TWI667344B - Lactobacillus reuteri strain GMNL-263 and composition thereof capable of improving hypertension - Google Patents
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Abstract
本發明公開一種乳桿菌組合物,包含一羅伊氏乳桿菌(Lactobacillus.reuteri)GMNL-263,其中該羅伊氏乳桿菌(Lactobacillus.reuteri)GMNL-263係為熱滅殺死菌,透過抑制一促發炎細胞激素IL-1β與提升一雙歧桿菌屬的生長,而具有降血壓之功效,該乳桿菌組合物為醫藥組合物、營養補充品、保健食品或其組合。 The present invention discloses a Lactobacillus composition comprising a Lactobacillus reuteri (Lactobacillus.reuteri) GMNL-263, wherein the Lactobacillus reuteri (Lactobacillus.reuteri) GMNL-263-based heat killed off bacteria through suppression The inflammatory cytokine IL-1β promotes the growth of Bifidobacterium and has the effect of lowering blood pressure, and the lactobacillus composition is a pharmaceutical composition, a nutritional supplement, a health food or a combination thereof.
Description
本發明係關於乳桿菌之組合物,用於改善高血壓之應用。 The present invention relates to a composition for lactobacilli for use in improving hypertension.
血壓是藉由心臟的壓縮與博動,進而令血液對於血管壁施加的壓力。藉由血壓的維持,而促進血液於全身循環,進而進行營養傳輸與廢物的代謝;血壓有兩種,收縮壓和舒張壓,分別為心臟跳動時肌肉收縮(systole)或舒張(diastole)時的測量值;正常血壓範圍為收縮壓90-139mmHg(最高讀數)和舒張壓60-89mmHg(最低讀數)。 Blood pressure is the compression and pulsation of the heart, which in turn causes the blood to exert pressure on the vessel wall. By maintaining blood pressure, it promotes blood circulation throughout the body, and then carries out nutrient transmission and waste metabolism; there are two kinds of blood pressure, systolic blood pressure and diastolic blood pressure, which are when systole or diastole is involved in heart beat. Measured values; normal blood pressure range is systolic blood pressure 90-139 mmHg (highest reading) and diastolic blood pressure 60-89 mmHg (lowest reading).
高血壓是一種動脈血壓升高的慢性病,也是國內最常見的慢性病,當血壓的升高使心臟推動血液在血管內循環時的負擔增大,血壓持續等於或高於140/90毫米汞柱(mmHg)時則為高血壓,由於很少顯示症狀,因此易於受到忽略,通常是通過篩查或者尋求解決其它健康間題時發現,部分患者有頭痛、頭暈、眩暈、耳鳴,一旦嚴重甚至會暈倒或是內部器官的損害,除了其症狀不明常容易被忽視外,也常伴隨著嚴重的併發症;隨著年齡增長、高血壓風險也隨著增加,且高血壓是讓心血管疾病風險以倍數增加的重要因素,更為世界衛生組織所公布導致心血管疾病死亡的主要原因之一,而因其屬於慢性病的一種,故患者須長期服藥控制,對於時間或是金錢都是沉重的開銷。 Hypertension is a chronic disease with elevated arterial blood pressure. It is also the most common chronic disease in China. When the blood pressure rises, the burden of the heart pushing the blood in the blood vessels is increased, and the blood pressure continues to be equal to or higher than 140/90 mmHg. When mmHg) is high blood pressure, it is easy to be neglected because it rarely shows symptoms. It is usually found through screening or seeking other health problems. Some patients have headache, dizziness, dizziness, tinnitus, and even if they are serious or even dizzy. Injury or internal organ damage, in addition to its symptoms are often easily overlooked, often accompanied by serious complications; with age, the risk of hypertension also increases, and hypertension is the risk of cardiovascular disease The important factor of the increase in multiples is one of the main causes of cardiovascular deaths announced by the World Health Organization. Because it is a kind of chronic disease, patients have to take long-term medication control, which is a heavy expense for time or money.
高血壓分為原發性或繼發性,原發性占了成因的90-95%,即沒 有明顯病因;另一種則為繼發性,表示由其它疾病所引發,佔約5-10%,如糖尿病、腎臟疾病、內分泌疾病、胸腹部肥胖、甲狀腺疾病及肢端肥大症或是生理的異常反應,例如促發炎細胞激素的大量產生(Krishnan et al.,2014)、腸胃道益生菌的減少(Li et al.,2017)等,均為引發或是加劇高血壓的原因。 Hypertension is classified as primary or secondary, and primary origin accounts for 90-95% of the cause, ie no There is a clear cause; the other is secondary, which is caused by other diseases, accounting for about 5-10%, such as diabetes, kidney disease, endocrine disease, chest and abdomen obesity, thyroid disease and acromegaly or physiological Abnormal reactions, such as the pro-inflammatory cytokine production (Krishnan et al., 2014), and the reduction of gastrointestinal probiotics (Li et al., 2017), are the causes of or exacerbate high blood pressure.
其中,長期罹患第二型糖尿病者(type 2 diabetes mellitus,T2DM)為一典型的疾病與高血壓連動的例子,由於糖尿病患者常衍生腎動脈和全身小動脈硬化的症狀,進而使周邊血管阻力與收縮壓上升,造成血壓升高,因此,二型糖尿病患者與高血壓常相伴發生,而高血壓還會加速血管病變,進而引起腦、眼、心、腎等器官之併發症,並顯著提升心肌梗塞及中風風險。 Among them, long-term type 2 diabetes mellitus (T2DM) is a typical example of the linkage between disease and hypertension. Because of the symptoms of renal artery and systemic arteriosclerosis, diabetic patients often cause peripheral vascular resistance. Systolic blood pressure rises, causing blood pressure to rise. Therefore, patients with type 2 diabetes often develop with hypertension, and hypertension can accelerate vascular disease, which can cause complications of brain, eye, heart, kidney and other organs, and significantly improve myocardial Infarction and stroke risk.
