An Update on the Role and Potential Molecules in Relation to Ruminococcus gnavus in Inflammatory Bowel Disease, Obesity and Diabetes Mellitus.

Ruminococcus gnavus (R. gnavus) is a gram-positive anaerobe commonly resides in the human gut microbiota. The advent of metagenomics has linked R. gnavus with various diseases, including inflammatory bowel disease (IBD), obesity, and diabetes mellitus (DM), which has become a growing area of investigation. The initial focus of research primarily centered on assessing the abundance of R. gnavus and its potential association with disease presentation, taking into account variations in sample size, sequencing and analysis methods. However, recent investigations have shifted towards elucidating the underlying mechanistic pathways through which R. gnavus may contribute to disease manifestation. In this comprehensive review, we aim to provide an updated synthesis of the current literature on R. gnavus in the context of IBD, obesity, and DM. We critically analyze relevant studies and summarize the potential molecular mediators implicated in the association between R. gnavus and these diseases. Across numerous studies, various molecules such as methylation-controlled J (MCJ), glucopolysaccharides, ursodeoxycholic acid (UDCA), interleukin(IL)-10, IL-17, and capric acid have been proposed as potential contributors to the link between R. gnavus and IBD. Similarly, in the realm of obesity, molecules such as hydrogen peroxide, butyrate, and UDCA have been suggested as potential mediators, while glycine ursodeoxycholic acid (GUDCA) has been implicated in the connection between R. gnavus and DM. Furthermore, it is imperative to emphasize the necessity for additional studies to evaluate the potential efficacy of targeting pathways associated with R. gnavus as a viable strategy for managing these diseases. These findings have significantly expanded our understanding of the functional role of R. gnavus in the context of IBD, obesity, and DM. This review aims to offer updated insights into the role and potential mechanisms of R. gnavus, as well as potential strategies for the treatment of these diseases.

Specific Alternation of Gut Microbiota and the Role of Ruminococcus gnavus in the Development of Diabetic Nephropathy.

In this study, we aim to investigate the precise alterations in the gut microbiota during the onset and advancement of diabetic nephropathy (DN) and examine the impact of Ruminococcus gnavus (R. gnavus) on DN. Eight-week-old male KK-Ay mice were administered antibiotic cocktails for a duration of two weeks, followed by oral administration of R. gnavus for an additional eight weeks. Our study revealed significant changes in the gut microbiota during both the initiation and progression of DN. Specifically, we observed a notable increase in the abundance of Clostridia at the class level, higher levels of Lachnospirales and Oscillospirales at the order level, and a marked decrease in Clostridia_UCG-014 in DN group. Additionally, there was a significant increase in the abundance of Lachnospiraceae, Oscillospiraceae, and Ruminococcaceae at the family level. Moreover, oral administration of R. gnavus effectively aggravated kidney pathology in DN mice, accompanied by elevated levels of urea nitrogen (UN), creatinine (Cr), and urine protein. Furthermore, R. gnavus administration resulted in down-regulation of tight junction proteins such as Claudin-1, Occludin, and ZO-1, as well as increased levels of uremic toxins in urine and serum samples. Additionally, our study demonstrated that orally administered R. gnavus up-regulated the expression of inflammatory factors, including nucleotide-binding oligomerization domain-like receptor pyrin domain-containing protein 3 (NLRP3) and Interleukin (IL)-6. These changes indicated the involvement of the gut-kidney axis in DN, and R. gnavus may worsen diabetic nephropathy by affecting uremic toxin levels and promoting inflammation in DN.

Jiangtang Decoction Ameliorates Diabetic Kidney Disease Through the Modulation of the Gut Microbiota.

