選單

2014年2月21日 星期五

氫氣(來自腸道細菌)可保護肝炎

這個研究給我們一個非常重要的提示,內源性氫也是非常重要的,那麼在進行研究過程中,應該設法排除這個干擾,作者在實驗設計中提供了一種方法,希望能引起我們的重視。
我們在研究中也發現,有時候實驗結果不穩定,可能的原因之一是,內源性氫氣的干擾,特別是肝臟和心臟,內源性氫氣的干擾會更大,這需要引起我們重視,如何來解決這個問題,根本的手段是測定組織內氫氣的含量,如果部分動物組織內氫氣的含量比較高,那麼干擾就可以預先排除,另外一種手段就是借鑒美國的研究該一定的抗生素預先處理,以降低內源性氫氣的干擾。美國學者的處理方法是:(1) Animals were supplied with water containing an antibiotics cocktail (Sulfamethoxazole磺胺甲基異噁唑, 4 mg/ml; Trimethoprim甲氧苄氨嘧啶, 0.8 mg/ml; and Ampicillin氨苄青黴素, 0.1 mg/ml) ad libitum for 3 days. (2) For three additional days, the animals were kept with drinking water containing Ampicillin氨苄青黴素 (0.1 mg/ml) ad libitum.。實驗前6天通過在飲水開始給動物三種抗生素3天,實驗前3天開始給一種抗生素3天,這樣就可以排除內源性氫氣的干擾。
我們在07年日本發表文章後,我們查找文獻後發現,由於人類等高等生物大腸記憶體在大量可產生氫氣的細菌,這些氫也可以被機體所吸收,從其含量水準來看,已經達到具有抗氧化作用的濃度。因此我們提出,氫是一種內源性抗氧化物質的概念。這個思路如果被實驗所證明,將也是一個重要的貢獻。現在已經有了真實的證據。

這個方面也將會是氫分子醫學的一個熱點。
Mikihito Kajiyaa, Kimihiro Satob, Marcelo J.B. Silvaa, Kazuhisa Ouharaa, Phi M. Doc, K.T. Shanmugamc and Toshihisa Kawainext terma, Corresponding Author Contact Information, E-mail The Corresponding Author

aDepartment of Immunology, The Forsyth Institute, Boston, MA, USA
bSkyview Enterprises, New York, NY, USA
cDepartment of Microbiology and Cell Science, University of Florida, Gainesville, FL, USA

Received 5 June 2009.
Available online 10 June 2009.

Abstract

It is well known that some intestinal bacteria, such as Escherichia coli, can produce a remarkable amount of molecular hydrogen (H2). Although the antioxidant effects of H2 are well documented, the present study examined whether H2 released from intestinally colonized bacteria could affect Concanavalin A (ConA)-induced mouse hepatitis. Systemic antibiotics significantly decreased the level of H2 in both liver and intestines along with suppression of intestinal bacteria. As determined by the levels of AST, ALT, TNF-α and IFN-γ in serum, suppression of intestinal bacterial flora by antibiotics increased the severity of ConA-induced hepatitis, while reconstitution of intestinal flora with H2-producing E. coli, but not H2-deficient mutant E. coli, down-regulated the ConA-induced liver inflammation. Furthermore, in vitro production of both TNF-α and IFN-γ by ConA-stimulated spleen lymphocytes was significantly inhibited by the introduction of H2. These results indicate that H2 released from intestinal bacteria can suppress inflammation induced in liver by ConA.
Keywords: Hepatitis; Concanavalin A; Molecular hydrogen; Inflammation; Mouse model; Lymphocytes; Bacteria; Antibiotics; TNF-α; IFN-γ

Article Outline

Introduction
Materials and methods
Animals
Establishment of GFP-expressing E. coli
Measurement of molecular hydrogen
Generation of H2 dissolved water
Concanavalin A-induced acute hepatitis model
Measurement of liver inflammation biomarkers and proinflammatory cytokines
Analysis of liver histopathology
In vitro analyses of proliferation of spleen lymphocytes and their production of proinflammatory cytokines
Results
Discussion
Acknowledgements
Appendix A. Supplementary data
References