目前以藥物控制高血壓,仍為主要治療方式,然而,雖血壓能穩定得到控制,但由於患者須長期服藥,不僅時間、金錢均為沉重的負擔外,服用不慎還會有風險。舉例而言,部分藥物會對孕婦或胎兒有害,而對原糖尿病患者而言,高血壓藥物可能會令影響血糖,造成糖尿病病情的惡化或是病情的錯誤評估;此外,隨著藥物本身的機制不同,如細胞受體的調控、抑制血臟搏動或是神經傳導的降低等等,而有一定程度的副作用。因此,尋找其他有效而無副作用的降血壓途徑為解決以及預防當今高血壓問題的必要之務,有許多研究,便針對如何透過健康食品控制、預防高血壓。 At present, the use of drugs to control high blood pressure is still the main treatment. However, although blood pressure can be stably controlled, but because patients have to take drugs for a long time, not only time and money are heavy burdens, but also risk of taking carelessly. For example, some drugs may be harmful to pregnant women or the fetus. For former diabetic patients, high blood pressure drugs may affect blood sugar, cause deterioration of diabetes or misdiagnosis of the disease; in addition, with the mechanism of the drug itself Different, such as the regulation of cell receptors, inhibition of blood pulsation or reduction of nerve conduction, etc., with a certain degree of side effects. Therefore, looking for other effective blood pressure-lowering pathways without side effects is necessary to solve and prevent today's high blood pressure problems. There are many studies on how to control and prevent high blood pressure through healthy foods.
人體的血壓調節系統主要是經由腎素-血管收縮素系統(Renin-Angiotensin System,RAS),以達血壓、體液及電解質平衡,而在這個系統中,血管收縮素I-轉化酵素(Angiotensin I-Converting Enzyme,ACE) 則是血壓調節中一重要的酵素,用以升高血壓。 The body's blood pressure regulation system is mainly through the Renin-Angiotensin System (RAS) to achieve blood pressure, body fluids and electrolyte balance, and in this system, angiotensin I-transferase (Angiotensin I- Converting Enzyme, ACE) It is an important enzyme in blood pressure regulation to raise blood pressure.
過去研究發現,益生菌發酵乳具有調節血壓之功效,益生菌可透過乳糖水解酵素分解酪蛋白,而產生不等量之血管收縮素I-轉化酵素抑制胜肽(ACE inhibitory peptide,以下簡稱ACE抑制胜肽)(Yamamoto,1999)進而降血壓;研究指出,Lactobacillus helveticus(L.helveticus)、Lactobacillus caseis(L.caseis)、Lactobacillus rhamnosus(L.rhamnosus)、Lactobacillus acidophilus(L.acidophilus)、Lactobacillus fermentum(L.fermentum)、Lactobacillus bulgaricus(L.bulgaricus)、Lactobacillus reuteri(L.reuteri)...等益生菌中,可篩選出特殊的活菌菌株,將菌株與ACE抑制胜肽添加於發酵乳中,藉由菌株能於發酵乳中產生更多的ACE抑制胜肽,進而對於高血壓患者有降血壓的功效(Beltran-Barrientos et al.,2016)。 In the past, it was found that probiotic fermented milk has the effect of regulating blood pressure. Probiotics can break down casein through lactose hydrolase, and produce unequal amount of angiotensin I-converting enzyme inhibitor (ACE inhibitory peptide). Peptide) (Yamamoto, 1999) in turn lowers blood pressure; studies indicate that Lactobacillus helveticus ( L.helveticus ), Lactobacillus caseis ( L.caseis ), Lactobacillus rhamnosus ( L.rhamnosus ), Lactobacillus acidophilus ( L.acidophilus ), Lactobacillus fermentum ( Among the probiotics such as L. fermentum ), Lactobacillus bulgaricus ( L. bulgaricus ), Lactobacillus reuteri ( L. reuteri ), etc., special live bacterial strains can be screened, and the strain and the ACE inhibitory peptide are added to the fermented milk. By using strains to produce more ACE inhibitory peptides in fermented milk, it has the effect of lowering blood pressure in hypertensive patients (Beltran-Barrientos et al., 2016).
然而,此部分研究僅限於部分特殊活菌菌株,且在施行上仍有若干限制與不足,在有效服用菌量以及服用時間方面,均有相當高的門檻,而在關於益生菌產品降血壓的系統性回顧性研究指出,人體需每天服用益生菌數超過1x1011cfu(colony forming unit)超過八週,才能具有較佳血壓調節之功效(Khalesi et al.,2014)。 However, this part of the study is limited to some special live bacterial strains, and there are still some limitations and shortcomings in the implementation, there are quite high thresholds in the effective dosage and time of administration, and in the blood pressure reduction of probiotic products. A systematic retrospective study indicated that the body needs to take more than 1 x 10 11 cfu (colony forming unit) per day for more than eight weeks in order to have better blood pressure regulation (Khalesi et al., 2014).
總體而言,現今的相關研究仍多僅止於體外或是動物實驗,僅服用益生菌便能改善血壓的人體臨床試驗數據不多,目前相關的人體數據,分別為針對高血壓病人使用L.helveticus與Saccharomyces cerevisiae(S.cerevisiae)複合菌株發酵乳(Hata et al.,1996),或針對血壓偏高之正常人給予L.helveticus CM4發酵乳(Aihara et al.,2005),均具有降低血壓之功效;而針對糖尿病危險群,使用包含益生質及同時包含以下菌株的產品L. casei、L.acidophilus、L.rhamnosus、L.bulgaricus、Bifidobacterium Breve(B.Breve)、B.longum、Streptococcus thermophiles(S.thermophiles),結果均具有血壓調節功能(Mahboobi et al.,2014)。 In general, the current research is still limited to in vitro or animal experiments. Only human probiotics can improve blood pressure. There are not many clinical trial data. The relevant human data are used for hypertensive patients . Helveticus and Saccharomyces cerevisiae ( S. cerevisiae ) complex strain fermented milk (Hata et al., 1996), or L.helveticus CM4 fermented milk (Aihara et al., 2005) for normal people with high blood pressure, both have blood pressure lowering the effect; and for diabetes risk groups, containing probiotic and quality products at the same time contain the following strains of L. casei, L.acidophilus, L.rhamnosus, L.bulgaricus , Bifidobacterium Breve (B.Breve), B.longum, Streptococcus thermophiles ( S. thermophiles ), the results have a blood pressure regulation function (Mahboobi et al., 2014).
