Article(id=1190373728392417804, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1190332325088039709, articleNumber=null, orderNo=null, doi=10.16438/j.0513-4870.2025-0183, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=research-article, receivedDate=1740412800000, receivedDateStr=2025-02-25, revisedDate=1742227200000, revisedDateStr=2025-03-18, acceptedDate=null, acceptedDateStr=null, onlineDate=1761736812922, onlineDateStr=2025-10-29, pubDate=1746979200000, pubDateStr=2025-05-12, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1761736812922, onlineIssueDateStr=2025-10-29, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1761736812922, creator=13701087609, updateTime=1761736812922, updator=13701087609, issue=Issue{id=1190332325088039709, tenantId=1146029695717560320, journalId=1189982191388893191, year='2025', volume='60', issue='5', pageStart='1183', pageEnd='1572', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=1, specialIssue=null, createTime=1761726941606, creator=13701087609, updateTime=1761813457266, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1190695198163354009, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1190332325088039709, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1190695198163354010, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1190332325088039709, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1228, endPage=1235, ext={EN=ArticleExt(id=1190373728669241869, articleId=1190373728392417804, tenantId=1146029695717560320, journalId=1189982191388893191, language=EN, title=Inulin gel/Clostridium butyricum synbiotic for prevention and treatment radiation-induced intestinal injury, columnId=1190332325767516958, journalTitle=Acta Pharmaceutica Sinica, columnName=Special Reports: Live biotherapeutic products based on engineered bacteria, runingTitle=null, highlight=null, articleAbstract=

Radiation-induced intestinal injury (RIII) is a common syndrome in the radiotherapy of abdominal and pelvic malignant tumors, heavily influencing the living quality, but no specific clinical regimens are available. Inulin is a naturally soluble dietary fiber. Clostridium butyricum (Cb) is a strict Gram-positive anaerobic bacillus, which can secrete and produce a large number of butyric acid, improving the intestinal barrier function and reducing the growth and colonization of opportunistic bacteria. A synbiotic of inulin gels (IG) and Cb exerts the synergistic effect of prebiotic intestinal retention and probiotics. In this study, an oral synbiotic of IG and Cb was applied for the prevention and treatment of RIII and the mechanisms were explored. Animal experiments were approved by the Ethics Committee of the Academy of Military Medical Sciences and the experiments were conducted in accordance with relevant guidelines and regulations (authorizing number: IACUC-DWZX-2022-525). An RIII mouse model was established after whole abdominal γ-ray radiation of 13 Gy. The synbiotic was intragastrically administered to the mice 1 h pre-radiation. Compared to the models, the mice of the synbiotic group had more regenerated intestinal crypts, longer villus and colon, and more tight junction protein on day 3.5. Moreover, the mice of the synbiotic group had an obvious increase in the relative abundance of gut microbiota on day 7, especially the amounts of multiple probiotics and short-chain fatty acid metabolites. On day 14, the mice of the synbiotic group had highly low permeability of intestinal mucosa according to the fluorescence labeling experiment, which was close to the normal level. Moreover, the mice of the synbiotic group showed a high decrease of proinflammatory factors including tumor necrosis factor-α and interleukin-6, close to the normal levels. Therefore, the oral synbiotic can alleviate the syndromes of RIII and improve the repair of damaged intestinal and colon tissues, and its protective effect is better than IG and Cb. The oral synbiotic is a safe and effective biological drug against RIII.