Introduction

The antioxidant effects of water dissolved with molecular hydrogen (H2) was demonstrated in the mouse model of brain injury induced by ischemia reperfusion [1]. Following this study, several other reports also demonstrated that H2 could suppress tissue injury in organs, such as liver, intestine and heart [2], [3] and [4], caused by oxidative stress following ischemia reperfusion. Since a close link between inflammation and oxidative stress is well recognized, as each one activates the other, an efficient antioxidant agent should also suppress the inflammation induced in tissue-destructive diseases. However, few reports documenting the anti-inflammatory aspects of H2 can be found.
Importantly, in past studies using animal models, H2 has been exogenously applied in the form of gas or dissolved in water supplied to the animals [1], [2], [3] and [4]. However, it is also true that some intestinal bacteria, such as Escherichia coli (E. coli), can produce H2 as a result of their possession of hydrogenases [5]. If, indeed, H2 is released by intestinal bacteria [6], such internally produced H2 should affect the host’s resistance to oxidative as well as inflammatory stresses. Again, however, no studies have thus far addressed the effects of H2, as produced by intestinal bacteria, on the host’s resistance to inflammatory stimuli.
Concanavalin A (ConA) is a hemagglutinin that agglutinates blood erythrocytes and a mitogen which predominantly stimulates T cells. Therefore, it causes acute inflammation by the infiltration of activated lymphocytes, which results in massive necrotic tissue injury of hepatocytes accompanied by intrasinusoidal hemostasis [7] and [8]. Accordingly, ConA-induced hepatitis has been used as an experimental murine model that mirrors most of the pathogenic properties of human autoimmune hepatitis [9]. The resistance to ConA-induced hepatitis by athymic nude mice and SCID mice clearly demonstrates the permissive role T cells play in the induction of hepatic injury induced by ConA [10] and [11]. Although the tissue injury caused by ConA is limited to the liver [11], the underlying mechanism that explains such organ specificity is still unclear. Nevertheless, ConA-mediated T cell activation also increases the blood level of proinflammatory cytokines, including tumor necrosis factor alpha (TNF-α) and interferon gamma (IFN-γ), which are released from activated T cells and considered to play critical roles in the development of ConA-induced hepatic inflammation [12], [13] and [14].
Using a mouse model of acute hepatitis induced by Concanavalin A, the present study examined (1) the amount of H2 released from bacteria colonized in the intestines and (2) the effects of H2 released from intestinal bacteria on the inflammation induced in liver.

Materials and methods


Animals

C57BL/6j mice (8- to 10-week-old males) were kept in a conventional room with a 12-h light-dark cycle at constant temperature. The experimental procedures employed in this study were approved by the Forsyth IACUC.

Establishment of GFP-expressing E. coli

Escherichia coli strain W3110 (ATCC 27325) and its hypF deletion mutant strain PMD23, which does not produce H2, were used in this study (Supplementary Material 1; accessible online). HypF is indispensable for the synthesis of active hydrogenase because its absence results in >95% decrease in hydrogenase activity [15] and [16]. Using electroporation, both strains of E. coli were transfected with pGFPuv-vector (Clontech, Mountain View, CA) possessing an Ampicillin-resistant gene (Ampr) in the promoter. The resulting two strains, E. coli W3110gfp+ (Ampr+/GFP+/HypF+) and E. coli PMD23gfp+ (Ampr+/GFP+/HypF−) were cultured in Luria–Bertani (LB) broth containing Ampicillin (100 μg/ml).

Measurement of molecular hydrogen

The molecular hydrogen (H2) produced in organs of mice was measured using a needle-type Hydrogen Sensor (Unisense A/S, Aarhus, Denmark) following the method published by Hayashida et al. [3]. Immediately after mice were sacrificed under CO2 inhalation, the needle-type Hydrogen Sensor was placed to the pilot paths prepared in organs by a 25-G needle. Otherwise, the Hydrogen Sensor was directly placed into blood sampled by cardiac puncture. The standard positive concentration of H2 was prepared by saturation of H2 gas in water (781 μM at 25 °C or 721 μM at 37 °C) at an atmospheric pressure, while non-treated control water was used for H2 amount 0 μM. The diffusion factor of H2 was always taken into account and adjusted (e.g., 0.7 μM/min from sampled blood in a plastic tube).

Generation of H2 dissolved water

High purity H2 gas (Airgas, Salem, NH) was ejected into water or culture medium until H2 concentration reached to saturation (780 μM, at 25 °C). Then, H2 at appropriate concentration was prepared by dilution. The saturated H2 in water showed pH 7.6 and very high redox potential (ORP level −511 mV).

