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Study of efficacy and mechanism of low FODMAPs diet on diarrhea-type irritable bowel syndrome based on a gut microbiota-dependent metabolite

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Author:: No author available

Journal Title:: World Chinese Journal of Digestology

Issue:: 24

DOI:: 10.11569/wcjd.v29.i24.1421

Key Word:: 腹泻型肠易激综合征;低FONMAPs饮食;苯丙氨酸;胰高血糖素样肽-1;促炎细胞因子

Abstract：背景肠易激综合征(irritable bowel syndrome,IBS)的发生与肠道菌群紊乱引起代谢产物异常改变相关.低可发酵的寡糖、双糖、单糖、多元醇(fermentable oligosaccharides,disaccharides,monosaccharides and polyols,FODMAPs)饮食在IBS治疗上是否通过影响肠道菌群代谢产物苯丙氨酸(phenylalanine,PHE)的产生进而起到治疗作用的研究具有重要意义.目的观察低FODMAPs饮食在腹泻型IB S(diarrhea-type irritable bowel syndrome,IBS-D)治疗上的疗效及其通过肠道菌群代谢产物PHE调控胰高血糖素样肽-1 (glucagon-like peptide-1,GLP-1)的分子机制.方法选择30例符合罗马Ⅳ标准的IB S-D患者入组,予低FODMAPs饮食,疗程4周.征集30名健康志愿者作基线检测对照.观察健康志愿者及IBS组患者治疗前后的临床症状评分,检测血清PHE,GLP-1,TNF-α,IFN-γ.采用NCI-H716细胞,加入不同浓度PHE,观察PHE对GLP-1的影响.结果经低FODMAPs饮食干预后,IBS患者临床症状评分较治疗前明显降低(P＜0.0001 &P＜0.001);IBS组血清PHE和GLP-1浓度较前上升(P＜0.05),TNF-α和IFN-γ浓度较前下降(P＜0.0001&P＜0.001).试验过程中无一例出现不良反应.体外实验发现,1 mmol/L PHE可以显著促进GLP-1分泌.结论低FODMAPs饮食能改善IBS-D患者临床症状,其作用机制可能与饮食因素影响肠道菌群代谢产物PHE调控GLP-1,抑制促炎细胞因子分泌相关.

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