, correspAuthors=Yi-guang JIN, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Acta Pharmaceutica Sinica. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Dong-dong LIU, Yu-bao FANG, Meng WEI, Hua XIE, Ying-bao SUN, Wen-rui YAN, Yan-li GUO, Yi-guang JIN), CN=ArticleExt(id=1190374198288683166, articleId=1190373728392417804, tenantId=1146029695717560320, journalId=1189982191388893191, language=CN, title=防治放射性肠损伤的菊粉凝胶载丁酸梭菌的合生制剂, columnId=1190332325914317601, journalTitle=药学学报, columnName=专题报道: 基于工程化细菌的活体生物药, runingTitle=null, highlight=null, articleAbstract=

放射性肠损伤(radiation-induced intestinal injury, RIII) 是腹盆腔恶性肿瘤患者放疗常见并发症, 严重影响生活质量, 临床无专门防治药物。菊粉是一种天然水溶性膳食纤维。丁酸梭菌(Clostridium butyricum, Cb) 属严格厌氧革兰阳性芽孢杆菌, 能分泌大量丁酸, 改善肠道屏障功能, 减少条件致病菌生长与定植。菊粉凝胶(inulin gel, IG) 载Cb合生制剂发挥益生元肠道滞留与益生菌的协同作用。本文将口服IG载Cb的合生制剂用于RIII防治并探讨机制。所有动物实验经军事医学研究院伦理委员会批准且实验均按照相关指导原则和规定进行(批准号: IACUC-DWZX-2022-525)。小鼠腹部经13 Gy γ射线照射, 成功建立RIII模型。照前1 h给小鼠灌胃合生制剂, 与模型组比较, 照后第3.5日合生制剂组小肠新生隐窝数量明显增多, 小肠绒毛更长; 结肠长度更长, 紧密连接蛋白表达提升。照后第7日肠道菌群相对丰度显著增加, 特别是多种益生菌数量, 粪便中短链脂肪酸含量增加。照后第14日, 荧光标记法证明合生制剂组小鼠肠黏膜渗透性明显减小, 达到健康水平; 合生制剂组小肠组织中促炎因子包括肿瘤坏死因子-α和白介素-6水平显著降低, 接近正常水平。合生制剂可减轻RIII症状, 促进小肠和结肠损伤组织修复, 效果优于IG与Cb。口服合生制剂是一种安全有效的抗RIII活体生物药。

, correspAuthors=金义光, authorNote=null, correspAuthorsNote=
*金义光, E-mail:
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A: H & E sections of small intestine tissues of mice; The regenerated crypts (B) and the villus length (C) on Day 3.5; Appearance of colon tissues (D), colon length (E), and H & E stained colon tissue sections (F) of irradiated mice on Day 3.5. <i>n</i> = 3, $\bar{x} \pm s$. <sup>*</sup><i>P</i> < 0.05, <sup>**</sup><i>P</i> < 0.01, <sup>***</sup><i>P</i> < 0.001 , figureFileSmall=tu/4E9uYtDf6AnpgfDO65g==, figureFileBig=kY+miYvAnEwLOszqgQqtKA==, tableContent=null), ArticleFig(id=1190694741755970372, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1190373728392417804, language=EN, label=null, caption=null, figureFileSmall=KME0yWWbjTU74+xPJh0MKw==, figureFileBig=1OI8H9VwI//GOqou5k4k+A==, tableContent=null), ArticleFig(id=1190694741856633670, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1190373728392417804, language=CN, label=Figure 4, caption= Expression of tight-binding proteins after the treatment with IG, Cb, and Synbiotic. Immunofluorescence images after occludin (A) and ZO-1 (B) staining of the small intestinal tissues on day 3.5; C: Immunofluorescence images after occludin staining of the colon tissues on day 3.5; D: FITC-dextran in the serum of mice. <i>n</i> = 4,$\bar{x} \pm s$. <sup>**</sup><i>P</i> < 0.01, <sup>***</sup><i>P</i> < 0.001. FITC: Fluorescein isothiocyanate , figureFileSmall=KME0yWWbjTU74+xPJh0MKw==, figureFileBig=1OI8H9VwI//GOqou5k4k+A==, tableContent=null), ArticleFig(id=1190694742041183048, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1190373728392417804, language=EN, label=null, caption=null, figureFileSmall=bgMhYKS7/zOkNbv7HQhnmw==, figureFileBig=SjCDeGoefk5lNTHo5w1MlQ==, tableContent=null), ArticleFig(id=1190694742129263434, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1190373728392417804, language=CN, label=Figure 5, caption= 16S rDNA sequencing analysis of mouse gut microbiota. 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防治放射性肠损伤的菊粉凝胶载丁酸梭菌的合生制剂
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刘冬冬 1, 2, 3 , 方玉宝 1 , 魏萌 1 , 谢华 1 , 孙莹宝 1 , 严文锐 1 , 郭艳丽 4 , 金义光 1, *
药学学报 | 专题报道: 基于工程化细菌的活体生物药 2025,60(5): 1228-1235
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药学学报 | 专题报道: 基于工程化细菌的活体生物药 2025, 60(5): 1228-1235
防治放射性肠损伤的菊粉凝胶载丁酸梭菌的合生制剂
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刘冬冬1, 2, 3, 方玉宝1, 魏萌1, 谢华1, 孙莹宝1, 严文锐1, 郭艳丽4, 金义光1, *
