1 β-酪蛋白衍生阿片肽的释放差异
表1 A1型和A2型β-酪蛋白对胃肠道效应及BCM-7释放的量化差异Table 1 Quantitative differences in gastrointestinal effects and BCM-7 release between A1 type and A2 type β-casein[20] |
| 项目 Items | A1型β-酪蛋白 A1 type β-casein | A2型β-酪蛋白 A2 type β-casein | 差异 Differences | P值 P-value |
|---|---|---|---|---|
| β-酪啡肽7释放 BCM-7 release | 高 | 极低/可忽略 | 显著 | |
| 所有参与者的大便性状 Stool property of all participants | 3.87 | 3.56 | 显著 | 0.04 |
| 女性参与者的大便性状 Stool property of female participants | 3.93 | 3.50 | 显著 | 0.01 |
| 腹痛与布里斯托大便分类法评分的相关性 Correlation between abdominal pain and Bristol Stool Form Scale scores | 显著正相关 | 无显著正相关 | 显著 | <0.001 |
| 粪便钙卫蛋白含量异常参与者数Number of participants with elevated FC content | 3人>100 μg/g | 0人>100 μg/g | ||
| 不耐受者症状加重 Worsening of symptoms in individuals with intolerance | 是 | 否 | 不显著 |
大便性状通过布里斯托大便分类法进行评分,评分标准:1型为分离的硬块,如坚果,很难排出;2型为腊肠状,但表面凹凸不平;3型为腊肠状,表面有裂纹;4型为光滑柔软的香蕉或蛇状,是最理想状态,表明肠道功能良好,消化和水分吸收正常;5型为软团状,边缘清晰;6型为绒状,糊状大便,边缘不清;7型为水样,无固体成分。 | |
Stool property was assessed using the Bristol Stool Form Scale, with the following scoring criteria: type 1, separate hard lumps, like nuts, difficult to pass; type 2, sausage-shaped but lumpy; type 3, sausage-shaped with cracks on its surface; type 4, like a banana or snake, smooth and soft, representing the ideal form and indicating good bowel function with normal digestion and water absorption; type 5, soft blobs with clear-cut edges; type 6, fluffy pieces with ragged edges, mushy consistency; type 7, watery, no solid fragments. |
2 β-酪蛋白衍生阿片肽与肠道屏障功能的关系
图1 长期阿片类药物治疗会通过减少抗菌肽来破坏肠道上皮屏障功能Chronic Opioid Treatment:慢性阿片类药物治疗;“Opioid” Microbiome:“阿片类”微生物组;“Leaky” Barrier:屏障受损;Inflammation:炎症;To the CNS:至中枢神经系统;Antinociceptive tolerance:抗伤害感受性耐受;Chronic Opioid Treatment plus FMT or Butyrate:慢性阿片类药物治疗+粪菌移植或丁酸盐;Oral Butyrate or FMT:口服丁酸盐或粪菌移植;Intact Barrier:屏障完整;Reduced Antinociceptive tolerance:抗伤害感受性耐受减轻;Antimicrobial Peptides:抗菌肽;Akkermansia muciniphila:嗜黏蛋白阿克曼氏菌。 Fig.1 Long-term opioid therapy impairs intestinal epithelial barrier function by reducing the expression of antimicrobial peptides[22] |
3 β-酪蛋白衍生阿片肽对干细胞相关信号通路的影响
4 β-酪蛋白衍生阿片肽对小鼠模型中肠道组织和功能的影响
5 β-酪蛋白衍生阿片肽在类器官模型中的应用
6 β-酪蛋白衍生阿片肽对肠道微生物群的影响
图2 阿片类药物对胃肠道系统产生影响,如便秘、恶心和呕吐Bacterial dysbiosis and decreased integrity of gut epithelium:肠道菌群失调与肠道上皮完整性降低;Euphoria, analgesia, sedation, physical dependence:欣快感、镇痛、镇静、躯体依赖;Respiratory depression:呼吸抑制;Bradycardia:心动过缓;Enterococcaceae:肠球菌科;Staphylococcaceae:葡萄球菌科;Enterobacteriaceae:肠杆菌科;Lactobacillaceae:乳杆菌科;Bifidobaceriaceae:双歧杆菌科;Reduced GI motility/transit:胃肠道动力/传输减弱;Constipation:便秘;Nausea:恶心;Vomiting:呕吐;Translocation of microbial products:微生物产物易位;Release of proinflammatory cytokines:促炎细胞因子释放;Systemic inflammation:全身性炎症;Neuroinflammation:神经炎症;Increased excitability of neurons:神经元兴奋性增加;Opioid receptor densensitzation:阿片受体脱敏。 Fig.2 Effects of opioid drugs on gastrointestinal system, such as constipation, nausea and vomiting[38] |

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