目前利用活菌透過發酵乳發酵,產生ACE抑制胜肽,使用者藉由飲用而控制血壓,為主要的途徑。但因益生菌非為藥物劑型,而是以健康食品型式,而少有人體數據支持,故對於飲用之有效劑量、頻率等功效資訊往往並不明確;此外,因活菌製備過程一旦當使用或保存不當,造成汙染、過期等問題,便極易引發使用者健康風險;且因發酵乳組成往往做為乳酸菌的代謝基質以及調味的用途,故成分常具有糖分等添加物,對於可能具有其他併發症(例如:糖尿病),或是希望能控制熱量攝取的使用者而言,並不是最適合的選擇。 At present, the use of live bacteria fermented by fermented milk to produce ACE inhibiting peptides, and the user controls blood pressure by drinking, which is the main route. However, because the probiotics are not a pharmaceutical dosage form, but a healthy food type, and there is little human data support, it is often unclear about the effective dose and frequency of drinking; in addition, because the living bacteria preparation process is used or Improper preservation, causing pollution, overdue, etc., can easily lead to user health risks; and because the composition of fermented milk is often used as a metabolic substrate for lactic acid bacteria and for flavoring purposes, the ingredients often have additives such as sugar, which may have other concurrency It is not the most appropriate option for patients (such as diabetes) or those who want to control their caloric intake.
目前關於益生菌用於降血壓的專利,主要仍著重於前述將活菌投予發酵乳的方式,並往往須結合若干種乳酸菌群的加成作用,相關專利茲簡述於下。 At present, the patent on probiotics for lowering blood pressure mainly focuses on the above-mentioned method of feeding live bacteria to fermented milk, and often has to combine the addition of several kinds of lactic acid bacteria, and the related patents are briefly described below.
台灣專利公開號TW 201305331以及中國專利公開號CN 102098923A揭示瑞士乳酸菌,其透過獸乳可代謝產生發酵產物VPP(Valine-Proline-Proline,纈胺酸-脯胺酸-脯胺酸)及IPP(Isoleucine-Proline-Proline,異白胺酸-脯胺酸-脯胺酸),可抑制ACE,做為降血壓劑;然而,此發明是藉由推論因VPP以及IPP被報導具有抑制ACE的能力,而有此發酵乳可用於降血壓的結論,然而,並無試驗數據支持,且此發明仍然以活菌型式投予,在功效以及活菌保存風險、發酵乳成份的可接受群體上,仍具有潛在性問題。 Taiwan Patent Publication No. TW 201305331 and Chinese Patent Publication No. CN 102098923A disclose Swiss lactic acid bacteria which can be metabolized by animal milk to produce fermentation products VPP (Valine-Proline-Proline, lysine-proline-proline) and IPP (Isoleucine). -Proline-Proline, isoleucine-proline-proline, which inhibits ACE as a hypotensive agent; however, this invention is based on the inference that VPP and IPP have been reported to have the ability to inhibit ACE. The fermented milk can be used to lower blood pressure. However, there is no experimental data to support it, and the invention is still administered in the form of live bacteria. There is still potential in the efficacy and the risk of preservation of the live bacteria and the acceptable population of fermented milk. Sexual problems.
台灣專利公開號TW 200603741揭露一種含有ACE抑制劑之機能性發酵乳的製備方法,其步驟包含於一可供製備發酵乳之原料乳中接種適量的乳酸菌,該乳酸菌選自於乳桿菌屬(Lactobacillus spp.)、鏈球菌屬(Streptococcus spp.)及雙歧桿菌屬(Bifidobacterium spp.)所組成之族群,該乳酸菌透過發酵乳,生產出ACE抑制胜肽,並經老鼠動物試驗證實具有降血壓之功效;然而,此發明因同樣是藉由發酵乳的活菌型式投予,而仍具前述功效不明以及活菌保存、發酵乳成份的可接受群體有限之潛在風險,且僅有小鼠實驗數據,並未有人體數據佐證功效。 Taiwan Patent Publication No. TW 200603741 discloses a method for preparing ACE inhibitors are functional fermented milk containing, comprising the step in which a raw material milk for the milk fermentation inoculated with the appropriate amount of lactic acid was prepared, the lactic acid bacterium selected from Lactobacillus (Lactobacillus a group consisting of spp. ), Streptococcus spp. , and Bifidobacterium spp. , which produces fermented lactic acid to produce an ACE-inhibiting peptide, which has been shown to have hypotensive blood pressure in a mouse animal test. Efficacy; however, the invention is also administered by the live bacteria type of fermented milk, but still has the aforementioned unclear potential and the potential risk of living bacteria preservation, limited acceptable population of fermented milk components, and only experimental data of mice There is no human body data to prove the efficacy.
雖已有相關發明提出益生菌作為降血壓的方法,但是因途徑屬於健康食品,故少有人體臨床數據支持,且若需達至指定功效,則菌量需有相當的要求,並往往需合併ACE抑制胜肽,藉由發酵乳型式,以活菌投予;此外,目前除了L.helveticus外,目前並無給予單一種活性菌株便可用以調節人體血壓之相關人體臨床研究,而前述關於L.helveticus的研究,也是須以活菌型式並結合ACE抑制胜肽之機制的發酵乳才能達到降血壓的功效,而因發酵乳又有活菌保存與汙染風險,並且添加成份對於無法攝取多餘糖分或是需控制熱量者而言,仍非可行之方案。 Although the related invention proposes probiotics as a method for lowering blood pressure, since the route belongs to healthy foods, there is little human clinical data support, and if the specified efficacy is required, the amount of bacteria needs to have considerable requirements, and often needs to be combined. ACE inhibitory peptides, by type of fermented milk, viable cell administration; in addition, the exception of L. helveticus, currently no single one active strain can be administered to human clinical study of the regulation of blood pressure-related, and on the L The study of .helveticus is also a fermented milk that requires a live bacterial type combined with the mechanism of ACE inhibition of peptides to achieve blood pressure lowering, and fermented milk has the risk of preservation and contamination of live bacteria, and the added ingredients are unable to ingest excess sugar. Or those who need to control the heat, it is still not a viable solution.
有鑑於此,本案發明人深刻瞭解前案之不足與缺陷,乃亟思加以改良創新,並經多年苦心孤詣潛心研究後,終於成功完成本件利用熱滅殺死菌之羅伊氏乳桿菌(L.reuteri)GMNL-263,即可降血壓之發明。 In view of this, the inventor of this case has a deep understanding of the shortcomings and defects of the previous case, but he has made improvements and innovations, and after years of painstaking research, he finally succeeded in completing the use of heat-killing bacteria to kill L. reuteri ( L. reuteri) GMNL-263, the invention can reduce blood pressure.