作者信息
  • 1.军事科学院军事医学研究院, 北京 100850
  • 2.中国康复研究中心, 中国康复科学所, 北京 100068
  • 3.首都医科大学康复医学院, 北京 100068
  • 4.解放军总医院京南医疗区, 北京 100036

通讯作者:

*金义光, E-mail:
Inulin gel/Clostridium butyricum synbiotic for prevention and treatment radiation-induced intestinal injury
Dong-dong LIU1, 2, 3, Yu-bao FANG1, Meng WEI1, Hua XIE1, Ying-bao SUN1, Wen-rui YAN1, Yan-li GUO4, Yi-guang JIN1, *
Affiliations
  • 1. Academy of Military Medical Sciences, Academy of Military Sciences, Beijing 100850, China
  • 2. China Rehabilitation Research Center, China Rehabilitation Science Institute, Beijing 100068, China
  • 3. School of Rehabilitation Medicine, Capital Medical University, Beijing 100068, China
  • 4. Jingnan Medical Area, Chinese PLA General Hospital, Beijing 100036, China
出版时间: 2025-05-12 doi: 10.16438/j.0513-4870.2025-0183
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放射性肠损伤(radiation-induced intestinal injury, RIII) 是腹盆腔恶性肿瘤患者放疗常见并发症, 严重影响生活质量, 临床无专门防治药物。菊粉是一种天然水溶性膳食纤维。丁酸梭菌(Clostridium butyricum, Cb) 属严格厌氧革兰阳性芽孢杆菌, 能分泌大量丁酸, 改善肠道屏障功能, 减少条件致病菌生长与定植。菊粉凝胶(inulin gel, IG) 载Cb合生制剂发挥益生元肠道滞留与益生菌的协同作用。本文将口服IG载Cb的合生制剂用于RIII防治并探讨机制。所有动物实验经军事医学研究院伦理委员会批准且实验均按照相关指导原则和规定进行(批准号: IACUC-DWZX-2022-525)。小鼠腹部经13 Gy γ射线照射, 成功建立RIII模型。照前1 h给小鼠灌胃合生制剂, 与模型组比较, 照后第3.5日合生制剂组小肠新生隐窝数量明显增多, 小肠绒毛更长; 结肠长度更长, 紧密连接蛋白表达提升。照后第7日肠道菌群相对丰度显著增加, 特别是多种益生菌数量, 粪便中短链脂肪酸含量增加。照后第14日, 荧光标记法证明合生制剂组小鼠肠黏膜渗透性明显减小, 达到健康水平; 合生制剂组小肠组织中促炎因子包括肿瘤坏死因子-α和白介素-6水平显著降低, 接近正常水平。合生制剂可减轻RIII症状, 促进小肠和结肠损伤组织修复, 效果优于IG与Cb。口服合生制剂是一种安全有效的抗RIII活体生物药。

菊粉凝胶  /  丁酸梭菌  /  合生制剂  /  放射性肠损伤  /  电离辐射

Radiation-induced intestinal injury (RIII) is a common syndrome in the radiotherapy of abdominal and pelvic malignant tumors, heavily influencing the living quality, but no specific clinical regimens are available. Inulin is a naturally soluble dietary fiber. Clostridium butyricum (Cb) is a strict Gram-positive anaerobic bacillus, which can secrete and produce a large number of butyric acid, improving the intestinal barrier function and reducing the growth and colonization of opportunistic bacteria. A synbiotic of inulin gels (IG) and Cb exerts the synergistic effect of prebiotic intestinal retention and probiotics. In this study, an oral synbiotic of IG and Cb was applied for the prevention and treatment of RIII and the mechanisms were explored. Animal experiments were approved by the Ethics Committee of the Academy of Military Medical Sciences and the experiments were conducted in accordance with relevant guidelines and regulations (authorizing number: IACUC-DWZX-2022-525). An RIII mouse model was established after whole abdominal γ-ray radiation of 13 Gy. The synbiotic was intragastrically administered to the mice 1 h pre-radiation. Compared to the models, the mice of the synbiotic group had more regenerated intestinal crypts, longer villus and colon, and more tight junction protein on day 3.5. Moreover, the mice of the synbiotic group had an obvious increase in the relative abundance of gut microbiota on day 7, especially the amounts of multiple probiotics and short-chain fatty acid metabolites. On day 14, the mice of the synbiotic group had highly low permeability of intestinal mucosa according to the fluorescence labeling experiment, which was close to the normal level. Moreover, the mice of the synbiotic group showed a high decrease of proinflammatory factors including tumor necrosis factor-α and interleukin-6, close to the normal levels. Therefore, the oral synbiotic can alleviate the syndromes of RIII and improve the repair of damaged intestinal and colon tissues, and its protective effect is better than IG and Cb. The oral synbiotic is a safe and effective biological drug against RIII.

