基于肠道菌群和HPG轴探讨辛伐他汀与左卡尼汀改善高脂血症性少弱精症的作用机制

    Mechanism of Simvastatin and Levocarnitine in Improving Hyperlipidemic Oligoasthenospermia Based on Gut Microbiota and the HPG Axis

    • 摘要:
      目的 探讨辛伐他汀(simvastatin,SIM)与左卡尼汀(levocarnitine,LC)对高脂血症大鼠肠道菌群及下丘脑-垂体-性腺(hypothalamic-pituitary-gonadal axis,HPG)轴失衡和精液质量的改善效果。
      方法 将40只SD大鼠随机分为正常对照组(NC)、高脂组(HFD)、辛伐他汀干预组(SIM)和左卡尼汀干预组(LC),每组10只。其中HFD、SIM和LC组高脂喂养4周建立高脂血症模型,SIM、LC组分别接受对应药物灌胃干预4周,而后比较4组大鼠血脂、炎症因子、氧化应激、脏器系数、性激素、睾丸病理切片、肠道菌群以及精液质量水平的差异。
      结果 与NC组相比,HFD组血脂异常,血清总胆固醇(total cholesterol,TC)、甘油三酯(triglycerides,TG)、低密度脂蛋白胆固醇(low-density lipoprotein cholesterol,LDL-C)显著上升(P<0.01);炎症因子C反应蛋白(C-reactive protein,CRP)、白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)显著增高(P<0.05或P<0.01);氧化应激指标丙二醛(malondialdehyde,MDA)上升(P<0.05),总超氧化物歧化酶(total superoxide dismutase,T-SOD)活性下降;HPG轴相关促黄体生成素(luteinizing hormone,LH)含量降低,卵泡刺激素(follicle-stimulating hormone,FSH)、睾酮(testosterone,T)含量显著降低(P<0.05或P<0.01)。肠道菌群门水平上,厚壁菌门、放线菌门、变形菌门比例升高,拟杆菌门、螺旋体门、弯曲杆菌门丰度降低;属水平上,Ligilactobacillus、Romboutsia_B等丰度升高,Lactobacillus等丰度降低。同时,睾丸和附睾系数显著降低(P<0.01),精子前向运动力(progressive motility,PR)显著下降(P<0.05)、不活动率显著上升(P<0.05),间质细胞和精子细胞数量显著减少(P<0.05)。表明高脂饮食可引起血脂异常、炎症反应、氧化应激及肠道菌群紊乱,通过抑制 HPG 轴功能,进而造成睾丸损伤与精子质量下降。相较HFD组,SIM和LC组TC、TG、LDL-C水平降低,氧化应激指标MDA含量降低,T-SOD活性显著升高(P<0.01),HPG轴相关LH、FSH、T水平上升;LC组CRP水平显著降低(P<0.05);SIM 组IL-6、CRP、TNF-α表达水平降低。肠道菌群门水平:SIM组螺旋体门、疣微菌门丰度上升,厚壁菌门、拟杆菌门、放线菌门等丰度下降;LC组螺旋体门等丰度上升,拟杆菌门、放线菌门、变形菌门等丰度下降。属水平SIM组和LC组有益菌如Lactobacillus、Akkermansia等丰度上升,有害菌丰度下降;且LC组Prevotella增加。2组睾丸和附睾系数增加,PR升高,精子不活动率降低,间质细胞增加,精子细胞数量显著增多(P<0.05)。提示SIM与LC可能通过降脂、抗炎、抗氧化及重塑肠道菌群恢复HPG轴活性并改善生殖功能。
      结论 肠道菌群失调可能通过加剧炎症-氧化应激反应及抑制HPG轴功能影响精液质量,SIM与LC有一定的治疗作用,靶向调节特定菌群或可通过多通路协同作用成为治疗新策略。

       

