51
|
Cigarran Guldris S, González Parra E, Cases Amenós A. Gut microbiota in chronic kidney disease. Nefrologia 2016; 37:9-19. [PMID: 27553986 DOI: 10.1016/j.nefro.2016.05.008] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 04/25/2016] [Accepted: 05/10/2016] [Indexed: 02/06/2023] Open
Abstract
The intestinal microflora maintains a symbiotic relationship with the host under normal conditions, but its imbalance has recently been associated with several diseases. In chronic kidney disease (CKD), dysbiotic intestinal microflora has been reported with an increase in pathogenic flora compared to symbiotic flora. An enhanced permeability of the intestinal barrier, allowing the passage of endotoxins and other bacterial products to the blood, has also been shown in CKD. By fermenting undigested products that reach the colon, the intestinal microflora produce indoles, phenols and amines, among others, that are absorbed by the host, accumulate in CKD and have harmful effects on the body. These gut-derived uraemic toxins and the increased permeability of the intestinal barrier in CKD have been associated with increased inflammation and oxidative stress and have been involved in various CKD-related complications, including cardiovascular disease, anaemia, mineral metabolism disorders or the progression of CKD. The use of prebiotics, probiotics or synbiotics, among other approaches, could improve the dysbiosis and/or the increased permeability of the intestinal barrier in CKD. This article describes the situation of the intestinal microflora in CKD, the alteration of the intestinal barrier and its clinical consequences, the harmful effects of intestinal flora-derived uraemic toxins, and possible therapeutic options to improve this dysbiosis and reduce CKD-related complications.
Collapse
Affiliation(s)
| | - Emilio González Parra
- Servicio de Nefrología, Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Madrid, España
| | - Aleix Cases Amenós
- Servicio de Nefrología, Hospital Clinic, Universitat de Barcelona, Barcelona, España
| |
Collapse
|
52
|
Brigant B, Metzinger-Le Meuth V, Massy ZA, McKay N, Liabeuf S, Pelletier M, Sallée M, M'Baya-Moutoula E, Paul P, Drueke TB, Burtey S, Metzinger L. Serum microRNAs are altered in various stages of chronic kidney disease: a preliminary study. Clin Kidney J 2016. [PMID: 28643818 PMCID: PMC5469576 DOI: 10.1093/ckj/sfw060] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Background MicroRNAs (miRNAs) are innovative and informative blood-based biomarkers involved in numerous pathophysiological processes. In this study and based on our previous experimental data, we investigated miR-126, miR-143, miR-145, miR-155 and miR-223 as potential circulating biomarkers for the diagnosis and prognosis of patients with chronic kidney disease (CKD). The primary objective of this study was to assess the levels of miRNA expression at various stages of CKD. Methods RNA was extracted from serum, and RT-qPCR was performed for the five miRNAs and cel-miR-39 (internal control). Results Serum levels of miR-143, -145 and -223 were elevated in patients with CKD compared with healthy controls. They were further increased in chronic haemodialysis patients, but were below control levels in renal transplant recipients. In contrast, circulating levels of miR-126 and miR-155 levels, which were also elevated in CKD patients, were lower in the haemodialysis group and even lower in the transplant group. Four of the five miRNA species were correlated with estimated glomerular filtration rate, and three were correlated with circulating uraemic toxins. Conclusions This exploratory study suggests that specific miRNAs could be biomarkers for complications of CKD, justifying further studies to link changes of miRNA levels with outcomes in CKD patients.
Collapse
Affiliation(s)
- Benjamin Brigant
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1088, Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires (MP3C), CURS, Université Picardie Jules Verne, Amiens, France
| | - Valérie Metzinger-Le Meuth
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1088, Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires (MP3C), CURS, Université Picardie Jules Verne, Amiens, France.,University Paris 13, Sorbonne Paris Cité, UFR SMBH, Bobigny, France
| | - Ziad A Massy
- Division of Nephrology, Ambroise Paré Hospital, Paris Ile de France Ouest (UVSQ) University, Boulogne Billancourt, France.,INSERM U1018, Centre de recherche en épidémiologie et santé des populations, Equipe 5, Villejuif, France
| | - Nathalie McKay
- INSERM UMR_S 1076, Aix Marseille Université, INSERM UMR_S 1076, Marseille, France
| | - Sophie Liabeuf
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1088, Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires (MP3C), CURS, Université Picardie Jules Verne, Amiens, France
| | - Marion Pelletier
- INSERM UMR_S 1076, Aix Marseille Université, INSERM UMR_S 1076, Marseille, France
| | - Marion Sallée
- INSERM UMR_S 1076, Aix Marseille Université, INSERM UMR_S 1076, Marseille, France
| | - Eléonore M'Baya-Moutoula
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1088, Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires (MP3C), CURS, Université Picardie Jules Verne, Amiens, France
| | - Pascale Paul
- INSERM UMR_S 1076, Aix Marseille Université, INSERM UMR_S 1076, Marseille, France
| | - Tilman B Drueke
- INSERM U1018, Centre de recherche en épidémiologie et santé des populations, Equipe 5, Villejuif, France
| | - Stéphane Burtey
- INSERM UMR_S 1076, Aix Marseille Université, INSERM UMR_S 1076, Marseille, France
| | - Laurent Metzinger
- Institut National de la Santé et de la Recherche Médicale (INSERM) U1088, Mécanismes physiopathologiques et conséquences des calcifications cardiovasculaires (MP3C), CURS, Université Picardie Jules Verne, Amiens, France
| |
Collapse
|