北京大學第三醫院一直在生殖領域比較強,所以有了新的研究也不令人驚訝。這次在Nature Medicine 在線發表的最新研究,也為我們對多囊防治的未來有了更多信息。
首先說說Nature Medicine,這是一本影響因子全球排名20多名的期刊,也就是證明這篇論文的學術水平、以及論文質量是比較高的。
論文題目是
Gut microbiota–bile acid–interleukin-22 axis orchestrates polycystic ovary syndrome(腸道菌-膽汁酸-IL22軸調控多囊卵巢症候群發病)
研究發現,把PCOS患者的腸道菌移植或者給予B.vulgatus菌種重塑小鼠腸道菌群後,呈現PCOS樣表型,伴隨腸道免疫因子IL-22水平下降。給予PCOS樣小鼠膽汁酸GDCA或IL-22治療後,可顯著改善激素異常、多囊樣變、胰島素抵抗等。
我們似乎已經看到了一種治療方式。腸道菌-膽汁酸-IL22軸來調控多囊卵巢症候群發病,是繼基因、抗穆勒氏管激素(重大研究進展—可能找到治癒辦法)、環境毒素等等之後的新視角。雖然應用到臨床還需要時間,但是這是來自我們中國自己的研究,相信未來會一步步更好。
現在我們越來越知道腸道健康對我們的整體健康,更對我們的多囊卵巢症候群都有至關重要的意義。很多人馬上反應是不是要補益生菌,但是到底哪些菌群對我們最有利呢,市面上又是否有呢,這我還是要打一個問號?至少在這次研究中發現,我們身體中B.vulgatus菌種顯著過多,導致腸道菌群異常,要如何去恢復它,非常非常期待更多研究和臨床應用。
我也知道國內還有其他重量級研究團隊在針對我們多囊進行深入研究,對未來很有信心。
感謝喬傑院士團隊和姜長濤研究院團隊的努力付出,期待更多的好消息。
文章連結:https://www.nature.com/articles/s41591-019-0509-0
Abstract
Polycystic ovary syndrome (PCOS) is characterized by androgen excess, ovulatory dysfunction and polycystic ovaries1, and is often accompanied by insulin resistance2. The mechanism of ovulatory dysfunction and insulin resistance in PCOS remains elusive, thus limiting the development of therapeutics. Improved metabolic health is associated with a relatively high microbiota gene content and increased microbial diversity3,4. This study aimed to investigate the impact of the gut microbiota and its metabolites on the regulation of PCOS-associated ovarian dysfunction and insulin resistance. Here, we report that Bacteroides vulgatus was markedly elevated in the gut microbiota of individuals with PCOS, accompanied by reduced glycodeoxycholic acid and tauroursodeoxycholic acid levels. Transplantation of fecal microbiota from women with PCOS or B. vulgatus-colonized recipient mice resulted in increased disruption of ovarian functions, insulin resistance, altered bile acid metabolism, reduced interleukin-22 secretion and infertility. Mechanistically, glycodeoxycholic acid induced intestinal group 3 innate lymphoid cell IL-22 secretion through GATA binding protein 3, and IL-22 in turn improved the PCOS phenotype. This finding is consistent with the reduced levels of IL-22 in individuals with PCOS. This study suggests that modifying the gut microbiota, altering bile acid metabolism and/or increasing IL-22 levels may be of value for the treatment of PCOS.
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