      Abstract:
      OBJECTIVE To investigate the ameliorative effects of the simvastatin(SIM) and levocarnitine(LC) on gut microbiota and hypothalamic-pituitary-gonadal(HPG) axis imbalance and semen quality in hyperlipidemic rats.
      METHODS Forty SD rats were randomly divided into normal control group(NC), high-fat diet group(HFD), simvastatin intervention group(SIM), and the levocarnitine intervention group(LC), with 10 rats in each group. The HFD, SIM, and LC groups were fed with a high-fat diet for 4 weeks to establish the hyperlipidemia model. The SIM and LC groups were intragastrically administered with corresponding drugs for 4 weeks. Subsequently, the differences in blood lipids levels, inflammatory factors, oxidative stress indicators, organ coefficients, sex hormones, testicular pathological sections, gut microbiota, and semen quality were compared among the 4 groups.
      RESULTS Compared with the NC group, the HFD group showed abnormal blood lipids, and serum total cholesterol(TC), triglycerides(TG), and low-density lipoprotein cholesterol(LDL-C) were were significantly increased(P<0.01). Meanwhile, the inflammatory factors including C-reactive protein(CRP), interleukin-6(IL-6), and tumor necrosis factor-α(TNF-α) were significantly increased(P<0.05 or P<0.01). The oxidative stress index malondialdehyde(MDA) was increased(P<0.05), while the activity of total superoxide dismutase(T-SOD) was decreased. The contents of HPG axis-related luteinizing hormone(LH), follicle-stimulating hormone(FSH) and testosterone(T) were reduced(P<0.05 or P<0.01). At the phylum level of gut microbiota, the proportions of Firmicutes, Actinobacteria, and Proteobacteria were increased, whereas those of Bacteroidetes, Spirochaetes, and Campylobacterota were decreased. At the genus level, the abundances of Ligilactobacillus, Romboutsia_B were upregulated, while the abundance of Lactobacillus was downregulated. Meanwhile, the testicular and epididymal coefficients were decreased(P<0.01), sperm progressive motility(PR) was reduced(P<0.05), the sperm immobility rate was elevated(P<0.05), and the numbers of interstitial cells and spermatogenic cells were declined(P<0.05). It indicated that a high-fat diet could induce dyslipidemia, inflammatory response, oxidative stress imbalance and gut microbiota disorder, inhibit the function of the HPG axis, and further lead to testicular injury and declined semen quality. Compared with the HFD group, the levels of TC, TG and LDL-C were decreased, MDA content was reduced and T-SOD activity was significantly elevated in SIM and LC groups(P<0.01), accompanied by increased levels of LH, FSH and T related to the HPG axis. The CRP level was significantly decreased in the LC group(P<0.05), while the expression levels of IL-6, CRP and TNF-α were reduced in the SIM group. At the phylum level of gut microbiota: the abundances of Spirochaetes and Verrucomicrobia were increased, while those of Firmicutes, Bacteroidetes and Actinobacteria were decreased in the SIM group. In the LC group, the abundance of Spirochaetes was upregulated, and the abundances of Bacteroidetes, Actinobacteria and Proteobacteria were downregulated. At the genus level, the abundances of beneficial bacteria such as Lactobacillus and Akkermansia were increased and harmful bacteria were decreased in both SIM and LC groups; meanwhile, the abundance of Prevotella was elevated in the LC group. In both groups, the testicular and epididymal coefficients were increased, PR was improved, the sperm immobility rate was reduced, and the quantities of interstitial cells and spermatogenic cells were increased(P<0.05). It was suggested that SIM and LC could restore HPG axis activity and improve reproductive function via lipid-lowering, anti-inflammatory, antioxidant effects and gut microbiota remodeling.
      CONCLUSION Gut microbiota dysbiosis may affect semen quality by exacerbating the inflammatory-oxidative stress response and inhibiting the function of the HPG axis. SIM and LC have a certain therapeutic effect. Targeted regulation of specific gut microbiota is expected to become a novel therapeutic strategy through multi-pathway synergistic effects.

       

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