inulin gel  /  Clostridium butyricum  /  synbiotic  /  radiation-induced intestinal injury  /  ionizing radiation
刘冬冬, 方玉宝, 魏萌, 谢华, 孙莹宝, 严文锐, 郭艳丽, 金义光. 防治放射性肠损伤的菊粉凝胶载丁酸梭菌的合生制剂. 药学学报, 2025 , 60 (5) : 1228 -1235 . DOI: 10.16438/j.0513-4870.2025-0183
Dong-dong LIU, Yu-bao FANG, Meng WEI, Hua XIE, Ying-bao SUN, Wen-rui YAN, Yan-li GUO, Yi-guang JIN. Inulin gel/Clostridium butyricum synbiotic for prevention and treatment radiation-induced intestinal injury[J]. Acta Pharmaceutica Sinica, 2025 , 60 (5) : 1228 -1235 . DOI: 10.16438/j.0513-4870.2025-0183
放射性肠损伤(radiation-induced intestinal injury, RIII) 是腹腔、腹膜后及盆腔肿瘤放疗的常见并发症。根据发病时间和病理特点可分为急性RIII和慢性RIII。急性RIII通常发生在放疗开始后的数小时至数天内, 其病理机制主要由电离辐射直接损伤隐窝上皮细胞及诱导肠干细胞凋亡, 导致肠黏膜屏障完整性破坏。患者可能出现恶心、呕吐、腹痛、腹泻等症状, 严重时甚至可能引发肠黏膜出血[1]。慢性RIII则通常在放疗结束后的6~24个月内发生, 但也有少数患者在数年甚至数十年后才出现症状, 临床表现包括慢性腹痛、腹泻、肠梗阻、肠瘘等, 严重时可能导致肠管狭窄或穿孔, 严重影响患者的生活质量[2]
放疗后患者肠道菌群结构发生改变, 肠道菌群α多样性降低, 人体内主要菌群厚壁菌门和拟杆菌门减少, 变形杆菌、梭菌属、大肠杆菌、葡萄球菌、链球菌等增加[3]。电离辐射可减慢肠道蠕动, 缩短肠道微绒毛, 为条件致病菌或致病菌等提供接触、黏附并定植于肠黏膜的机会。肠道细菌的主要代谢产物短链脂肪酸(short-chained fatty acid, SCFA) 可以增强屏障免疫, 阻断肠道屏障受损后持续性的细菌侵入[4]。防治RIII的肠道菌群调节疗法的临床研究包括使用益生菌、粪菌移植(fecal microbiota transplantation, FMT) 等。FMT面临的问题主要有供体的筛选成本、材料准备和给药等[5, 6]。因此, 亟需开发一种适合口服给药的减轻电离辐射组织损伤的益生菌制剂。
菊粉是一种从植物中提取的亲水、价格低廉、体内可降解的天然多糖, 是由聚合度较低的果聚糖组合而成的天然膳食纤维[7]。传统的菊粉虽然具有一定电离辐射防护作用, 但其在肠道内滞留时间短, 防护作用效率低。本实验室已证明肠道菌群和电离辐射损伤有较密切关系, 口服菊粉凝胶(inulin gels, IG) 靶向结肠部位改善肠道微生态环境对RIII有一定防护作用[8]。丁酸梭菌(Clostridium butyricum, Cb) 属于严格厌氧的革兰阳性芽孢杆菌, 抗逆性强, 能够在高温、高湿的环境中存在。Cb能够分泌产生大量丁酸, 改善肠道屏障功能, 减少肠道内条件致病菌的生长与定植[9]。合生制剂(synbiotic) 通常指益生菌和益生元的组合剂[10]。将Cb负载至具有三维网络结构的IG中, 形成IG/Cb合生制剂。本研究采用动物模型口服合生制剂进行防治RIII研究, 考察防护效果和作用机制。
药物与试剂   菊粉、异硫氰酸荧光素-葡聚糖(FITC-dextran) (20210620、46944-FD4, Sigma试剂公司); 丁酸梭菌(BNCC337239, 北纳生物科技有限公司); 强化梭菌培养基(20220818, 青岛海博生物技术有限公司); 小鼠肿瘤坏死因子-α检测试剂盒、小鼠白细胞介素-6检测试剂盒、小鼠白细胞介素-22检测试剂盒(202209、202206、202203, 上海酶联生物科技有限公司); 用水均为去离子水, 用纯水仪制备。
