GUT: 李兰娟院士+郑大一附院团队：口腔微生物标志物有助于诊断COVID-19

2021-04-11 MedSci原创 MedSci原创

微生物标志物结合RT-PCR技术可进一步提高对人群中潜在COVID-19患者的检测效果，减少感染源和传播范围。

COVID-19在全球迅速蔓延，造成1亿多人感染，200多万人死亡。然而，作为新冠肺炎诊断的金标准，RT-PCR核酸检测受到质疑，其假阴性率至少为20%。因此，寻找一种新的诊断方法迫在眉睫。ACE2是SARS-CoV-24的一个靶点，在肺、肝、肾、脑和小肠上皮中表达。SARS-CoV-2激活肠道ACE2受体，引发炎症，导致胃肠道症状和微生物菌群失调。人的微生物群参与宿主的免疫和代谢，与病毒性疾病密切相关。先前的研究报告了COVID-19在住院期间和康复后的肠道或气道微生物特征。然而，COVID-19和康复患者的口腔微生物群尚未报道。此外，微生物标记物作为一种非侵入性诊断工具已在许多疾病中建立。Gu等通过16S rRNA MiSeq测序构建了基于5个肠道微生物标记的分类器。该分类器对COVID-19的诊断精度高，曲线下面积(AUC)高达0.89。然而，尚未评估口腔微生物组对COVID-19的诊断潜力。代谢物的变化可以反映疾病的进展短链脂肪酸(SCFAs)作为微生物组的脂质代谢产物，参与宿主细胞的基因表达、炎症、分化和凋亡。反过来，短链脂肪酸可以为微生物组提供能量，维持其生存。之前的一项研究描述了COVID-19患者的蛋白质组学和代谢组学特征，并将非重症和重症患者区分开来。然而，COVID-19患者和康复患者的脂质组学研究尚未开展。浙江大学李兰娟院士和郑州大学第一附属医院的任志刚/余祖江团队假设口腔和肠道微生物群参与COVID-19的发展，并可作为辅助诊断工具。此外，脂质组学与微生物组的相互作用可能有助于COVID-19的进展和恢复。该文章发表在GUT杂志。

为了验证这一假设，Ren Z等应用16S rRNA MiSeq测序和脂质组学技术，对392份舌苔样本、172份粪便样本和155份血清样本进行了COVID-19患者和康复患者的人体微生物组和脂质组学分析。评估微生物组作为COVID-19非侵入性生物标志物的潜力;并探索微生物组和脂质谱之间的相关性。在发现队列中构建了微生物分类器，并验证了来自华东地区74例确诊患者(CPs)和37例IgG阳性疑似患者(SPs)的诊断潜力。

与健康对照组相比，CPs组的口腔和粪便微生物多样性显著降低。与hc相比，CPs中产生丁酸的细菌减少，产生脂多糖的细菌增加。基于8种最佳口腔微生物标记物(7种粪便微生物标记物)的分类器在不同队列中获得了良好的诊断效率。重要的是，在跨地区队列中诊断效能达到87.24%。IgG抗体阳性的SPs诊断阳性率为CPs，诊断效能达92.11%(占粪便微生物组的98.01%)。与CPs相比，证实患者恢复时鞘磷脂(SM)(d40:4)、鞘磷脂(SM)(d38:5)和单甘油酯(33:5)等47个脂质分子被清除，磷脂酰胆碱(36:4p)、磷脂酰乙醇胺(PE)(16:0p/20:5)和二甘油酯(20:1/18:2)等122个脂质分子被富集。

该研究首先发现了COVID-19相关口腔微生物组的成分和功能改变，确定了特定的微生物标志物并构建了诊断模型，在中国两个不同地区的三个队列中取得了良好的诊断效果。令人信服的研究表明，口腔微生物组与病毒性疾病密切相关，可作为一种非侵入性诊断工具的特定疾病或病毒性疾病。首先提出口腔微生物标志物可能是COVID-19潜在的非侵入性诊断工具。同时，利用诊断模型首次提出并成功诊断出IgG阳性的SPs患者为COVID-19患者。

