of birth and breastfeeding on gut microbiota during the first year of life: a prospective cohort study. BJOG, 2016, 123(6):983-993. doi: 10.1111/1471-0528.13601. doi: 10.1111/1471-0528.13601
[12]	Ruiz-Calderon JF, Cavallin H, Song SJ, et al. Walls talk: Microbial biogeography of homes spanning urbanization. Sci Adv, 2016, 2(2):e1501061. doi: 10.1126/sciadv.1501061. doi: 10.1126/sciadv.1501061
[13]	Chung KF. Airway microbial dysbiosis in asthmatic patients: A target for prevention and treatment? J Allergy Clin Immunol, 2017, 139(4):1071-1081. doi: 10.1016/j.jaci.2017.02.004. doi: 10.1016/j.jaci.2017.02.004
[14]	Mjösberg J, Rao A. Lung inflammation originating in the gut. Science, 2018, 359(6371):36-37. doi: 10.1126/science.aar4301. doi: 10.1126/science.aar4301
[15]	Khan N, Vidyarthi A, Nadeem S, et al. Alteration in the Gut Microbiota Provokes Susceptibility to Tuberculosis. Front Immunol, 2016, 7:529. doi: 10.3389/fimmu.2016.00529. doi: 10.3389/fimmu.2016.00529
[16]	Zhang YB, Liu SJ, Hu ZD, et al. Increased Th17 activation and gut microbiota diversity are associated with pembrolizumab-triggered tuberculosis. Cancer Immunol Immunother, 2020, 69(12):2665-2671. doi: 10.1007/s00262-020-02687-5. doi: 10.1007/s00262-020-02687-5
[17]	Camelo-Castillo AJ, Mira A, Pico A, et al. Subgingival microbiota in health compared to periodontitis and the influence of smoking. Front Microbiol, 2015, 6:119. doi: 10.3389/fmicb.2015.00119. doi: 10.3389/fmicb.2015.00119
[18]	杨翰, 李欢, 郗隽, 等. 初治结核病患者肠道菌群变性梯度凝胶电泳指纹图谱分析. 中国防痨杂志, 2019, 41(9):985-992. doi: 10.3969/j.issn.1000-6621.2019.09.013. doi: 10.3969/j.issn.1000-6621.2019.09.013
[19]	Maji A, Misra R, Dhakan DB, et al. Gut microbiome contri-butes to impairment of immunity in pulmonary tuberculosis patients by alteration of butyrate and propionate producers. Environ Microbiol, 2018, 20(1):402-419. doi: 10.1111/1462-2920.14015. doi: 10.1111/1462-2920.14015
[20]	Khaliq A, Ravindran R, Afzal S, et al. Gut microbiome dysbiosis and correlation with blood biomarkers in active-tuberculosis in endemic setting. PLoS One, 2021, 16(1):e0245534. doi: 10.1371/journal.pone.0245534. doi: 10.1371/journal.pone.0245534
[21]	Luo M, Liu Y, Wu P, et al. Alternation of Gut Microbiota in Patients with Pulmonary Tuberculosis. Front Physiol, 2017, 8:822. doi: 10.3389/fphys.2017.00822. doi: 10.3389/fphys.2017.00822
[22]	Huang SF, Yang YY, Chou KT, et al. Systemic proinflammation after Mycobacterium tuberculosis infection was correlated to the gut microbiome in HIV-uninfected humans. Eur J Clin Invest, 2019, 49(5):e13068. doi: 10.1111/eci.13068. doi: 10.1111/eci.13068
[23]	Winglee K, Eloe-Fadrosh E, Gupta S, et al. Aerosol Mycobacterium tuberculosis infection causes rapid loss of diversity in gut microbiota. PLoS One, 2014, 9(5):e97048. doi: 10.1371/journal.pone.0097048. doi: 10.1371/journal.pone.0097048
[24]	Wipperman MF, Fitzgerald DW, Juste MAJ, et al. Antibiotic treatment for Tuberculosis induces a profound dysbiosis of the microbiome that persists long after therapy is completed. Sci Rep, 2017, 7(1):10767. doi: 10.1038/s41598-017-10346-6. doi: 10.1038/s41598-017-10346-6