仪器   60Co γ辐射装置(军事医学研究院); 扫描电镜(scanning electron microscope, SEM, S4800, 日本日立公司); 气相色谱-质谱联用仪(GC-MS, 6890B/5977B, 安捷伦科技有限公司); 倒置荧光显微镜(BDS200-FL, 重庆奥特光学仪器有限责任公司); EnSpire多功能酶标仪(SN23000371, 美国铂金埃尔默有限公司); 高速组织研磨仪(KI-Ⅱ, 武汉谷歌生物科技有限公司); 纯水仪(Heal Force Super NW, 上海康雷仪器有限公司)。
实验动物   C57BL/6J小鼠, SPF级, 雄性, 体重22 ± 2 g, 购于北京维通利华实验动物技术有限公司, 许可证号: SCXK (京) 2021⁃0006。实验期间自由给予水和食物。动物实验经军事医学研究院伦理委员会批准, 且实验均按相关指导原则和规定进行, 伦理批号为IACUC-DWZX-2022-525。
丁酸梭菌的培养   厌氧条件, 37 ℃, 强化梭菌培养基(reinforced clostridium medium, RCM) 进行培养24 h。RCM各成分: 酵母膏3.0 g、牛肉膏10.0 g、葡萄糖5.0 g、胰胨10.0 g、氯化钠5.0 g、可溶性淀粉1.0 g、L-半胱氨酸盐酸盐0.5 g和醋酸钠3.0 g, 溶于1.0 L去离子水中, pH为6.8 ± 0.2。121 ℃, 15 min灭菌。
菊粉凝胶与载丁酸梭菌合生制剂的制备   称取300 mg菊粉加入至1 mL的去离子水中。将含有菊粉的水溶液在室温下超声5 min, 充分混匀, 将混匀的菊粉水溶液转移至预加热至80 ℃的水浴锅中, 加热5 min, 将其置于4 ℃冰箱中, 静置24 h便可形成白色的IG。待菊粉溶液降温至37 ℃以下, 取Cb混悬液加入至IG中形成合生制剂, Cb浓度为1×108 CFU·mL-1, 并放至4 ℃冰箱中储存。
丁酸梭菌与菊粉凝胶载丁酸梭菌合生制剂微观形貌表征   分别取适量Cb与合生制剂冻干粉末, 粘在导电胶上, 使用离子溅射仪在真空条件下对其进行喷金处理, 喷金完成后使用扫描电镜观察形貌, 电压设置为20 kV。
放射性肠损伤动物模型建立及给药方案   将小鼠随机分为5组: 健康组(Healthy)、模型组(Model)、IG组(IG)、Cb组(Cb) 和合生制剂组(Synbiotic), 每组20只。在全腹部照射前3日和当日照射前1 h, 模型组小鼠灌胃0.3 mL生理盐水, IG组小鼠灌胃0.3 mL IG (30%, 剂量3.6 g·kg-1), Cb组小鼠灌胃0.3 mL Cb (1×108 CFU·mL-1), 合生制剂组小鼠灌胃0.3 mL合生制剂(IG: 3.6 g·kg-1, Cb: 1×108 CFU·mL-1), 10 min后小鼠麻醉固定后局部屏蔽进行腹部辐照, 采用60Co γ射线腹部单次照射, 剂量为13 Gy, 剂量率为73.12 cGy·min-1, 建立RIII动物模型, 并于照后连续3日灌胃。健康组不做任何处理。
肠黏膜渗透性实验   小鼠辐照后第14日, 提前禁食12 h, 灌胃0.2 mL FITC-dextran (7.5%, 剂量0.6 g·kg-1), 4 h后摘眼球取血, 1 000 r·min-1离心15 min取得血清。取100 μL血清, 在激发波长490 nm和发射波长520 nm下用酶标仪测定血清中的荧光强度。
小肠与结肠病理检查   分别于小鼠辐照后第1、3.5日分别麻醉处死小鼠, 取距胃部下端5 cm处的小肠组织, 放入4%多聚甲醛溶液中固定24 h, 苏木精-伊红(hematoxylin and eosin, H & E) 染色后在显微镜下观察组织病理形态, 并对小肠隐窝数以及小肠绒毛长度进行计数并统计, 小肠组织与结肠组织分别进行occludin与ZO-1紧密连接蛋白的染色。
短链脂肪酸含量测定   在小鼠辐照后第7日, 取小鼠新鲜粪便3~5粒, 收集后立即液氮冷冻。粪便中SCFA含量采用GC-MS进行测定, 主要方法包括标准品配置, 标准品前处理, 样品前处理, 上机检测等步骤。
炎症因子与免疫因子含量测定   在小鼠辐照后第14日, 取距胃部下端5 cm处的小肠组织, 加入4 ℃的9倍质量生理盐水, 用高速组织研磨仪研磨, 研磨液在10 000 ×g, 4 ℃高速离心15 min, 取上清用试剂盒分别测定小鼠肿瘤坏死因子-α (tumor necrosis factor-α, TNF-α)、小鼠白细胞介素-6 (interleukin-6, IL-6)、小鼠白细胞介素-22 (interleukin-22, IL-22)。
