乳酸菌调控体内胆固醇代谢综述

2016-04-27 12:01国立东王丽群2蒋琛刘晓艳刘莉莉
中国乳品工业 2016年2期
关键词:杆菌属乳酸菌胆固醇

国立东,王丽群2,蒋琛,刘晓艳,刘莉莉

(1.黑龙江中医药大学药学院,哈尔滨150040;2.黑龙江省农业科学院食品加工研究所,哈尔滨150086)

乳酸菌调控体内胆固醇代谢综述

国立东1,王丽群2,蒋琛1,刘晓艳1,刘莉莉1

(1.黑龙江中医药大学药学院,哈尔滨150040;2.黑龙江省农业科学院食品加工研究所,哈尔滨150086)

心血管疾病已成为全球死亡率和发病率的首因,血清胆固醇水平过高是其主要危险因素。目前,降低人体内胆固醇水平的方法主要包括膳食干预和药物治疗,但药物通常具有副作用。乳酸菌作为益生菌的主要来源,已通过动物或人体临床试验证实了其降胆固醇作用,至少能对血清总胆固醇、总甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇中的一项及以上指标有改善作用。乳酸菌可以通过调控体内胆固醇的吸收转运、分解代谢和/或合成代谢相关基因表达的机制来降低机体内胆固醇水平。不论是乳酸菌的体内降胆固醇能力还是作用机制,都存在着菌株特异性。文中对上述内容进行了综述,并对存在的问题进行了分析与展望,旨在为降胆固醇乳酸菌的深入研究提供参考。

乳酸菌;胆固醇;代谢;调控;机制

0 引 言

心血管疾病已成为中国乃至全球人群的主要死因之一[1,2],血清胆固醇过高是引发冠心病的主要危险因素[3],人体血清总胆固醇每降低1%,冠心病发生的危险性可降低2%~3%[4]。临床应用的他汀类降胆固醇药物成本高且副作用明显[5],故天然的非药物方法相继提出,如乳酸菌的使用。乳酸菌已被人类大规模安全消费数以千年[6,7],为人体肠道正常有益菌群,在糖/脂代谢、肥胖、炎症等方面发挥重要作用[8-10]。自Mann和Spoerry发现血清胆固醇与乳酸菌的相关性[11],大量体内外研究均证明了乳酸菌的降胆固醇能力,然而体内试验特别是临床数据则更为关键。因此,文中对降胆固醇乳酸菌的动物及临床试验证据,及其调控体内胆固醇代谢机理进行了总结,并对其存在的问题进行了分析与展望。

1 乳酸菌体内降胆固醇作用

动物与人体模型用于评价乳酸菌对机体血清胆固醇水平的影响已进行了数十年,已有充分证据证明乳酸菌的降胆固醇能力,并且在降胆固醇的菌种成员中仍有一些新的乳酸菌菌种不断出现。

1.1 动物模型数据

动物模型数据通常能间接反映人体内的实际发生情况。因此,临床前适宜的动物模型通常被构建进而评价乳酸菌的潜在降胆固醇作用,如大鼠、小鼠、仓鼠、猪、兔等动物模型[12-23]的应用。如果单纯研究乳酸菌的降胆固醇作用,通常是构建高胆固醇血症模型动物[12-13,16,19-23],也有乳酸菌能降低酒精性肝病、II型糖尿病以及肥胖等模型动物[14,17,18,24]体内胆固醇水平的报道。目前,已报道可有效降低模型动物体内胆固醇水平的乳酸菌菌种有十余种,主要分布于乳杆菌属、双歧杆菌属和肠球菌属,其中以乳杆菌属和双歧杆菌属菌株报道最多,具体见表1。在有降胆固醇活性的乳杆菌属中,以嗜酸乳杆菌、植物乳杆菌、罗伊氏乳杆菌、鼠李糖乳杆菌、干酪乳杆菌等为常见,而双歧杆菌属中以长双歧杆菌、动物双歧杆菌乳亚种等为常见,肠球菌属中主要为屎肠球菌。这些降胆固醇乳酸菌菌株主要来源于两方面:一是来源于健康人体肠道或唾液,包括婴幼儿、成人;二是来源于传统发酵食品,如酸奶、干酪、马奶酒等乳制品,泡菜、酸菜等植物性食品,发酵鱼、香肠等肉制品。受试动物摄入乳酸菌的方式多样,包括直接制成悬液(悬于生理盐水或脱脂乳中)定量灌胃动物,以发酵食品(发酵乳、发酵谷物酱、酸面团等)的形式定量给予动物,甚至将菌种直接加到水或饲料中由动物自由采食。乳酸菌给予受试动物的剂量也不尽相同,从每天最低的104g-1有效剂量到最高达1013g-1饲料的高有效剂量,有效的干预周期从最短14 d到最长70 d不等。检测指标通常以血清中总胆固醇(TC)、总甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)为主,这些供试乳酸菌中至少能对其中一项指标有改善作用。