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本發明係利用益生菌中的羅伊氏乳桿菌(L.reuteri)GMNL-263組合物,以預防高血壓或是降血壓。 The present invention is based in the use of probiotic Lactobacillus reuteri (L.reuteri) GMNL-263 composition, to prevent high blood pressure or lowering blood pressure.
為達前述發明目的,本發明係為一種用於改善高血壓的乳桿菌組合物,包含一羅伊氏乳桿菌(Lactobacillus.reuteri,L.reuteri)GMNL-263,其中該羅伊氏乳桿菌係為死菌。 To achieve the foregoing object of the invention, the invention is a method for improving hypertension Lactobacillus composition comprising a Lactobacillus reuteri (Lactobacillus.reuteri, L.reuteri) GMNL-263 , wherein the line L. reuteri It is dead.
為達前述發明目的,前述羅伊氏乳桿菌(L.reuteri)GMNL-263,寄存於台灣食品工業研究所,編號為BCRC 910452、中國典型培養物保藏中心(CCTCC),寄存編號為CCTCC M 209263。 To achieve the above purpose of the invention, the aforementioned Lactobacillus reuteri (L.reuteri) GMNL-263, registered in Taiwan Food Industry Institute, numbered BCRC 910452, China Type Culture Collection (CCTCC), register number CCTCC M 209263 .
為達前述發明目的,其中該羅伊氏乳桿菌(L.reuteri)GMNL-263可用於糖尿病或是需控制糖量攝取族群。 To achieve the foregoing object of the invention, wherein the Lactobacillus reuteri (L.reuteri) GMNL-263 can be used to control diabetes or for an intake of sugar groups.
為達前述發明目的,其中該乳桿菌組合物為醫藥組合物、營養補充品、保健食品或其組合。 To achieve the aforementioned object, the lactobacillus composition is a pharmaceutical composition, a nutritional supplement, a health food or a combination thereof.
為達前述發明目的,其中該乳桿菌組合物係以口服型式劑型投予。 To achieve the aforementioned object, the lactobacillus composition is administered in an oral dosage form.
為達前述發明目的,其中該醫藥組合物可進一步包含藥學上可接受之載劑。 For the purpose of the foregoing invention, the pharmaceutical composition may further comprise a pharmaceutically acceptable carrier.
為達前述發明目的,其中該乳桿菌組合物可進一步包含一可食性材料,該可食性材料包含水、流體乳品、牛奶、濃縮牛奶、優酪乳、酸乳、冷凍優格、乳桿菌發酵飲料、奶粉、冰淇淋、乳酪、乾酪、豆奶、發酵豆奶、蔬果汁、果汁、運動飲料、甜點、果凍、糖果、嬰兒食品、健康食品、動物飼料、中草藥材或膳食補充品。 For the purpose of the foregoing invention, the lactobacillus composition may further comprise an edible material comprising water, fluid dairy, milk, concentrated milk, yogurt, yogurt, frozen yogurt, lactobacillus fermented beverage , milk powder, ice cream, cheese, cheese, soy milk, fermented soy milk, vegetable juice, juice, sports drinks, desserts, jellies, sweets, baby food, health foods, animal feed, Chinese herbal medicines or dietary supplements.
本發明之另一目的係為提供一種乳桿菌用於製備改善高血壓之組合物的新用途,其中該乳桿菌組合物包含一羅伊氏乳桿菌(L.reuteri)GMNL-263,其中該羅伊氏乳桿菌係為死菌。 Another object of the present invention is to provide a system for the preparation of lactobacillus compositions to improve the use of the new composition of high blood pressure, wherein the composition comprises a Lactobacillus Lactobacillus reuteri (L.reuteri) GMNL-263, wherein the Lo Lactobacillus johnsonii is a dead bacterium.
為達前述發明目的,其中改善高血壓係透過抑制一促發炎細胞激素與提升一益生菌群的生長,使血壓降低。 To achieve the aforementioned object, the improvement of hypertension lowers blood pressure by inhibiting an inflammatory cytokine and increasing the growth of a probiotic group.
為達前述發明目的,其中該促發炎細胞激素係為IL-1β。 For the purpose of the foregoing invention, the proinflammatory cytokine is IL-1β.
為達前述發明目的,其中該益生菌群係指雙歧桿菌屬(Bifidobacterium)。 For the purpose of the foregoing invention, the probiotic group refers to Bifidobacterium.
為達前述發明目的,其中該用途特別指改善糖尿病族群之高血壓。 To achieve the aforementioned object of the invention, wherein the use specifically refers to improving hypertension in the diabetic population.
為達前述發明目的,其中該糖尿病係指第二型糖尿病。 For the purpose of the foregoing invention, wherein the diabetes refers to type 2 diabetes.
本發明實施例經由人體臨床試驗證明,組合物中以熱滅殺型式存在之GMNL-263,經由九個月的觀察,證實具有降血壓的功效,而同種的另一株菌GMNL-89則並不具有此功效。 According to the human clinical trial, the GMNL-263 which exists in the heat killing type in the composition has the effect of lowering blood pressure after nine months of observation, and the other strain of the same kind of GMNL-89 is Does not have this effect.
本發明另一實施例亦透過比對試驗期間之受試者檢體,證實GMNL-263係透過降低人體促發炎細胞激素IL-1β,而具有降血壓的功效。 Another embodiment of the present invention also confirmed that the GMNL-263 system has a blood pressure lowering effect by lowering the human proinflammatory cytokine IL-1β by comparing the subject samples during the test.
本發明再一實施例亦證明,服用GMNL-263的確提升益生菌群中雙歧桿菌屬的表現,該雙歧桿菌屬表現提升與血壓之淨變化值呈現統計學中的顯著負相關,表示服用GMNL-263而造成的雙歧桿菌屬表現提升,促進了降血壓的功效。 Still another embodiment of the present invention also proves that taking GMNL-263 does improve the performance of Bifidobacterium in the probiotic group, and the Bifidobacterium performance increase has a statistically significant negative correlation with the net change in blood pressure, indicating that taking The performance of Bifidobacterium caused by GMNL-263 is enhanced, which promotes the effect of lowering blood pressure.