肠道菌群检测   在小鼠辐照后第7日, 用灭菌后的1.5 mL离心管接取小鼠新鲜粪便, 收集后立即液氮冷冻, 并贮存于-80 ℃待分析。委托安升达公司进行菌群的16s rDNA测序, 利用R语言等软件进行数据分析。
统计学分析   采用SPSS 16.0软件通过单因素方差分析对数据进行统计学分析。实验数据以均数±标准差($\bar{x} \pm s$) 表示; 比较组间差异, P < 0.05表示具有显著性差异。
基于本实验室前期工作研究, IG能够滞留于结肠部位, 因此选择IG包载Cb。SEM图显示Cb呈现两端钝圆, 中间部分轻度膨胀, 细菌呈直杆状或稍有弯曲, 尺寸约为0.7 μm × (2.0~3.0 μm) (图 1A)。IG与Cb共同形成具有多孔的三维网状结构, 放大一定倍数后能够明显地观察到IG基质中含有大量Cb, IG包裹于Cb的表面(图 1B)。
肠组织上皮细胞增殖能力强, 但辐照剂量较大时, 肠组织损伤过于严重, 肠黏膜难以修复, 甚至出现死亡[11]。经13 Gy 60Co γ射线全腹部辐照后, 模型组小鼠体重明显下降, 辐照后第14日也未能恢复至初始体重; 而IG、Cb以及合生制剂组小鼠辐照后在开始阶段的第1~4日体重下降明显, 但第5日开始上升, 合生制剂组小鼠体重第14日恢复至接近正常水平(图 2A)。死亡率是评价药物防护效果的重要指标[12]。全腹部照射后第4日, 模型组小鼠死亡2只, 而合生制剂组均存活, IG组死亡1只, Cb组死亡2只; 模型组小鼠于第5、6日都出现死亡, IG组死亡1只, Cb组死亡2只; 而合生制剂组均存活(图 2B)。因此, 小鼠在辐照前后口服合生制剂, 可显著增加全腹部受照小鼠的体重和生存率, 具有较好的抗辐射作用。
小肠绒毛和隐窝是肠上皮组织的重要组成, 有重要的吸收、免疫功能[13]。电离辐射会严重损伤肠干细胞, 影响肠黏膜修复[14]。辐照后第1日, 模型组小肠隐窝明显皱缩(图 3A); 辐照后第3.5日, 模型组绒毛排列混乱, 大量隐窝丢失, 且出现空泡; 合生制剂组在辐照后的整个过程中肠绒毛长度与健康组无明显差异, 而新生隐窝数量明显多于模型组(图 3BC), 绒毛下端可见大量排列整齐的上皮细胞, 已恢复接近正常水平。与健康组比较, 辐照后第3.5日, 模型组结肠长度明显下降(图 3DE); 而与模型组、IG组与Cb组比较, 合生制剂组结肠长度明显提升, 已恢复接近正常水平(图 3EF)。因此, 口服合生制剂可明显减轻辐射肠损伤, 在恢复后期能显著促进肠组织的修复。
电离辐射可破坏小鼠肠细胞紧密连接, 肠黏膜屏障功能受损, 肠渗透性增加。肠渗透性实验可评价辐照后小肠黏膜屏障的恢复[15]。肠黏膜通透性和肠上皮细胞间的ZO-1和occludin蛋白有很大关系。ZO-1和occludin家族成员是小肠与结肠组织中肠道完整性相关的经典细胞间紧密连接蛋白[16]。第3.5天, 相比较未受电离辐照组, 模型组与Cb组小肠组织中ZO-1和occludin紧密连接蛋白表达下降, 但仅合生制剂组紧密连接蛋白表达明显, 表明合生制剂组小肠黏膜屏障功能明显修复, IG对肠黏膜屏障功能修复有一定的促进作用, 但其作用效果弱于合生制剂(图 4AB)。同样在结肠组织中模型组occludin紧密连接蛋白表达下降, IG与Cb组occludin紧密连接蛋白表达上升, 但是其作用效果弱于合生制剂(图 4C)。合生制剂组小鼠外周血中FITC-dextran的含量低, 与健康组无明显差异; 而模型组与Cb组肠黏膜屏障受损严重, 大量FITC-dextran进入血液, 与合生制剂组、IG组以及健康组相比具有明显差异(图 4D)。因此, 联合IG与Cb的合生制剂能有效保护辐照小鼠的肠上皮, 改善肠上皮细胞紧密连接, 增强肠黏膜屏障功能, 效果优于单独IG组及Cb组, 发挥IG与Cb的协同作用。
电离辐射除影响人体细胞外, 也影响肠道微生物[17]。辐照往往致肠道菌群紊乱, 大量益生菌死亡, 降低肠道微生物群丰富度和多样性[18]。根据辐照小鼠主要肠道微生物群落, 可得到Shannon及Chao指数。辐照后小鼠肠道菌群丰富度与多样性明显下降, 而合生制剂组小鼠的菌群丰富度和多样性明显高于模型组, 与健康组小鼠微生物群落相近; IG组小鼠的菌群丰富度和多样性有所提升, 但其效果弱于合生制剂(图 5AB)。IG与Cb的联合干预能够增加受照小鼠肠道菌群的多样性, 具有较好地修复受照小鼠肠道菌群失调的作用。