综上所述,乳酸菌降低模型动物体内胆固醇水平是显而易见的。但是,上述报道中因选取的供试乳酸菌菌株不同,干预周期不同,剂量和给药方式不同,故无法比较各菌株间降胆固醇能力的差异。此外,关于乳酸菌体内降胆固醇作用的剂量-效应关系方面的数据比较缺乏,如高、中、低三个剂量的实验设计。

1.2 临床数据

乳酸菌降胆固醇作用的研究终究是为人类服务,而动物模型数据并不能完全代表人体内的真实情况,往往与人体试验数据存在一定偏差。因此,研究乳酸菌降胆固醇的作用,其人体临床证据是非常必要与重要的。关于降胆固醇作用乳酸菌的临床数据,如表2所示。目前,已经过人体临床试验的降胆固醇乳酸菌菌株也同样集中在乳杆菌属[25-31]和双歧杆菌属[29-32]两个菌属,也有嗜热链球菌[31,33]和屎肠球菌[33,34]的应用。这些菌株通常是单一菌种或混合菌种,以发酵酸乳或口服胶囊的形式给予受试人群,每天服用剂量一般在109~1012,服用周期一般在4~56周。受试群体为儿童、成人或老年人,多为高胆固醇血症人群,也有II型糖尿病、非酒精性脂肪肝及健康人群为受试对象,均证明了受试乳酸菌人体内的降胆固醇作用。然而,临床试验中也有发现乳酸菌无降胆固醇作用的报道[35],分析原因可能是人体临床试验数据受外界因素影响较大,如受试人群饮食难于控制、个体差异大以及样本数量少等。

表1 不同种属代表性乳酸菌对模型动物的降胆固醇作用

表2 乳酸菌降胆固醇作用的临床证据

2 乳酸菌调控体内胆固醇代谢的机制

机体内胆固醇平衡主要受三个方面的调控,即胆固醇的合成、分解与吸收转运。若筛选降胆固醇活性药物或食品,以此为切入点则更为直接。乳酸菌对胆固醇代谢调控机制主要是基于细胞及动物模型提出,益生乳酸菌对胆固醇代谢调控的可能途径如图1所示。

图1 乳酸菌调控胆固醇代谢的可能途径

2.1 调控胆固醇吸收与转运

这种调控作用主要发生在小肠,可通过抑制胆固醇吸收、促进胆固醇外排来降低体内胆固醇水平。小肠对胆固醇吸收转运的调控主要由肝脏X受体(LXR s)介导,包括LXR-α和LXR-β(也称作NR 1H 3和NR 1H 2),其属于核受体,通过控制转录参与脂质代谢。一旦被激活,LXR s能够诱导胆固醇吸收、流出、转运和分泌相关的一系列基因的表达。比如,肠道胆固醇吸收的关键转运蛋白Niemann-Pick C1 Like 1(NPC1L1)[36],激活LXRs可下调NPC1L1表达进而抑制肠道对胆固醇的吸收。此外,LXR s的激活可介导腺苷三磷酸结合盒转运蛋白(ATP-binding cassette transpo rt)A 1(ABCA1)、G 1(ABCG 1)、G 5和G 8(ABCG 5/G 8)表达上调[37,38],ABCA 1、ABCG 1、ABCG 5/G 8的过表达将增加胆固醇从肠细胞内排出进入肠腔,促进体内胆固醇的清除。乳酸菌可通过激活LXR s,从而介导NPC 1L1表达下调[39-41]、ABCG 5/ G8[41,42]、ABCA1和ABCG1[43]表达上调,进而抑制胆固醇在体内的吸收。除此之外,肝脏也可以调控胆固醇的吸收转运。肝脏低密度脂蛋白受体(LDLR)能调节机体血浆低密度脂蛋白胆固醇(LDL-C)的体内平衡。肝脏LDLR表达增加,会通过受体介导的胞吞作用来提高血浆LDL-C的清除,LDLR表达主要受固醇调节元件结合蛋白(SREBPs,包括SREBP-1c和SREBP-2)的控制[44]。乳酸菌也可通过上调肝脏SREBP-2[24]和LDLR[24,45,46]表达的机理来降低动物血清胆固醇水平。

2.2 促进胆固醇分解代谢

降胆固醇的另一种方式就是促进体内胆固醇分解。胆固醇7α-羟化酶(CYP7A 1)是肝脏胆固醇分解代谢的限速酶,提高CYP7A 1活性便可降低体内胆固醇浓度。胆酸(盐)是胆固醇分解代谢的产物,在人体内主要以牛磺胆酸盐和甘氨胆酸盐两种结合态形式存在,并参与肝肠循环[47]。益生乳酸菌产生的BSH能将进入肠道内的结合型胆酸盐水解成游离胆汁酸。一方面,生成的游离胆汁酸相比于结合型胆酸不容易被小肠吸收,大部分不参与肝肠循环而随粪便直接排出体外,由于反馈调节作用导致胆固醇在肝脏内被进一步分解生成新的胆汁酸,从而降低体内胆固醇水平[48]。另一方面,乳酸菌可通过提高肝脏CYP7A 1活性从而加速肝脏胆固醇分解来降低体内胆固醇浓度[46,49,50],而乳酸菌对CYP7A 1的调控作用,主要是通过其BSH活性而生成的游离胆汁酸作用于法尼醇X受体(FXR),抑制FXR活性,并由FXR介导下调小异源二聚体伴侣受体(SHP)的表达来完成[50]。由此可见,乳酸菌自身产生的BSH活性对其体内降胆固醇作用的贡献是双重的。因此,是否具有BSH活性便成为体外筛选降胆固醇益生菌的首要条件。