本發明利用羅伊氏乳桿菌(L.reuteri)GMNL-263,透過熱滅殺死菌的型式,達到降血壓功效之發明;並進一步發現,其機制是藉由抑制 促發炎細胞激素,以及提升益生菌群中雙歧桿菌屬(Bifidobacterium)的表現,有別於以往抑制ACE的模式;本發明更經平行比較,證明即使同為羅伊氏乳桿菌,不同菌落(L.reuteri GMNL-89)便無法表現此降血壓之功效。 The present invention utilizes Lactobacillus reuteri (L.reuteri) GMNL-263, through heat killed off bacteria types, the effectiveness of the invention is to achieve the reduction of blood pressure; and further found that the mechanism by inhibiting proinflammatory cytokines, and enhancing The performance of Bifidobacterium in probiotics is different from the previous mode of inhibiting ACE; the present invention is further compared in parallel to prove that even if it is the same as L. reuteri, different colonies ( L. reuteri GMNL-89) It is impossible to express the effect of lowering blood pressure.
本發明係為乳桿菌組合物,屬於益生菌,因此使用上安全而無藥物副作用,可應用於預防以及治療高血壓;且首度揭露以死菌方式投予,不需經發酵乳即可降血壓;本發明進一步證實該GMNL-263降血壓之功效並非普遍存在於同種羅伊氏乳桿菌中,需進一步進行臨床測試方可確知;並首度提出抑制IL-1β以及提升雙歧桿菌屬表現可作為益生菌用以降血壓之途徑。 The present invention is a Lactobacillus composition, which belongs to a probiotic, and therefore is safe to use without drug side effects, and can be applied for prevention and treatment of hypertension; and the first disclosure is administered by dead bacteria, and can be lowered without fermenting milk. Blood pressure; the present invention further confirms that the efficacy of the GMNL-263 to lower blood pressure is not ubiquitous in the same species of L. reuteri, and further clinical testing is needed to confirm; and for the first time, inhibition of IL-1β and improvement of Bifidobacterium expression are proposed. It can be used as a probiotic to lower blood pressure.
圖1A 係為人體臨床試驗分組;圖1B 係為人體臨床試驗流程;圖2 係為平均血壓(Mean arterial pressure,MAP)與益生菌之雙歧桿菌屬的相關性分析。 Figure 1A is a human clinical trial group; Figure 1B is a human clinical trial procedure; Figure 2 is a correlation analysis between Mean arterial pressure (MAP) and probiotic Bifidobacterium.
本發明係以下面的實施例予以示範闡明,但本發明不受下述實施例所限制。本發明所使用之材料,除有特別指明者,皆為市售易於取得之材料,本發明所使用之羅伊氏乳桿菌(Lactobacilus reuteri,L.reuteri)GMNL-263[以下代稱GMNL-263],寄存於台灣食品工業研究所,編號為BCRC 910452、中國典型培養物保藏中心(CCTCC),寄存編號為CCTCC M 209263。 The present invention is exemplified by the following examples, but the present invention is not limited by the following examples. The material used in the present invention, in addition to those specifically stated, are all readily available commercial materials, the use of the present invention is Lactobacillus reuteri (Lactobacilus reuteri, L.reuteri) GMNL- 263 [ hereinafter referred Generation GMNL-263] It is deposited at the Taiwan Food Industry Research Institute under the number BCRC 910452, China National Type Culture Collection (CCTCC), and the registration number is CCTCC M 209263.
實施例1、熱滅殺之GMNL-263具有降血壓之功效Example 1. Heat killing GMNL-263 has the effect of lowering blood pressure
本實施例為人體臨床試驗,有鑑於糖尿病第二型之患者往往好發高血壓,因此患者以第二型糖尿病確診超過6個月為主,其餘納入條件分別為:7%<HbA1c(醣化血色素,glycated hemoglobin)≦10%;年齡:25~70歲;BMI>18.5;排除條件為:懷孕/孕婦;3年內罹患重大疾病,如癌症(良性腫瘤且控制穩定除外)、腎衰竭/洗腎、心臟病、中風、自體免疫疾病、試驗前四週與試驗期間食用降血糖藥物以外之改善血糖保健品、固定食用益生菌產品、固定使用抗生素、肝腎功能異常、腸胃道不健全、不能口服藥物者。 This example is a human clinical trial. In view of the fact that patients with type 2 diabetes tend to have high blood pressure, the patients were diagnosed with type 2 diabetes for more than 6 months, and the remaining conditions were: 7% <HbA1c (glycated hemoglobin) ,glycated hemoglobin)≦10%; age: 25~70 years old; BMI>18.5; exclusion conditions: pregnancy/pregnancy; major diseases within 3 years, such as cancer (except for benign tumors and stable control), renal failure/dialysis , heart disease, stroke, autoimmune disease, blood glucose supplements other than hypoglycemic drugs before and during the test, fixed probiotics, fixed antibiotics, liver and kidney dysfunction, gastrointestinal tract is not healthy, can not be taken orally By.
本實施例於臨床試驗公開網站(Clinicaltrial.gov)登錄號為NCT02274272,進行於台灣彰化基督教醫院,入類研究倫理審查委員會(Institutional Review Board,IRB)通過編號為No.140703。圖1A以及圖1B說明試驗設計方式以及流程,為平行研究,具有對照組,採用雙盲、隨機分派的方法,入案74人,隨機分配成三組執行,扣除離開試驗者,最終分析數據之病人共為68人,分別為安慰劑組(placebo,N=22人),服用羅伊氏乳桿菌GMNL-89活菌組(以下代稱GMNL-89)(GMNL-89,N=22人),以及服用羅伊氏乳桿菌GMNL-263熱滅殺菌組(GMNL-263,N=24人)為兩組益生菌試驗組;此外,扣除一受試者遺失糞便檢體,因此,糞便菌相分析數據為67人,在併用現行處方用藥情況下,探討基本生化值、血糖等代謝指標、腸道菌相以及促發炎細胞激素等,在服用前和服用益生菌六個月後及停止服用後三個月,總計九個月之變化。 This example was submitted to the Changhua Christian Hospital in Taiwan on the clinical trial publication website (Clinicaltrial.gov) under the accession number NCT02274272. The Institutional Review Board (IRB) was numbered No. 140703. Figure 1A and Figure 1B illustrate the experimental design method and flow. For the parallel study, there is a control group, using a double-blind, random assignment method, 74 people are enrolled, randomly assigned to perform in three groups, deducting the leave tester, and finally analyzing the data. A total of 68 patients were placed in the placebo group (placebo, N=22), and the L. reuteri GMNL-89 live bacteria group (hereinafter referred to as GMNL-89) (GMNL-89, N=22 people). And taking the L. reuteri GMNL-263 heat sterilization group (GMNL-263, N=24 people) as two groups of probiotics test group; in addition, deducting one subject lost stool sample, therefore, fecal bacteria phase analysis The data was 67 people. Under the condition of using the current prescription drugs, the basic biochemical values, blood glucose and other metabolic indicators, intestinal bacteria and pro-inflammatory cytokines were discussed. Before taking the probiotics for six months and stopping taking them three times. Months, a total of nine months of change.