Purpose: This study aimed to elucidate the impact of Jiangtang decoction (JTD) on diabetic kidney disease (DKD) and its association with alterations in the gut microbiota. Methods: Using a diabetic mouse model (KK-Ay mice), daily administration of JTD for eight weeks was undertaken. Weekly measurements of body weight and blood glucose were performed, while kidney function, uremic toxins, inflammation factors, and fecal microbiota composition were assessed upon sacrifice. Ultra-structural analysis of kidney tissue was conducted to observe the pathological changes. Results: The study findings demonstrated that JTD improve metabolism, kidney function, uremic toxins and inflammation, while also exerting a modulatory effect on the gut microbiota. Specifically, the genera Rikenella, Lachnoclostridium, and unclassified_c_Bacilli exhibited significantly increased abundance following JTD treatment, accompanied by reduced abundance of norank_f_Lachnospiraceae compared to the model group. Importantly, Rikenella and unclassified_c_Bacilli demonstrated negative correlations with urine protein levels. Lachnoclostridium and norank_f_Lachnospiraceae were positively associated with creatinine (Cr), indoxyl sulfate (IS) and interleukin (IL)-6. Moreover, norank_f_Lachnospiraceae exhibited positive associations with various indicators of DKD severity, including weight, blood glucose, urea nitrogen (UN), kidney injury molecule-1 (KIM-1) levels, trimethylamine-N-oxide (TMAO), p-cresyl sulfate (pCS), nucleotide-binding oligomerization domain (Nod)-like receptor family pyrin domain-containing 3 (NLRP3) and IL-17A production. Conclusion: These findings suggested that JTD possess the ability to modulate the abundance of Rikenella, Lachnoclostridium, unclassified_c_Bacilli and norank_f_Lachnospiraceae within the gut microbiota. This modulation, in turn, influenced metabolic processes, kidney function, uremic toxin accumulation, and inflammation, ultimately contributing to the amelioration of DKD.

Curative effect of Dingqi analgesic patch on cancer pain: a single-blind randomized controlled trail.

OBJECTIVE: To observe the curative effect of an acupoint application with a Dingqi analgesic patch on moderate to severe pain caused by liver cancer. METHODS: Forty patients with moderate to severe pain caused by liver cancer were randomly divided into a treatment group (TG) and a control group (CG). Patients with moderate pain were given 100 mg qd of a sustainably released tablet of tramadol hydrochloride; patients with severe pain were given 4.2 mg q3d of the fentanyl transdermal system. The ashi points Ganshu (BL 18), Danshu (BL 19) and Qimen (LR 14) were chosen for the acupoint application intervention. CG patients were given a sham patch and TG patients were given a Dingqi analgesic patch. A visual analogue scale (VAS) was used before treatment and after 1, 3, 6, 9 and 12 days of treatment. The Karnofsky score was measured before treatment and after 12 days of treatment. Any main adverse reactions (e.g. nausea, constipation, dizziness and headache) were recorded after 6 and 12 days of treatment. Any skin side effects (i.e. skin irritation and allergic reactions) were recorded. RESULTS: The VAS in TG was significantly lower than that in CG after 3, 6, 9 and 12 days of treatment (P < 0.05). There was no significant difference in the Karnofsky score before treatment and after 12 days of treatment between CG and TG. There were also no significant differences in the main adverse reactions or skin side effects after 6 and 12 days of treatment between CG and TG (P > 0.05). CONCLUSION: The Dingqi analgesic patch can enhance the analgesic effect of tramadol and fentanyl.

[The summary of the clinic study of Zhi-Xin-Fang treating the heart failure resulting from cardiomyopathy].

OBJECTIVE: To observe the therapeutic and prognostic effects and to evaluate the safety of Zhi-Xin-Fang on heart failure resulting from cardiomyopathy. METHODS: 62 patients with cardiomyopathy combined with heart failure were treated with standard western medical therapy as treatment group. The other 60 patients with the same diseases were administered with both Zhi-Xin-Fang and standard western medicines as control. Several parameters were observed to evaluate the effect of Zhi-Xin-Fang on the heart failure, containing the therapeutic effect of clinical symptom and physical signs, the improvement of heart function and the ultrasonic caridogram. We also observed the effect of Zhi-Xin-Fang to relieve the clinical symptom and improve the heart function and quality of life and prognosis. RESULTS: As the NYHA classify for heart failure, the effective rate for the treatment group was 95% , more effective than the control group (effective rate: 80.65%) (P<0.05). There was significant improvement for LVEF and LVDS for both groups. However, the treatment group was better than the control group (P<0.05). The clinical symptom was significantly improved compared to the untreatment in both groups. The treatment group was better than the control group for effective rate (P<0.05) but not for the total effective rate. There was no significant difference for the function of liver and kidney, blood routine method, electrolyte compared to before for the two groups. CONCLUSION: The standard western medicines combined with Zhi-Xin-Fang is a good therapy for treating heart failure resulting from cardiomyopathy. The combined therapy can relieve the cinical symptom of heart failure, improve the heart function and quality of life. It is also safer for the patients. However, its long-term prognosis should be further studied in the future.