每种疾病都有其独特的口腔和肠道微生物变化。该研究发现IgG阳性SPs中的微生物变化与CPs一致，这支持从微生物组的角度用微生物模型诊断SPs为CPs的想法。微生物标志物结合RT-PCR技术可进一步提高对人群中潜在COVID-19患者的检测效果，减少感染源和传播范围。微生物群与疾病康复密切相关。RA和牙周炎患者的口腔微生物群失调在治疗后部分恢复正常，提示微生物群在恢复中起重要作用。该研究首次报道了COVID-19康复期患者口腔微生物群和脂质组学特征，发现了可能参与COVID-19发展和预后的关键细菌和脂质分子。微生物群可能通过向血液中分泌脂质分子影响COVID-19的进展。该研究报道了微生物组与脂质之间的相关性。口腔微生物组和肠道微生物组分别与白细胞、淋巴细胞等临床指标相关。随着微生物组影响疾病的可能机制的进一步研究，使用微生物辅助诊断、治疗和预后对COVID-19患者很有帮助。

原文出处

Ren Z, Wang H, Cui G, et al. Alterations in the human oral and gut microbiomes and lipidomics in COVID-19 [published online ahead of print, 2021 Mar 31]. Gut. 2021;gutjnl-2020-323826. doi:10.1136/gutjnl-2020-323826

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2022-01-23 wjcjjian

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2021-08-20 hukaixun

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beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69365, encryptionId=3c746936567, topicName=生物标志)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=63db15173977, createdName=zhu_jun9842, createdTime=Tue Apr 13 14:38:48 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1568340, encodeId=7532156834011, content=<a href='/topic/show?id=51c195324db' target=_blank style='color:#2F92EE;'>#郑大一附院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95324, encryptionId=51c195324db, topicName=郑大一附院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ddd15361752, createdName=wodejia-dayu, createdTime=Tue Apr 13 14:38:48 CST 2021, time=2021-04-13, status=1, ipAttribution=), 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956060, encodeId=a9a29560605f, content=李兰娟，厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b7a31928393, createdName=学医无涯, createdTime=Mon Apr 12 07:09:57 CST 2021, time=2021-04-12, status=1, ipAttribution=)]
2021-08-19 1de11937m40(暂无匿称)

内容很好

117 0
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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956060, encodeId=a9a29560605f, content=李兰娟，厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b7a31928393, createdName=学医无涯, createdTime=Mon Apr 12 07:09:57 CST 2021, time=2021-04-12, status=1, ipAttribution=)]
2021-08-19 1de11937m40(暂无匿称)

学习了

96 0
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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956060, encodeId=a9a29560605f, content=李兰娟，厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b7a31928393, createdName=学医无涯, createdTime=Mon Apr 12 07:09:57 CST 2021, time=2021-04-12, status=1, ipAttribution=)]
2021-04-13 zhu_jun9842

#生物标志#

81 0
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beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69365, encryptionId=3c746936567, topicName=生物标志)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=63db15173977, createdName=zhu_jun9842, createdTime=Tue Apr 13 14:38:48 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1568340, encodeId=7532156834011, content=<a href='/topic/show?id=51c195324db' target=_blank style='color:#2F92EE;'>#郑大一附院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95324, encryptionId=51c195324db, topicName=郑大一附院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ddd15361752, createdName=wodejia-dayu, createdTime=Tue Apr 13 14:38:48 CST 2021, time=2021-04-13, status=1, ipAttribution=), 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956060, encodeId=a9a29560605f, content=李兰娟，厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b7a31928393, createdName=学医无涯, createdTime=Mon Apr 12 07:09:57 CST 2021, time=2021-04-12, status=1, ipAttribution=)]
2021-04-13 zhu_jun9842