Concanavalin A-induced acute hepatitis model

Experimental Protocol-A. (1) Animals were supplied with water containing an antibiotics cocktail (Sulfamethoxazole, 8 mg/ml, and Trimethoprim, 1.6 mg/ml) or control antibiotics-free water ad libitum for 3 days. (2) For two additional days, both groups of animals were rested with antibiotics-free water ad libitum. (3) ConA (Sigma, St. Louis, MO, 15 mg/kg; saline solution) was injected i.v. to both groups of mice, and ALT and AST in serum was monitored at 0, 2 and 10 h afterwards.
Experimental Protocol-B. (1) Animals were supplied with water containing an antibiotics cocktail (Sulfamethoxazole, 4 mg/ml; Trimethoprim, 0.8 mg/ml; and Ampicillin, 0.1 mg/ml) ad libitum for 3 days. (2) For three additional days, the animals were kept with drinking water containing Ampicillin (0.1 mg/ml) ad libitum. (3) ConA (15 mg/kg, saline solution) was injected to two groups of mice: (a) those receiving H2-enriched water (780 μM, pH 7.6, 1 ml/mouse [p.o.], n = 5/group) or (b) those receiving control water (1 ml/mouse [p.o.], n = 5/group) at 12 h prior to ConA injection and 0 and 3 h after ConA injection. After ConA injection, both groups were still supplied with drinking water containing Ampicillin. The diagram of Experimental Protocol-B is shown in Fig. 2A.





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Fig. 1. Effects of systemic antibiotics treatment on the H2 level in intestinal ducts and liver and the susceptibility of mice to ConA-induced hepatitis. (A) H2 concentrations in different organs shown in the histogram were measured using a needle-type Hydrogen Sensor (n = 3/group). (B) Fresh fecal samples collected from the mice treated with or without antibiotics for 3 days followed by a 2-day resting period (feces, 20 mg/10 ml of LB broth, n = 3/group) were incubated for 1 h or 12 h at 37 °C, followed by measurement of H2 in the bacterial culture. (C and D) ConA (15 mg/kg) was injected i.v. to the mice which were pretreated with or without antibiotics (Sulfamethoxazole, 8 mg/ml, and Trimethoprim, 1.6 mg/ml) for 3 days followed by a 2-day resting period with antibiotics-free water. The levels of ALT (C) and AST (D) in blood serum were measured. Data are shown as the mean ± SD of five mice per group. *p < 0.05, **p < 0.01: values differ significantly (t-test).



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Fig. 2. Effects of exogenously applied H2 on ConA-induced liver injury of C57BL/6j mice which were pretreated with antibiotics. (A) Diagram of Experimental Protocol-B: details are described in Materials and methods. The levels of ALT (C), AST (D), TNF-α (E) and IFN-γ (F) collected from mice at 0, 2 and 6 h after ConA injection were measured and presented in histograms. Columns and bars in each histogram (C, D, E and F) indicate mean ± SD of respective values (n = 5/group). *p < 0.05, **p < 0.01: values differ significantly (t-test).

Experimental Protocol-C. (1) Animals were supplied with water containing the same cocktail of three antibiotics as indicated in Protocol-B for 3 days. (2) For three additional days, the animals were kept with water containing Ampicillin (1 mg/ml) ad libitum. (3) ConA (15 mg/kg, saline solution) was injected to two groups of mice: (a) those reconstituted with E. coli W3110gfp+ (n = 5/group) or (b) those colonized with PMD23gfp+ (n = 5/group). The two strains of E. coli growing in the mid-log phase were harvested and applied (109 bacteria/100 μl saline with 5% carboxymethyl cellulose/mouse [p.o.]) using a Popper feeding needle at 2 days prior to ConA injection. Even after ConA injection, both groups were supplied with drinking water containing Ampicillin. The diagram of Experimental Protocol-C is shown in Fig. 3A.