GMNL-89活菌菌粉及GMNL-263熱滅殺菌菌粉是由景岳生物科技公司發酵生產製備,GMNL-89活菌劑量為4×109ctu(colony forming unit)/天,GMNL-263劑量為2×1010cells/天,每天持續服用,共計六個月。 GMNL-89 live bacteria powder and GMNL-263 heat sterilization fungus powder are prepared by fermentation of Jingyue Biotechnology Co., Ltd., and the dose of GMNL-89 is 4×10 9 ctu (colony forming unit)/day, GMNL-263 The dose was 2 x 10 10 cells/day and continued for 6 months.
各項統計分析方面,基本資料之比較是利用Chi-quare test或two sample t-test;而用藥記錄及高血壓比較則是利用Fisher exact test,其他部分則是利用two sample t-test。 In terms of statistical analysis, the basic data were compared using Chi-quare test or two sample t-test; while the medication record and hypertension comparison were performed using Fisher exact test, and the other part was using two sample t-test.
首先進行病人基本資料分析,表1 為三組受試者在試驗開始時的各項基本資料之比較,三組並無明顯差異;表2 顯示三組受試者高血壓的比例無統計上的差異,表示三組受試者之背景條件接近,且在血壓方面,雖然這些受試者均有以藥物控制血壓,然研究過程中所使用之藥物種類三組並無統計上差異,因此不具有藥物造成之實驗誤差的可能,但收縮壓(systolic blood pressure,SBP)仍是較偏高的,表示血壓控制不良。 First, the patient's basic data were analyzed. Table 1 compares the basic data of the three groups at the beginning of the trial. There is no significant difference between the three groups. Table 2 shows that the proportion of hypertension in the three groups is not statistically significant. The difference indicates that the background conditions of the three groups of subjects are close, and in terms of blood pressure, although these subjects have blood pressure controlled by drugs, there are no statistical differences between the three groups of drugs used in the study, so there is no The experimental error caused by the drug is possible, but the systolic blood pressure (SBP) is still relatively high, indicating poor blood pressure control.
實驗結果顯示,經過六個月,服用GMNL-89活菌組的糖尿病病人的糖化血色素(HbA1c)之淨變化值(代表第六個月扣除第一個月之值,net change value:6M-0M)有明顯之降低(-0.39±0.80,P<0.05);而GMNL-263熱滅殺菌組則與安慰劑組無太大差異(0.24±0.93),表示服用GMNL-263熱滅殺菌組不會影響糖尿病患者之血糖值。 The results of the experiment showed that after six months, the net change in glycated hemoglobin (HbA1c) in diabetic patients taking the GMNL-89 live bacteria group (representing the value of the first month after the sixth month, net change value: 6M-0M There was a significant decrease (-0.39±0.80, P<0.05); while the GMNL-263 heat sterilization group did not differ much from the placebo group (0.24±0.93), indicating that taking the GMNL-263 heat sterilization group would not Affect the blood sugar level of diabetic patients.
而在血壓方面(表3),服用GMNL-263熱滅殺菌組,其收縮壓(SBP)及平均血壓(mean blood pressure)之淨變化值明顯下降,並呈現統計上的顯著差異(P<0.05),表示GMNL-263具有降血壓之功效;然而,同為羅伊氏乳桿菌的GMNL-89,各種血壓測定值均無顯著變化,表示不具有調節血壓之功效。此對比也顯示,降血壓功效需於羅伊氏乳桿菌菌種中的特定菌株才具有,並非普遍存在且易於推知,須經實驗證實才能確認。 In terms of blood pressure (Table 3 ), the net change in systolic blood pressure (SBP) and mean blood pressure was significantly decreased in the GMNL-263 heat-killing group, and there was a statistically significant difference (P<0.05). ), indicating that GMNL-263 has the effect of lowering blood pressure; however, GMNL-89, which is also Lactobacillus reuteri, has no significant change in various blood pressure measurement values, indicating that it does not have the effect of regulating blood pressure. This comparison also shows that the blood pressure lowering effect is required for specific strains in the Lactobacillus reuteri strain, is not ubiquitous and easy to infer, and must be confirmed by experiments.
實施例2、熱滅殺之GMNL-263透過降低促發炎細胞激素IL-1β,而具降血壓之功效Example 2. Heat-killing GMNL-263 has the effect of lowering blood pressure by lowering the pro-inflammatory cytokine IL-1β.
為測試GMNL-263是透過何種機制達到降血壓的功效,進一步進行細胞激素的含量變化分析。首先,收集三組受試者在試驗開始(0M)以及六個月後(6M)的血液檢體,利用ELISA套組進行各種細胞激素之含量分析,包含human IL-6(Cat#900-K16,PeproTech,USA)、human IL-10(Cat#900-K21,PeproTech,USA)、human TNF-α(Cat# 50-114-2609,eBioscience,USA)、human IL-1β(Cat# 437005,Biolegend,USA),數據處理為六個月(6M)減掉開始(0M)的淨變化值,並進一步以two sample t-test進行統計分析。 In order to test the mechanism by which GMNL-263 achieves blood pressure lowering, the cytokine content change analysis is further carried out. First, blood samples from three groups of subjects at the beginning (0M) and six months (6M) were collected, and various cytokine contents were analyzed using an ELISA kit, including human IL-6 (Cat#900-K16). , PeproTech, USA), human IL-10 (Cat#900-K21, PeproTech, USA), human TNF-α (Cat# 50-114-2609, eBioscience, USA), human IL-1β (Cat# 437005, Biolegend , USA), the data processing is six months (6M) minus the net change value of the start (0M), and further statistical analysis with two sample t-test.