使用Spearman相关分析对辐照后第7日的所有样本丰度最高的20个门进行聚类分析, 并以热图的形式呈现[19]。肠道菌群主要包含4大类, 包括硬壁菌门(Firmicutes)、拟杆菌门(Bacteroidetes)、变形菌门(Proteobacteria)、弯曲杆菌(Campylobacter)[20]。与健康组相比, 辐照组小鼠的Firmicutes及Bacteroidetes的相对丰度均发生明显的下降, 其中模型组以Bacteroidetes下降的最为突出, Cb组与IG组Firmicutes下降的最为突出, 合生制剂组提升幅度最大。与健康组相比, 模型组、Cb组与IG组肠道菌群中Proteobacteria相对丰度明显提高, 而合生制剂组Proteobacteria明显下降, 接近于健康组, 表明IG与Cb的单独干预作用效果弱于合生制剂, 因此, 合生制剂可有效缓解辐射引起的肠道菌群紊乱(图 5C)。
对几种差异明显的菌在属水平上进行统计分析, 小鼠受到辐照后, 相比于健康组, 肠道内Blautia, Butyricicoccus, f_Lachnospiraceae等益生菌属明显下降。相比于模型组, IG干预能够有效提升受照小鼠肠道菌群Blautia属(图 5D), 然而, Cb组未发现明显的提升, 且3种菌属与模型组均无差异。合生制剂组能够提升受照小鼠肠道菌群BlautiaButyricicoccus、f_Lachnospiraceae属, 其中Blautia属明显提升, 与IG组、模型组、Cb组均有显著性差异(图 5D~F)。Butyricicoccus是一种产生丁酸的细菌, 能够为肠道上皮细胞提供丁酸作为主要营养物质[21]。辐照后小鼠肠道内Butyricicoccus属相对丰度为0, 给与合生制剂小鼠肠道内Butyricicoccus属相对丰度提升至1.4左右, IG结合Cb, 有助于增加肠道内Butyricicoccus属的相对丰度(图 5E)。因此, 合生制剂组能够有效发挥益生元IG与Cb的协同作用, 促进产丁酸细菌的增殖, 改善肠道环境, 促进受照小鼠肠道功能的恢复。
益生菌Blautia属、Lachnospiraceae属与Butyricicoccus属可代谢体内的益生元IG, 产生SCFA等活性小分子物质, SCFA可通过降低肠道pH, 增加肠道益生菌定植, 保护肠黏膜屏障, 促进肠黏膜的恢复[22-24]。检测受照小鼠粪便中SCFA的含量, 结果发现相比于健康组, IG组与合生制剂组小鼠粪便中乙酸、丙酸、丁酸的含量都有所增加, 具有明显差异(图 6A)。相比于IG组, 合生制剂组小鼠粪便中SCFA水平高。通过将IG与Cb结合, 促进肠道Butyricicoccus的增殖, 丁酸的含量明显升高, 促进受照小鼠肠道黏膜屏障的恢复。在RIII恢复过程中, IL-22免疫因子可通过增强抗菌肽表达, 促进肠上皮细胞再生, 促进肠屏障功能恢复[25]。IG组与合生制剂组小鼠肠组织IL-22水平显著高于模型组(图 6B), 而促炎因子IL-6TNF-α水平明显低于模型组, 且与健康组差异无统计学意义(图 6CD)。口服合生制剂可通过调节肠道微生态, 促进SCFA的产生, 降低肠道环境pH, 调节肠道免疫因子的表达, 降低炎症, 促进电离辐射肠损伤的恢复。
放疗后患者肠道菌群结构发生改变, 肠道菌群α多样性降低, 防治RIII的肠道菌群调节疗法的临床研究逐渐开展, 包括使用益生菌、FMT等。然而FMT在实际应用中仍存在供体筛选标准严苛、菌液制备工艺复杂及给药途径依从性差等关键问题[26]。因此, 亟需开发一种适合口服给药且减轻电离辐射组织损伤的益生菌制剂。
菊粉是一种从植物中提取的亲水、体内可降解的天然多糖。已有大量研究将菊粉制成靶向结肠的凝胶用于改善肠道菌群, 增加SCFA的含量, 改善肠道环境[27]。Cb属于厌氧革兰阳性芽孢杆菌, 分泌产生大量丁酸, 改善肠道屏障功能。合生制剂中的益生元减少益生菌在恶劣的胃酸环境与肠道胆汁酸环境中的损失, 并且能够增加益生菌在肠道内的定植, 发挥益生元与益生菌的协同作用。本实验室已证明口服结肠滞留的IG载多种益生菌可减轻辐射损伤, 提升受照小鼠的血细胞数量, 增加SCFA代谢物[12]。口服单独益生菌难以抵抗胃肠道环境, IG能够包裹Cb抵抗胃肠道环境, 增加Cb结肠内的滞留。同时, 菊粉作为益生元, 直接供给Cb营养, 所以本研究尝试将口服IG/Cb合生制剂用于肠黏膜损伤防护, 并且针对RIII的病理特征, 重点考察口服合生制剂对肠黏膜炎症与屏障以及肠道菌群的影响。