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Fig. 3. Reconstitution of intestinal duct with H2-producing E. coli, but not H2-deficient E. coli, can down-regulate the ConA-induced liver injury in C57BL/6 mice pretreated with antibiotics. (A) Experimental Protocol-C: details are described in Materials and methods. (B) Level of H2 production by E. coli strain PMD23 (Ampr+/GFP+/HypF−) or W3110 (Ampr+/GFP+/HypF+), as cultured in LB broth supplemented with Ampicillin (100 μg/ml) for 12 h. The levels of ALT (B), AST (C), TNF-α (D) and IFN-γ (E) collected from mice at 0, 2 and 6 h after ConA injection were measured and are shown in histograms as mean ± SD of respective values (n = 5/group). *p < 0.05, **p < 0.01: Significantly different by t-test.

Measurement of liver inflammation biomarkers and proinflammatory cytokines

The extent of liver injury was analyzed by determining the serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) using detection kits and following the manufacturer’s instructions (Biotron Diagnostics, Hemet, CA). Quantification of proinflammatory cytokines, TNF-α and IFN-γ, was performed by enzyme-linked immunosorbent assay (ELISA) kits (PeproTech, Rocky Hill, NJ).

Analysis of liver histopathology

The left lobes of the livers sampled from sacrificed mice 10 h following ConA injection were processed for histological analysis by hematoxylin and eosin (H&E)-staining.

In vitro analyses of proliferation of spleen lymphocytes and their production of proinflammatory cytokines

The mononuclear lymphocytes were isolated from the spleen of C57BL/6j mice by a density gradient centrifugation using Histopaque (Sigma). In a 96-well plate, the lymphocytes (2 × 105/well) were pretreated with H2 dissolved in RPMI medium supplemented with 10% FBS, l-glutamine and antibiotics (H2 at concentrations of 175, 350 and 700 μM). The cells in the 96-well plate were then reacted with or without ConA (1 μg/ml) for 24 h, and the culture supernatants were subjected to ELISA for detection of TNF-α and IFN-γ. The spleen lymphocytes in the 96-well plate were further incubated with [3H] thymidine (0.5 μCi) for the last 16 h of a total 48 h culture, and the radioactivity incorporated in the cells under proliferation (cpm) was monitored by a radio scintillation counter.