結果呈現,服用GMNL-263六個月後,病人血中IL-1β與安慰劑組相比,呈現統計上顯著意義地明顯下降,反觀其他細胞激素則沒有太大之差異(表4),表示GMNL-263是透過令IL-1β下降,調控全身慢性發炎反應,進而達到降血壓之目的。 The results showed that after taking GMNL-263 for six months, the IL-1β in the blood of the patients showed a statistically significant decrease compared with the placebo group. In contrast, other cytokines did not differ much (Table 4 ). GMNL-263 regulates the systemic chronic inflammatory response by lowering IL-1β, thereby achieving the goal of lowering blood pressure.
實施例3、熱滅殺之GMNL-263透過提升腸道雙歧桿菌屬表現,而具降血壓之功效Example 3, heat killing GMNL-263 has the effect of lowering blood pressure by improving the performance of Bifidobacterium in the intestine
為釐清GMNL-263的降血壓功效是否與腸道益生菌群的調控有關,收集受試者於試驗開始(0M)及六個月(6M)的糞便檢體,以定量聚合酶鏈鎖反應(Quantitative polymerase chain reaction,Q-PCR)分析糞便菌相中的DNA,計算服用益生菌六個月後的菌相消長變化,其計算方式為,(服用六個月之糞便DNA利用Q-PCR所得之CT(Threshold cycle)值-總菌的CT值)=△Ct,△Ct-(尚未服用者之糞便DNA利用Q-PCR所得之CT值-總菌的CT值)=△△Ct;將其換算為2-△△Ct,即為服用益生菌六個月後之菌相之消長變化。 To clarify whether the blood pressure lowering effect of GMNL-263 is related to the regulation of intestinal probiotics, collect the fecal samples from the beginning (0M) and six months (6M) of the subjects to quantify the polymerase chain reaction ( Quantitative polymerase chain reaction (Q-PCR) analyzes the DNA in the fecal bacteria phase and calculates the change in the growth and decline of the bacteria phase after taking the probiotic for six months. The calculation method is: (take six months of fecal DNA using Q-PCR) CT (Threshold cycle) value - CT value of total bacteria) = △ Ct, △ Ct - (CT value obtained by Q-PCR of fecal DNA of the untreated person - CT value of total bacteria) = △ △ Ct; It is 2 - △ △ Ct , which is the change of the growth and decline of the bacterial phase after taking the probiotic for six months.
利用Q-PCR分析糞便菌相,可分為抽DNA以及進行Q-PCR分析兩部分,首先,糞便檢體抽DNA的方法,係利用DNA套組(QIAamp DNA Stool Mini Kit,QIAGEN,Lot.51504),將病人糞便去除RNA later保護劑後,加入Buffer ASL,而後置於70℃加熱板中加熱5分鐘,再加入0.1mm滅菌後的微珠(型號:BioSpec Products 0.1MM ZIRCONIA/SILICA BEADS,cat.No.11079101z)強烈震盪至少15秒,直至糞便全部混勻攪 碎;以13,000rpm離心1分鐘,取上清,接續進行DNA之萃取,並將萃取後的DNA,調整為1ng/μl備用。 The Q-PCR analysis of fecal bacteria phase can be divided into two parts: DNA extraction and Q-PCR analysis. First, the method of DNA extraction from stool samples is based on the DNA kit (QIAamp DNA Stool Mini Kit, QIAGEN, Lot.51504). After removing the RNA later protectant from the patient's stool, add Buffer ASL, then heat it on a 70 °C hot plate for 5 minutes, then add 0.1 mm sterilized microbeads (Model: BioSpec Products 0.1MM ZIRCONIA/SILICA BEADS, cat .No.11079101z) Strongly shake for at least 15 seconds until the feces are mixed and pulverized; centrifuge at 13,000 rpm for 1 minute, take the supernatant, and then extract the DNA, and adjust the extracted DNA to 1 ng/μl for use.
而後,進行糞便Q-PCR分析,將上述萃取出之DNA當作模板進行Q-PCR,每一份反應試劑以5μl的2x Rotor-Gene SYBR Green PCR Master Mix(QIAGEN,Cat.204076),加入2μl糞便DNA後,再加入3μl的待測菌相引子(0.66μM Forward(F)+Reverse primers(R)),使總體積為10μl,以PCR機器(型號QIAGEN:Rotor-Gene Q 2Plex)執行即時Q-PCR。 Then, fecal Q-PCR analysis was performed, and the extracted DNA was used as a template for Q-PCR. Each reaction reagent was added with 2 μl of 2× Rotor-Gene SYBR Green PCR Master Mix (QIAGEN, Cat. 204076). After fecal DNA, add 3 μl of the test phase primer (0.66 μM Forward(F)+Reverse primers(R)) to make a total volume of 10 μl, and perform an instant Q with a PCR machine (model QIAGEN: Rotor-Gene Q 2Plex). - PCR.
菌相變化數據以Two sample t-test進行統計分析;而菌相變化與血壓變化之相關性分析,則是利用統計軟體PASW Statistics 18 Software(SPSS Inc)進行Spearman's rho correlation。 The bacterial phase change data was statistically analyzed by Two sample t-test; and the correlation analysis between the bacterial phase change and the blood pressure change was performed by the statistical software PASW Statistics 18 Software (SPSS Inc) for Spearman's rho correlation.