2.3 抑制胆固醇体内自身合成

抑制肝脏中胆固醇合成的限速酶—3-羟基-3-甲基戊二酸单酰辅酶A(HMG-CoA)还原酶活性即可降低体内胆固醇水平。临床上应用已久的他汀类药物就是通过这种机理来达到降胆固醇功效的。有研究报道,乳酸菌可通过调控HMG-CoA还原酶活性进而降低大鼠血清胆固醇水平[45,51],这种调控作用的可能机制是乳酸菌通过抑制SREBPs表达的途径来降低HMG-CoA还原酶活性的[51]。

3 结论与展望

乳酸菌与体内胆固醇代谢的关系已进行了半个世纪的研究与探讨,目前已有充分的证据证明乳酸菌可有效降低动物或人体内胆固醇水平,这是毋庸置疑的,尽管存在着菌株特异性。从整体上看,乳酸菌对模型动物体内胆固醇水平的降低程度普遍高于人体模型,这可能与模型动物个体之间差异小和饮食易控制等因素有关。迄今为止,已有大量的降胆固醇乳酸菌保健食品或发酵产品在全球上市,如VSL#3[31]、Gaio[33],以及上海光明乳业股份有限公司生产的“光明畅优植物乳酸菌饮品”,其中具有独立自主知识产权的植物乳杆菌ST-III是从传统食品泡菜中筛选获得的降胆固醇功能乳酸菌[52]。

相比于体外,乳酸菌体内降胆固醇机制的研究相对滞后。近五年,随着研究的深入,乳酸菌调控体内胆固醇代谢的机制逐渐被揭示,研究人员主要从三个方面对此进行了探究,即对体内胆固醇的吸收转运、分解代谢以及合成代谢的影响。乳酸菌对体内胆固醇代谢的调控机制,也同样存在着菌株特异性。目前,乳酸菌对体内胆固醇代谢调控机制的研究尚停留在现象阶段,即经过乳酸菌干预后,体内胆固醇代谢相关基因出现了差异表达,便认为乳酸菌是通过调控这些差异表达的基因来降低体内胆固醇水平,缺乏本质的发现。此外,乳酸菌对体内胆固醇代谢调控的活性物质是代谢产物还是细胞壁组分,是直接调控还是间接调控,间接调控又是怎样的作用机理,这些都有待于深入挖掘。同时,随着组学技术的发展,乳酸菌与体内胆固醇代谢的关系将会得到更好的澄清。

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Regulation of cholesterol metabolism in vivo by Lactic acid bacteria:A review

GUO Li-dong1,WANG Li-qun2,JIANG Chen1,LIU Xiao-yan1,LIU Li-li1
(1.College of Pharmacy,Heilongjiang University o f Chinese Medicine,Harbin 150040,China;2.Food Processing Institute,Heilongjiang Academy of Agricultural Sciences,Harbin 150086,China)

Cardiovascular diseases(CVD)are the leading cause of global mortality and morbidity.Elevated serum cholesterol level is a contributory risk factor for the development of CVD.In human,current cholesterol-lowering methods include dietary intervention and drug therapy.However,all the drugs have severe side effects.As a main source of probiotic bacteria,lactic acid bacteria have shown a positive effect on the serum cholesterol levels in animal and/or human model.They could improve one or more of the serum lipid profiles,including total cholesterol,triglyceride,low-density lipoprotein cholesterol and high-density lipoprotein cholesterol.Lacticacid bacteria could reduce cholesterol levels by regulating relative gene expression of the absorption and transportation,catabolism and/or synthetic metabolism of cholesterol in vivo.The cholesterol-lowering effect and mechanism of Lactic acid bacteria is strain-specific.The purpose of this paper is to provide a comprehensive overview on the above contents,and to describe its future prospects of current problem.It’s also a reference of cholesterol-lowering lactic acid bacteria for further research.

Lactic acid bacteria;cholesterol;metabolism;regulation;mechanism

Q939.11+7

:B

:1001-2230(2016)02-0032-05

2015-07-31

黑龙江省教育厅面上项目(12531631);黑龙江中医药大学校科研基金项目(201104;201316);黑龙江省自然科学基金项目(C201233)。

国立东(1982-),男,副教授,研究方向为功能性食品与食品生物技术。

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