Results

H2 is produced in the intestine of animals as a byproduct of carbohydrate fermentation [17]. It was also demonstrated that H2 concentrations in live mouse stomach or livers (about 20–80 μM) are over 20 times greater than the apparent whole-cell Km for hydrogen [6] and [18]. Based on this evidence, we hypothesized that such elevated level of H2 in abdominal organs is derived from intestinal bacteria. To test this premise, mice were treated with or without antibiotics (Sulfamethoxazole and Trimethoprim) for 3 days, followed by a 2-day resting period with antibiotics-free water. Thereafter, the effect of antibiotics in suppressing intestinal flora was confirmed by the culture of fresh feces in red blood agar plate (control non-treated mice, 1.6 ± 0.5 × Log109 CFU/g; antibiotics-treated mice, 7.0 ± 6.1 × Log107 CFU/g). Fig. 1A shows the amount of H2 in different organs. The amount of H2 detected in the caecum was highest, followed, in descending order, by small intestine, large intestine, liver, spleen and blood. A trace level of H2 was detected in the brain. The systemic treatment of mice with antibiotics (Sulfamethoxazole and Trimethoprim) significantly decreased the amount of H2 detected in all organs tested. The ex vivo culture of fresh fecal matter sampled from the mice treated with antibiotics also showed significantly lower H2 production than the sample collected from control non-treated mice (Fig. 1B). These data demonstrate the antibiotics-dependent change of H2, as measured in situ of mouse organs and by ex vivo feces culture, and indicate that H2 in intestinal ducts, as well as liver and spleen, is directly derived from resident bacteria.
To explore whether the presence of commensal bacteria, which produce H2 in intestinal ducts, affects the susceptibility of mice to ConA-induced liver injury, ConA (15 mg/kg) was injected i.v. to the mice which were pretreated with or without antibiotics (Experimental Protocol-A). Baseline levels of ALT and AST showed no difference between the mouse groups pretreated with or without antibiotics (Fig. 1C and D), indicating that antibiotics did not cause liver damage. The levels of ALT and AST in blood serum measured at 2 h were significantly elevated in mice receiving antibiotics, but did not differ from the control baseline level measured at 0 h (Fig. 1C and D). Histo-morphological analysis of liver also demonstrated that the level of tissue damage was worse in antibiotics-treated mice compared to control non-treated mice (see Supplementary Data 1), suggesting that antibiotics treatment increased the susceptibility of mice to ConA-induced hepatitis. In other words, without antibiotics, the presence of intestinal bacterial flora seems to give sufficient protection against the development of ConA-induced hepatitis.
If H2 produced by intestinal bacteria is responsible for the protection of liver from ConA-induced inflammation, then the exogenous supplement of antibiotics-treated mice with H2 should down-regulate the level of inflammatory responses to ConA challenge in the antibiotics-treated mice. To test this premise, the antibiotics-treated mice received water dissolved with H2 (p.o.) (Experimental Protocol-B). As expected, exogenously applied H2 by the oral route significantly suppressed the inflammatory ALT and AST biomarkers in antibiotics-treated mice measured at 6 h from ConA injection (Fig. 2B amd C). Importantly, the proinflammatory cytokines in serum, TNF-α and IFN-γ, which are produced by activated T cells, were also significantly down-regulated by application of H2 in antibiotics-treated mice (Fig. 2D and E).
In order to examine the effects of H2 derived from intestinal bacteria on ConA-induced liver injury, mice pretreated with antibiotics were reconstituted by two different strains of E. coli, i.e., (1) H2-producing E. coli strain W3110gfp+ or (2) H2-deficient E. coli strain PMD23gfp+; then, ConA was injected i.v. (Fig. 3A, Experimental Protocol-C; Fig. 3B, H2 production by W3110gfp+ and PMD23gfp+). The colonization of both strains of E. coli in the mice which received the drinking water with Ampicillin was confirmed by the recovery of GFP+ bacteria from the feces of mice as cultured on agar plate containing Ampicillin. An elevated amount of H2 was detected in the small and large intestines, caecum and liver of mice that were colonized with W3110gfp+, whereas mice colonized with the PMD23gfp+ retained a low level of H2 in those organs (see Supplementary Data 2; accessible online). Compared to the PMD23gfp+-harboring- or control-mice, the levels of ALT and AST in the sera collected at 6 h after ConA injection were significantly lower in the W3110 strain mice (Fig. 3C and D). The serum levels of TNF-α and IFN-γ were also significantly suppressed in the mice harboring the W3110gfp+ compared to the PMD23gfp+-harboring- or control-mice (Fig. 3E and F). Therefore, based on the results from Experimental Protocols-A, -B, and -C, H2 released from intestinal bacteria seems to play a role in the suppression of the inflammation induced in liver by ConA injection.
It is thought that TNF-α and IFN-γ released from activated T cells cause hepatic tissue damage in the ConA-induced hepatitis model [12], [13] and [14]. Therefore, to address whether H2 can affect TNF-α and IFN-γ production in ConA-stimulated T cells, spleen mononuclear lymphocytes (MNL) were stimulated in vitro with ConA in the presence or absence of H2. As shown in Fig. 4, the presence of H2 in the culture medium significantly suppressed the proliferation of MNL (Fig. 4A), as well as the production of TNF-α and IFN-γ (Fig. 4B and C, respectively), compared to the stimulation of MNL with ConA in the absence of H2. It is noteworthy that H2 alone neither affected the proliferation nor the production of IFN-γ by non-stimulated MNL. Consequently, this in vitro study strongly supported the premise that H2 can suppress ConA-mediated T cell activation which results in the tissue-destructive production of TNF-α and IFN-γ.




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Fig. 4. In vitro effects of H2 on the inflammatory responses by lymphocytes stimulated with ConA. Mononuclear lymphocytes isolated from C57BL/6 mouse spleen were pretreated with medium dissolved with H2 at concentrations of 175, 350 and 700 μM for 1 h in a 96-well plate. The cells were then reacted with or without ConA (1 μg/ml) for 24 h to measure the expressions of proinflammatory cytokines using ELISA or for 48 h to assess the proliferation by [3H] thymidine incorporation assay. Proliferation of lymphocytes (A) and production of TNF-α and IFN-γ in culture supernatant (B and C) are shown in histograms. SI (Stimulation Index): ratio of cpm for stimulated cells to the cpm for unstimulated cells. Columns and bars indicate mean ± SD of respective values of three different cultures. *p < 0.05, **p < 0.01: values differ significantly (t-test).