結果呈現,服用熱滅殺GMNL-263六個月後可以觀察到受試者益生菌群中的雙歧桿菌屬表現增加,與安慰劑組相較,據統計上的顯著差異(表5);為了釐清菌相與血壓變化之關聯,且進一步利用相關性統計分析,發現雙歧桿菌屬的含量提升與平均血壓淨變化值呈負相關(R=-0.268、P=0.028,圖2),表示當雙歧桿菌屬含量多時,會促進血壓降低。因此,證明熱殺滅GMNL-263能經由增加糞便中之益生菌中的雙歧桿菌屬,達到調降血壓之功效。 The results showed that Bifidobacterium expression in the probiotic flora of the subjects was observed to increase after six months of heat killing of GMNL-263, compared with the placebo group, according to statistically significant differences (Table 5 ); In order to clarify the relationship between bacterial phase and blood pressure changes, and further use correlation statistical analysis, it was found that the increase in Bifidobacterium content was negatively correlated with the mean change in mean blood pressure (R=-0.268, P=0.028, Figure 2 ), indicating When the amount of Bifidobacterium is high, it will promote blood pressure lowering. Therefore, it was proved that the heat killing of GMNL-263 can achieve the effect of lowering blood pressure by increasing the Bifidobacterium in the probiotics in the feces.
表5、三組受試者經六個月實驗後之微生物態變化Table 5. Microbial changes after three months of experiment in three groups of subjects
本發明證明服用熱滅殺羅伊氏乳桿菌GMNL-263,六個月後可幫助有高血壓症狀之糖尿病病人調降收縮壓及平均血壓,且不影響血糖值,對於需控制糖分或熱量攝取的群體或是糖尿病病患十分有助益;該菌係經熱滅殺處理,可製成膠囊或粉包,具有穩定性高、以及簡便的優勢;此外,因為乳桿菌屬於益生菌,為健康食品,因此並無安全之疑慮,一般人也可使用,以預防或是控制高血壓,使用族群無限制,可應用範圍極廣;本發明進一步由相關性統計分析,證實熱滅殺羅伊氏乳桿菌GMNL-263同時經由降低促發炎細胞激素IL-1β,並且調節病人腸道菌相,以增加益生菌中的雙歧桿菌屬的方式,達到降血壓的效果;且藉由相同菌種之對照組GMNL-89證明,並非所有羅伊氏乳桿菌均可用於降血壓,需特定菌株,並經臨床試驗才可證實。上述羅伊氏乳桿菌GMNL-263用於降血壓之發明,均為益生菌用於降血壓應用領域的首度發現,並破除了前案的形式以及使用群體限制。 The invention proves that taking heat-killing L. reuteri GMNL-263 can help diabetic patients with hypertension symptoms reduce systolic blood pressure and average blood pressure after six months without affecting blood sugar level, and need to control sugar or caloric intake. The group or the diabetic patient is very helpful; the strain is heat-killed and can be made into capsules or powder packs, which has the advantages of high stability and simplicity; in addition, because the lactobacillus belong to probiotics, it is healthy. Food, therefore, there is no safety concern, and can be used by ordinary people to prevent or control high blood pressure. The use of ethnic groups is unlimited and can be applied in a wide range. The present invention further confirms the heat killing of Roy's milk by correlation statistical analysis. Bacillus GMNL-263 simultaneously achieves a blood pressure lowering effect by lowering the proinflammatory cytokine IL-1β and regulating the intestinal flora of the patient to increase the bifidobacteria in the probiotic bacteria; and by the same species control The group GMNL-89 proved that not all Lactobacillus reuteri can be used for lowering blood pressure, requiring specific strains, and can be confirmed by clinical trials. The above-mentioned invention of Lactobacillus reuteri GMNL-263 for lowering blood pressure is the first discovery of probiotics for blood pressure lowering applications, and breaks the form of the previous case and the use group restrictions.
本案不僅於技術思想上確屬創新,並具備習用之傳統方法所不及之多項功效,已充分符合新穎性及進步性之法定發明專利要件,爰依法提出申請,懇請 貴局核准本件發明專利申請案,以勵發明,至感德便。 This case is not only innovative in terms of technical thinking, but also has many functions that are not in the traditional methods of the past. It has fully complied with the statutory invention patent requirements of novelty and progressiveness, and applied for it according to law. You are requested to approve the invention patent application. In order to invent, to the sense of virtue.
國內寄存資訊【請依寄存機構、日期、號碼順序註記】 Domestic registration information [please note according to the registration authority, date, number order]
1.寄存機構-食品工業發展研究所、寄存日期-2009年11月6號、寄存編號-BCRC 910452 1. Depository institution - Food Industry Development Research Institute, storage date - November 6, 2009, registration number - BCRC 910452
國外寄存資訊【請依寄存國家、機構、日期、號碼順序註記】 Foreign deposit information [please note according to the country, organization, date, number order]
1.寄存國家-中國、寄存機構-中國典型培養物保藏中心(CCTCC)、寄存日期-2009年11月13號、寄存編號-CCTCC M 209263 1. Host country - China, depository - China Type Culture Collection (CCTCC), deposit date - November 13, 2009, deposit number - CCTCC M 209263
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| Hsieh et al., Oral administration of Lactobacillus reuteri GMNL-263 improves insulin resistance and ameliorates hepatic steatosis in high fructose-fed rats. Nutr Metab (Lond). 2013 Apr 17;10(1):35. doi: 10.1186/1743-7075-10-35. |
| Lu et al., Effect of Lactobacillus reuteri GMNL-263 treatment on renal fibrosis in diabetic rats. J Biosci Bioeng. 2010 Dec;110(6):709-15. doi: 10.1016/j.jbiosc.2010.07.006. |
| Lu et al., Effect of Lactobacillus reuteri GMNL-263 treatment on renal fibrosis in diabetic rats. J Biosci Bioeng. 2010 Dec;110(6):709-15. doi: 10.1016/j.jbiosc.2010.07.006. Hsieh et al., Oral administration of Lactobacillus reuteri GMNL-263 improves insulin resistance and ameliorates hepatic steatosis in high fructose-fed rats. Nutr Metab (Lond). 2013 Apr 17;10(1):35. doi: 10.1186/1743-7075-10-35. Pereira et al., Influence of a Co-culture of Streptococcus thermophilus and Lactobacillus casei on the Proteolysis and ACE-Inhibitory Activity of a Beverage Based on Reconstituted Goat Whey Powder. Probiotics Antimicrob Proteins. 2017 Dec 5. doi: 10.1007/s12602-017-9362-y * |
| Pereira et al., Influence of a Co-culture of Streptococcus thermophilus and Lactobacillus casei on the Proteolysis and ACE-Inhibitory Activity of a Beverage Based on Reconstituted Goat Whey Powder. Probiotics Antimicrob Proteins. 2017 Dec 5. doi: 10.1007/s12602-017-9362-y |
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