[25]	孙玉霞, 赵善良, 刘加洪, 等. 强化四周抗结核药物治疗对结核病患者肠道微生态影响分析. 实用预防医学, 2019, 26(10):1177-1182. doi: 10.3969/j.issn.1006-3110.2019.10.007. doi: 10.3969/j.issn.1006-3110.2019.10.007
[26]	Hu Y, Yang Q, Liu B, et al. Gut microbiota associated with pulmonary tuberculosis and dysbiosis caused by anti-tuberculosis drugs. J Infect, 2019, 78(4):317-322. doi: 10.1016/j.jinf.2018. 08.006. doi: 10.1016/j.jinf.2018. 08.006
[27]	Scriba TJ, Carpenter C, Pro SC, et al. Differential Recognition of Mycobacterium tuberculosis-Specific Epitopes as a Function of Tuberculosis Disease History. Am J Respir Crit Care Med, 2017, 196(6):772-781. doi: 10.1164/rccm.201706-1208OC. doi: 10.1164/rccm.201706-1208OC
[28]	Kovatcheva-Datchary P, Nilsson A, Akrami R, et al. Dietary Fiber-Induced Improvement in Glucose Metabolism Is Associated with Increased Abundance of Prevotella. Cell Metab, 2015, 22(6):971-982. doi: 10.1016/j.cmet.2015.10.001. doi: 10.1016/j.cmet.2015.10.001
[29]	Sandberg J, Kovatcheva-Datchary P, Björck I, et al. Abundance of gut Prevotella at baseline and metabolic response to barley prebiotics. Eur J Nutr, 2019, 58(6):2365-2376. doi: 10.1007/s00394-018-1788-9. doi: 10.1007/s00394-018-1788-9
[30]	Koh A, De Vadder F, Kovatcheva-Datchary P, et al. From Dietary Fiber to Host Physiology: Short-Chain Fatty Acids as Key Bacterial Metabolites. Cell, 2016, 165(6):1332-1345. doi: 10.1016/j.cell.2016.05.041. doi: 10.1016/j.cell.2016.05.041
[31]	Nicolas GR, Chang PV. Deciphering the Chemical Lexicon of Host-Gut Microbiota Interactions. Trends Pharmacol Sci, 2019, 40(6):430-445. doi: 10.1016/j.tips.2019.04.006. doi: 10.1016/j.tips.2019.04.006
[32]	Hu Y, Feng Y, Wu J, et al. The Gut Microbiome Signatures Discriminate Healthy From Pulmonary Tuberculosis Patients. Front Cell Infect Microbiol, 2019, 9:90. doi: 10.3389/fcimb. 2019.00090. doi: 10.3389/fcimb. 2019.00090
[33]	Frati F, Salvatori C, Incorvaia C, et al. The Role of the Microbiome in Asthma: The Gut Lung Axis. Int J Mol Sci, 2018, 20(1):123. doi: 10.3390/ijms20010123. doi: 10.3390/ijms20010123
[34]	Alverdy JC, Krezalek MA. Collapse of the Microbiome, Emergence of the Pathobiome, and the Immunopathology of Sepsis. Crit Care Med, 2017, 45(2):337-347. doi: 10.1097/CCM. 0000000000002172. doi: 10.1097/CCM. 0000000000002172
[35]	Hooper LV, Littman DR, Macpherson AJ. Interactions between the microbiota and the immune system. Science, 2012, 336(6086):1268-1273. doi: 10.1126/science.1223490. doi: 10.1126/science.1223490
[36]	Nadeem S, Maurya SK, Das DK, et al. Gut Dysbiosis Thwarts the Efficacy of Vaccine Against Mycobacterium tuberculosis. Front Immunol, 2020, 11:726. doi: 10.3389/fimmu.2020.00726. doi: 10.3389/fimmu.2020.00726
[37]	Vorkas CK, Wipperman MF, Li K, et al. Mucosal-associated invariant and γδ T cell subsets respond to initial Mycobacterium tuberculosis infection. JCI Insight, 2018, 3(19):e121899. doi: 10.1172/jci.insight.121899. doi: 10.1172/jci.insight.121899