#生物标志#

68 0
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createdAvatar=https://img.medsci.cn/20210918/d701dc26df2c4b2385d0cf07543da176/9c816891eb564929ac67a864960af425.jpg, createdBy=f8c91671521, createdName=1de11937m40(暂无匿称), createdTime=Thu Aug 19 21:50:21 CST 2021, time=2021-08-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1561021, encodeId=e8f315610219d, content=<a href='/topic/show?id=3c746936567' target=_blank style='color:#2F92EE;'>#生物标志#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69365, encryptionId=3c746936567, topicName=生物标志)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=63db15173977, createdName=zhu_jun9842, createdTime=Tue Apr 13 14:38:48 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1567030, encodeId=0a16156e03018, content=<a href='/topic/show?id=3c746936567' target=_blank style='color:#2F92EE;'>#生物标志#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69365, encryptionId=3c746936567, topicName=生物标志)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=63db15173977, createdName=zhu_jun9842, createdTime=Tue Apr 13 14:38:48 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1568340, encodeId=7532156834011, content=<a href='/topic/show?id=51c195324db' target=_blank style='color:#2F92EE;'>#郑大一附院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95324, encryptionId=51c195324db, topicName=郑大一附院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ddd15361752, createdName=wodejia-dayu, createdTime=Tue Apr 13 14:38:48 CST 2021, time=2021-04-13, status=1, ipAttribution=), 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956060, encodeId=a9a29560605f, content=李兰娟，厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b7a31928393, createdName=学医无涯, createdTime=Mon Apr 12 07:09:57 CST 2021, time=2021-04-12, status=1, ipAttribution=)]
2021-04-13 wodejia-dayu

#郑大一附院#

0 0
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beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69365, encryptionId=3c746936567, topicName=生物标志)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=63db15173977, createdName=zhu_jun9842, createdTime=Tue Apr 13 14:38:48 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1568340, encodeId=7532156834011, content=<a href='/topic/show?id=51c195324db' target=_blank style='color:#2F92EE;'>#郑大一附院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95324, encryptionId=51c195324db, topicName=郑大一附院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ddd15361752, createdName=wodejia-dayu, createdTime=Tue Apr 13 14:38:48 CST 2021, time=2021-04-13, status=1, ipAttribution=), 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956060, encodeId=a9a29560605f, content=李兰娟，厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b7a31928393, createdName=学医无涯, createdTime=Mon Apr 12 07:09:57 CST 2021, time=2021-04-12, status=1, ipAttribution=)]
2021-04-12 blair4587

李兰娟，厉害👍🏻

85 0
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beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69365, encryptionId=3c746936567, topicName=生物标志)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=63db15173977, createdName=zhu_jun9842, createdTime=Tue Apr 13 14:38:48 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1568340, encodeId=7532156834011, content=<a href='/topic/show?id=51c195324db' target=_blank style='color:#2F92EE;'>#郑大一附院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95324, encryptionId=51c195324db, topicName=郑大一附院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ddd15361752, createdName=wodejia-dayu, createdTime=Tue Apr 13 14:38:48 CST 2021, time=2021-04-13, status=1, ipAttribution=), 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956060, encodeId=a9a29560605f, content=李兰娟，厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b7a31928393, createdName=学医无涯, createdTime=Mon Apr 12 07:09:57 CST 2021, time=2021-04-12, status=1, ipAttribution=)]
2021-04-12 大展宏图

好

162 0
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beContent=null, objectType=article, channel=null, level=null, likeNumber=68, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69365, encryptionId=3c746936567, topicName=生物标志)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=63db15173977, createdName=zhu_jun9842, createdTime=Tue Apr 13 14:38:48 CST 2021, time=2021-04-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1568340, encodeId=7532156834011, content=<a href='/topic/show?id=51c195324db' target=_blank style='color:#2F92EE;'>#郑大一附院#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=95324, encryptionId=51c195324db, topicName=郑大一附院)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2ddd15361752, createdName=wodejia-dayu, createdTime=Tue Apr 13 14:38:48 CST 2021, time=2021-04-13, status=1, ipAttribution=), 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status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=956060, encodeId=a9a29560605f, content=李兰娟，厉害, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b7a31928393, createdName=学医无涯, createdTime=Mon Apr 12 07:09:57 CST 2021, time=2021-04-12, status=1, ipAttribution=)]
2021-04-12 学医无涯

李兰娟，厉害

104 0

内科

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