BACKGROUND The duodenum plays a significant role in metabolic regulation,and thickened mucous membranes are associated with insulin resistance.Duodenal mucosal resurfacing(DMR),a new-style endoscopic procedure using h...BACKGROUND The duodenum plays a significant role in metabolic regulation,and thickened mucous membranes are associated with insulin resistance.Duodenal mucosal resurfacing(DMR),a new-style endoscopic procedure using hydrothermal energy to ablate this thickened layer,shows promise for enhancing glucose and lipid metabolism in type 2 diabetes(T2D)patients.However,the mechanisms driving these improvements remain largely unexplored.AIM To investigate the mechanisms by which DMR improves metabolic disorders using a rat model.METHODS Rats with T2D underwent a revised DMR procedure via a gastric incision using a specialized catheter to abrade the duodenal mucosa.The duodenum was evaluated using histology,immunofluorescence,and western blotting.Serum assays measured glucose,lipid profiles,lipopolysaccharide,and intestinal hormones,while the gut microbiota and metabolomics profiles were analyzed through 16S rRNA gene sequencing and ultra performance liquid chromatography-mass spectrum/mass spectrum,severally.RESULTS DMR significantly improved glucose and lipid metabolic disorders in T2D rats.It increased the serum levels of cholecystokinin,gastric inhibitory peptide,and glucagon-like peptide 1,and reduced the length and depth of duodenal villi and crypts.DMR also enhanced the intestinal barrier integrity and reduced lipopolysaccharide translocation.Additionally,DMR modified the gut microbiome and metabolome,particularly affecting the Blautia genus.Correlation analysis revealed significant links between the gut microbiota,metabolites,and T2D phenotypes.CONCLUSION This study illustrates that DMR addresses metabolic dysfunctions in T2D through multifaceted mechanisms,highlighting the potential role of the Blautia genus on T2D pathogenesis and DMR’s therapeutic impact.展开更多
基金Supported by the National Natural Science Foundation of China,No.82474318the Jiangsu Administration of Traditional Chinese Medicine,No.zt202105+1 种基金Subject of Jiangsu Province Hospital of Chinese Medicine,No.Y2021rc22a Research Career Scientist。
文摘BACKGROUND The duodenum plays a significant role in metabolic regulation,and thickened mucous membranes are associated with insulin resistance.Duodenal mucosal resurfacing(DMR),a new-style endoscopic procedure using hydrothermal energy to ablate this thickened layer,shows promise for enhancing glucose and lipid metabolism in type 2 diabetes(T2D)patients.However,the mechanisms driving these improvements remain largely unexplored.AIM To investigate the mechanisms by which DMR improves metabolic disorders using a rat model.METHODS Rats with T2D underwent a revised DMR procedure via a gastric incision using a specialized catheter to abrade the duodenal mucosa.The duodenum was evaluated using histology,immunofluorescence,and western blotting.Serum assays measured glucose,lipid profiles,lipopolysaccharide,and intestinal hormones,while the gut microbiota and metabolomics profiles were analyzed through 16S rRNA gene sequencing and ultra performance liquid chromatography-mass spectrum/mass spectrum,severally.RESULTS DMR significantly improved glucose and lipid metabolic disorders in T2D rats.It increased the serum levels of cholecystokinin,gastric inhibitory peptide,and glucagon-like peptide 1,and reduced the length and depth of duodenal villi and crypts.DMR also enhanced the intestinal barrier integrity and reduced lipopolysaccharide translocation.Additionally,DMR modified the gut microbiome and metabolome,particularly affecting the Blautia genus.Correlation analysis revealed significant links between the gut microbiota,metabolites,and T2D phenotypes.CONCLUSION This study illustrates that DMR addresses metabolic dysfunctions in T2D through multifaceted mechanisms,highlighting the potential role of the Blautia genus on T2D pathogenesis and DMR’s therapeutic impact.