[38]	Larsen JM. The immune response to Prevotella bacteria in chronic inflammatory disease. Immunology, 2017, 151(4):363-374. doi: 10.1111/imm.12760. doi: 10.1111/imm.12760
[39]	Huang Y, Tang J, Cai Z, et al. Prevotella Induces the Production of Th17 Cells in the Colon of Mice. J Immunol Res, 2020, 2020:9607328. doi: 10.1155/2020/9607328. doi: 10.1155/2020/9607328
[40]	Huang Y, Mao K, Chen X, et al. S1P-dependent interorgan trafficking of group 2 innate lymphoid cells supports host defense. Science, 2018, 359(6371):114-119. doi: 10.1126/science.aam5809. doi: 10.1126/science.aam5809
[41]	Bradley CP, Teng F, Felix KM, et al. Segmented Filamentous Bacteria Provoke Lung Autoimmunity by Inducing Gut-Lung Axis Th17 Cells Expressing Dual TCRs. Cell Host Microbe, 2017, 22(5):697-704. e4. doi: 10.1016/j.chom.2017.10.007. doi: 10.1016/j.chom.2017.10.007
[42]	Dheda K, Gumbo T, Maartens G, et al. The Lancet Respiratory Medicine Commission: 2019 update: epidemiology, patho-genesis, transmission, diagnosis, and management of multidrug-resistant and incurable tuberculosis. Lancet Respir Med, 2019, 7(9):820-826. doi: 10.1016/S2213-2600(19)30263-2. doi: 10.1016/S2213-2600(19)30263-2
[43]	熊燕鹃, 罗和生. 肠道菌群与酒精性肝病. 胃肠病学和肝病学杂志, 2016, 25(9):1062-1065. doi: 10.3969/j.issn.1006-5709.2016.09.025. doi: 10.3969/j.issn.1006-5709.2016.09.025
[44]	Knackstedt R, Gatherwright J. The role of thermal injury on intestinal bacterial translocation and the mitigating role of probiotics: A review of animal and human studies. Burns, 2020, 46(5):1005-1012. doi: 10.1016/j.burns.2019.07.007. doi: 10.1016/j.burns.2019.07.007
[45]	毕紫娟, 张仕晟, 袁建业. 益生菌与肠易激综合征. 医学综述, 2017, 23(1):125-128,133. doi: 10.3969/j.issn.1006-2084.2017.01.029. doi: 10.3969/j.issn.1006-2084.2017.01.029
[46]	胡明, 李晓莉, 甄鹏, 等. 益生菌治疗老年肺炎的临床疗效及其对炎性反应、细胞免疫功能的影响. 实用心脑肺血管病杂志, 2019, 27(4):99-102. doi: 10.3969/j.issn.1008-5971.2019.04.017. doi: 10.3969/j.issn.1008-5971.2019.04.017
[47]	Yang Z, Wu Q, Liu Y, et al. Effect of Perioperative Probiotics and Synbiotics on Postoperative Infections After Gastrointestinal Surgery: A Systematic Review With Meta-Analysis. JPEN J Parenter Enteral Nutr, 2017, 41(6):1051-1062. doi: 10.1177/0148607116629670. doi: 10.1177/0148607116629670
[48]	Manzanares W, Lemieux M, Langlois PL, et al. Probiotic and synbiotic therapy in critical illness: a systematic review and meta-analysis. Crit Care, 2016, 19:262. doi: 10.1186/s13054-016-1434-y. doi: 10.1186/s13054-016-1434-y
[49]	Dhakan DB, Maji A, Sharma AK, et al. The unique composition of Indian gut microbiome, gene catalogue, and associated fecal metabolome deciphered using multi-omics approaches. Gigascience, 2019, 8(3):giz004. doi: 10.1093/gigascience/giz004. doi: 10.1093/gigascience/giz004
[50]	Zmora N, Zilberman-Schapira G, Suez J, et al. Personalized Gut Mucosal Colonization Resistance to Empiric Probiotics Is Associated with Unique Host and Microbiome Features. Cell, 2018, 174(6):1388-1405. e21. doi: 10.1016/j.cell.2018.08.041. doi: 10.1016/j.cell.2018.08.041