Discussion

Accumulated lines of evidence have suggested that intestinal resident bacteria possess a host protective function in the context of their commensal host relationship [19] and [20]. However, the underlying mechanism supporting such bacteria-mediated host protective function has been unclear. Some studies revealed that the intestinal blood system of germ-free mice is poorly vasculated compared to that of conventional mice, suggesting that intestinal commensal bacteria can affect the host development of homeostatic angiogenesis [21]. Since, however, H2 produced from intestinal resident bacteria was shown to elicit an anti-inflammatory effect on Concanavalin A-induced hepatitis in mice, the present study demonstrated a novel anti-inflammatory mechanism mediated by intestinally colonized bacteria. If H2 released from intestinal bacteria does play a role in the suppression of inflammation induced in liver by ConA injection, as demonstrated in our Protocols-A, -B, and -C, then it is plausible that that the micro-capillary network promoted by commensal bacteria facilitates the transportation of H2 through the blood stream.
It is noteworthy that the anti-inflammatory effect of H2 administered orally was higher than that of H2 released from intestinal bacteria. The reverse is normally true since H2 is constantly released from bacteria present in intestinal digestive content (about 1 g/mouse), whereas total water consumption is about 2 ml/day/mouse, and all H2 from drinking water is immediately diffused from the stomach. Therefore, the relatively low anti-inflammatory potency of H2 released from intestinal bacteria in our study might be most plausibly attributed to the scavenging of H2 by other bacteria present deep inside the intestinal mucosa or in the stomach, such as Helicobacter hepaticus which is reported to consume significant amounts of H2 [6]. To prove this hypothesis, detailed profiling of bacteria that either produce or consume H2 in the oral gastrointestinal mucosa is required.
Although most previous studies examining the biological effects of H2 addressed the oxidative tissue injury caused by ischemia reperfusion of organs, such as liver and brain [1], [2], [3] and [4], it has been unclear if H2 can also affect the inflammation elicited by the activation of lymphocytes. Therefore, the novelty of this study derives from the finding that molecular hydrogen (H2) produced from commensal bacteria seemed to suppress the tissue-destructive production of proinflammatory cytokines, TNF-α and IFN-γ, from the ConA-stimulated lymphocytes. Moreover, ROS can activate TNF-α expression by up-regulation of the NF-kB signaling pathway [22], while, at the same time, it can activate NADPH–Oxygenase (NOX) expression that generates ROS from NADPH [23]. Thus, both inflammation and oxidation processes are reciprocally related. Such multiplicity of cross reactions between ROS and inflammation indicates that the H2-mediated suppression of TNF-α and IFN-γ from ConA-stimulated lymphocytes may also involve antioxidant effects by H2.
In summary, the present study indicates that H2 released from intestinally colonized bacteria can suppress inflammation induced in liver by Concanavalin A and that systemic antibiotics treatment may alter the number of host protective commensal bacterial flora in the intestines, ultimately resulting in a reduced concentration of H2 present in the liver. Since most mammalians lack the catabolic enzyme to generate H2, intestinal bacteria are the only possible source of protective H2 in the liver. In fact, one of the roles of commensal bacteria in host defense may be defined by the ability of resident flora to produce anti-inflammatory H2. Thus, exogenous factors, such as the introduction of antibiotics, may affect the functional amount of H2 and, consequently, the organism’s susceptibility to disease.

Acknowledgment

This study was supported by a research grant from Skyview Enterprises.

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Appendix A. Supplementary data




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Supplementary data. Histological evaluation of mouse livers. Livers sampled from; (A) a normal mouse that did not receive antibiotics, (B) antibiotics-treated mouse 10 h after Con A injection, and (E) control non-treated mouse 10 h after Con A injection, were sectioned and stained with hematoxylin–eosin (HE) (original magnification 200×).



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Supplementary data. Effects of reconstituted E. coli strains on the H2 concentration in different organs. Mice pretreated with antibiotics were reconstituted by two different strains of E. coli, i.e., (1) H2-producing E. coli strain W3110gfp+ or (2) H2-deficient E. coli strain PMD23gfp+ (Experimental Protocol-C). H2 concentrations in different organs were measured at Day-1 using a needle-type Hydrogen Sensor (n = 3/group). *p < 0.05: values differ significantly between the columns indicated by a bracket (t-test) .

1111Hydrogen from intestinal bacteria is protective for Concanavalin A-induced hepatitis

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