南方医科大学学报 ›› 2025, Vol. 45 ›› Issue (6): 1270-1279.doi: 10.12122/j.issn.1673-4254.2025.06.16

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多硫酸戊聚糖缓解环磷酰胺诱导的小鼠间质性膀胱炎/膀胱疼痛综合征的机制:基于调节肠道微生物群和胆汁酸代谢

祝越轩(), 诸章睿, 吴芃()   

  1. 南方医科大学南方医院泌尿外科,广东 广州 510515
  • 收稿日期:2024-11-27 出版日期:2025-06-20 发布日期:2025-06-27
  • 通讯作者: 吴芃 E-mail:zhuyuexuan0630@ outlook.com;doctorwupeng @gmail.com
  • 作者简介:祝越轩,在读硕士研究生,E-mail:zhuyuexuan0630@ outlook.com
  • 基金资助:
    国家自然科学基金(82370782)

Pentosan polysulfate alleviates cyclophosphamide-induced interstitial cystitis/bladder pain syndrome in mice by modulating gut microbiota and bile acid metabolism

Yuexuan ZHU(), Zhangrui ZHU, Peng WU()   

  1. Department of Urology, Nanfang Hospital Southern Medical University, Guangzhou 510515, China
  • Received:2024-11-27 Online:2025-06-20 Published:2025-06-27
  • Contact: Peng WU E-mail:zhuyuexuan0630@ outlook.com;doctorwupeng @gmail.com
  • Supported by:
    National Natural Science Foundation of China(82370782)

摘要:

目的 探究多硫酸戊聚糖(PPS)通过调节肠道微生物群和胆汁酸代谢来缓解环磷酰胺(CYP)诱导的间质性膀胱炎/膀胱疼痛综合征(IC/BPS)小鼠模型的疗效及其潜在机制。 方法 通过随机化方法将6~8周龄雌性C57BL/6小鼠分为:对照组、PPS处理组(PPS组)、CYP诱导组(CYP组)和CYP+PPS联合处理组(C+P组),6只/组。PPS以25 mg/kg剂量连续3周灌胃处理,CYP以50 mg/kg剂量在第4周分3次腹腔注射以建立IC/BPS模型。采用16S rDNA测序及非靶向代谢组学分析肠道菌群与代谢产物变化;通过粪便微生物移植(FMT)实验(CYP-FMT与C+P-FMT受体组)验证菌群介导作用。体外以LPS诱导人膀胱上皮细胞(SV-HUC-1)炎症模型,分组探究脱氧胆酸(DCA)及TGR5抑制剂(SBI-115)对屏障功能的影响。 结果 PPS治疗提升了CYP诱导的IC/BPS小鼠模型的机械疼痛阈值,改善了尿动力学参数,并减轻了膀胱炎症及屏障损伤(P<0.05)。PPS通过增加肠道中嗜木聚糖真杆菌的丰度和促进DCA产生,调节了肠道菌群和胆汁酸代谢(P<0.05)。FMT实验证实了PPS的疗效依赖于肠道菌群。在细胞层面,DCA激活TGR5受体,减轻了LPS诱导的SV-HUC-1细胞炎症和屏障损伤(P<0.05)。 结论 PPS通过富集嗜木聚糖真杆菌菌群促进DCA生成,激活TGR5信号通路,从而减轻膀胱炎症并修复屏障功能。本研究首次揭示PPS通过菌群-胆汁酸-TGR5轴调控IC/BPS的新机制,为靶向肠道微生态治疗膀胱疾病提供理论依据。

关键词: 间质性膀胱炎/膀胱疼痛综合征, 多硫酸戊聚糖, 环磷酰胺, 肠道微生物群, 胆汁酸

Abstract:

Objective To investigate the therapeutic efficacy and mechanism of pentosan polysulfate (PPS) for cyclophosphamide (CYP)-induced interstitial cystitis/bladder pain syndrome (IC/BPS) in mice. Methods Female C57BL/6 mice (6-8 weeks old) were randomized into control group, PPS treatment (25 mg/kg via gavage for 3 weeks) group, CYP treatment (3 separate intraperitoneal injections at 50 mg/kg in week 4), and CYP+PPS treatment group. Gut microbiota alterations of the mice were analyzed using 16S rDNA sequencing and non-targeted metabolomics. Fecal microbiota transplantation (FMT) was performed in CYP-treated recipient mice and those treated with both CYP and PPS. In the in vitro experiment, LPS-stimulated human bladder epithelial cells (SV-HUC-1) were used to assess the effects of deoxycholic acid (DCA) and TGR5 signaling inhibitor SBI-115 on barrier functions of bladder epithelial cells. Results PPS treatment significantly improved the mechanical pain thresholds, restored the urodynamic parameters, and attenuated bladder inflammation and barrier dysfunction in CYP-treated mice. Mechanistically, PPS enriched the abundance of Eubacterium xylanophilum and increased DCA levels in the intestines of CYP-treated mice. FMT experiments confirmed microbiota-dependent therapeutic effects of PPS, shown by reduced bladder pathology in the recipient mice treated with both CYP and PPS. In SV-HUC-1 cells, DCA obviously alleviated LPS-induced inflammation and barrier disruption, and treatment with SBI-115 abolished these protective effects of DCA. Conclusion PPS ameliorates IC/BPS in mice by remodeling gut microbiota to enhance DCA production and activate TGR5 signaling, suggesting a novel microbiota-bile acid-TGR5 axis that mediates the therapeutic effect of PPS and a therapeutic strategy for IC/BPS by targeting gut-bladder crosstalk.

Key words: interstitial cystitis/bladder pain syndrome, pentosan polysulfate, cyclophosphamide, gut microbiota, bile acids