TNF-α是一种多功能的促炎细胞因子, 使肠上皮细胞屏障功能以及结构发生改变, 破坏肠黏膜完整性。IL-6是急性炎症因子, 由各种类型细胞释放, 通过增强肠上皮细胞分泌电解质, 导致内皮细胞肿胀和通透性增加, TNF-α与IL-6是评价肠组织损伤的重要指标[28]。IL-22是一种抗炎因子, 可通过增强抗菌肽表达, 激活肠道免疫, 促进肠屏障功能恢复[29]。本研究证明RIII小鼠的促炎细胞因子IL-6、TNF-α表达显著增加, IL-22抗炎细胞因子表达减少, 大量肠上皮细胞被破坏。口服合生制剂可有效降低辐照小鼠肠组织中IL-6和TNF-α水平, 增强IL-22表达, 促进肠黏膜修复。因此合生制剂是一种可口服的有较好抗肠道炎症的药物。
肠道微生态环境特别是肠道菌群对肠黏膜结构和功能有重要影响。腹部辐照后可引起肠道菌群紊乱, 致病菌增加, 加重肠黏膜损伤。调节肠道菌群, 可通过释放更多SCFA等分子减轻辐射肠黏膜损伤, 口服益生元与益生菌等可有效改善肠道微生态环境, 维持肠道健康状态[30]。本研究证明合生制剂可显著增加BlautiaButyricicoccus等益生菌丰度, 原因可能是IG和Cb的双重作用, 其中IG增加肠道内Blautia丰度, Cb增加Butyricicoccus丰度。肠道菌群代谢IG, 增加肠道内SCFA的含量, 抑制致病菌的生长, 促进肠道内紧密连接蛋白occludin与ZO-1的表达, 修复肠道黏膜屏障, 降低肠黏膜渗透性, 合生制剂效果优于单用IG或Cb。本研究通过肠组织病理切片证明RIII肠组织被严重破坏, 血液中的FITC-dextran水平很高。口服合生制剂后, 肠黏膜上皮新生隐窝数量增多, 小肠绒毛长度恢复至正常水平, 血液中的FITC-dextran水平与健康组接近, 肠黏膜生理屏障得到重建。同时, 本研究证明13 Gy全腹部照射小鼠后, 体重下降, 第3日开始出现死亡, 后续连续出现死亡。口服合生制剂的小鼠体重从第4日开始增加, 动物全部存活, 存活率高于口服单独IG或Cb, 因此合生制剂发挥IG与Cb的双重作用。
RIII是临床难治疾病, 现无有效防治方法。本研究基于RIII的致病原因和病理特征, 通过口服IG/Cb合生制剂有效增加益生菌种类和相对丰度, 改善肠道微生态环境, 增加肠道内SCFA的含量, 增加紧密连接蛋白ZO-1与occludin的表达, 增加抗炎因子表达, 显著降低促炎因子表达, 促进肠黏膜生理屏障和肠道功能恢复, 降低死亡率, 改善动物生存状态, 表现良好的辐射防护效果。本研究通过证明口服靶向结肠的IG/Cb合生制剂防治RIII效果与机制, 为临床RIII的防治提供新选择。
作者贡献: 刘冬冬负责实验设计、实验操作、数据分析和文章撰写; 魏萌负责实验设计、结果分析和文章修改; 谢华、方玉宝参与实验并进行文章修改; 孙莹宝、严文锐与郭艳丽参与部分实验设计; 金义光负责课题设计、实验指导、数据分析、文章写作与修改。
利益冲突: 本文所有作者声明不存在利益冲突关系。
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doi: 10.16438/j.0513-4870.2025-0183
  • 接收时间:2025-02-25
  • 首发时间:2025-10-29
  • 出版时间:2025-05-12
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  • 收稿日期:2025-02-25
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    1.军事科学院军事医学研究院, 北京 100850
    2.中国康复研究中心, 中国康复科学所, 北京 100068
    3.首都医科大学康复医学院, 北京 100068
    4.解放军总医院京南医疗区, 北京 100036

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*金义光, E-mail:
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https://castjournals.cast.org.cn/joweb/yxxb/CN/10.16438/j.0513-4870.2025-0183
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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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