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Gul S, Durante-Mangoni E. Unraveling the Puzzle: Health Benefits of Probiotics-A Comprehensive Review. J Clin Med 2024; 13:1436. [PMID: 38592298 PMCID: PMC10935031 DOI: 10.3390/jcm13051436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 02/22/2024] [Accepted: 02/27/2024] [Indexed: 04/10/2024] Open
Abstract
A growing number of probiotic-containing products are on the market, and their use is increasing. Probiotics are thought to support the health of the gut microbiota, which in turn might prevent or delay the onset of gastrointestinal tract disorders. Obesity, type 2 diabetes, autism, osteoporosis, and some immunological illnesses are among the conditions that have been shown to possibly benefit from probiotics. In addition to their ability to favorably affect diseases, probiotics represent a defense system enhancing intestinal, nutritional, and oral health. Depending on the type of microbial strain utilized, probiotics can have variable beneficial properties. Although many microbial species are available, the most widely employed ones are lactic acid bacteria and bifidobacteria. The usefulness of these bacteria is dependent on both their origin and their capacity to promote health. Probiotics represent a valuable clinical tool supporting gastrointestinal health, immune system function, and metabolic balance. When used appropriately, probiotics may provide benefits such as a reduced risk of gastrointestinal disorders, enhanced immunity, and improved metabolic health. Most popular probiotics, their health advantages, and their mode of action are the topic of this narrative review article, aimed to provide the reader with a comprehensive reappraisal of this topic matter.
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Affiliation(s)
- Sabiha Gul
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Via de Crecchio 7, 80138 Napoli, Italy;
| | - Emanuele Durante-Mangoni
- Department of Precision Medicine, University of Campania “Luigi Vanvitelli”, Via de Crecchio 7, 80138 Napoli, Italy;
- Unit of Infectious & Transplant Medicine, A.O.R.N. Ospedali dei Colli—Ospedale Monaldi, Piazzale Ettore Ruggieri, 80131 Napoli, Italy
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Celano G, Calabrese FM, Riezzo G, D’Attoma B, Ignazzi A, Di Chito M, Sila A, De Nucci S, Rinaldi R, Linsalata M, Vacca M, Apa CA, Angelis MD, Giannelli G, De Pergola G, Russo F. Effects of a Very-Low-Calorie Ketogenic Diet on the Fecal and Urinary Volatilome in an Obese Patient Cohort: A Preliminary Investigation. Nutrients 2023; 15:3752. [PMID: 37686784 PMCID: PMC10490432 DOI: 10.3390/nu15173752] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Several recent studies deepened the strong connection between gut microbiota and obesity. The effectiveness of the very-low-calorie ketogenic diet (VLCKD) has been measured in terms of positive impact on the host homeostasis, but little is known of the modification exerted on the intestinal metabolome. To inspect this complex relationship, we analyzed both fecal and urinary metabolome in terms of volatile organic compounds (VOCs) by the GC-MS method in 25 obese patients that were under VLCKD for eight weeks. Partial least square discriminant analysis evidenced specific urinary and fecal metabolites whose profile can be considered a signature of a partial restore toward the host eubiosis. Specifically, among various keystone VOCs, the decreased concentration of four statistically significant fecal esters (i.e., propanoic acid pentyl ester, butanoic acid hexyl ester, butanoic acid pentyl ester, and pentanoic acid butyl ester) supports the positive effect of VLCKD treatment. Our pilot study results suggest a potential positive effect of VLCKD intervention affecting fecal and urinary volatilome profiles from obese patients. Meta-omics techniques including the study of genes and transcripts will help in developing new interventions useful in preventing or treating obesity and its associated health problems.
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Affiliation(s)
- Giuseppe Celano
- Department of Soil, Plant and Food Science, University of Bari Aldo Moro, 70126 Bari, Italy; (G.C.); (M.V.); (C.A.A.); (M.D.A.)
| | - Francesco Maria Calabrese
- Department of Soil, Plant and Food Science, University of Bari Aldo Moro, 70126 Bari, Italy; (G.C.); (M.V.); (C.A.A.); (M.D.A.)
| | - Giuseppe Riezzo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (B.D.); (A.I.); (M.L.)
| | - Benedetta D’Attoma
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (B.D.); (A.I.); (M.L.)
| | - Antonia Ignazzi
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (B.D.); (A.I.); (M.L.)
| | - Martina Di Chito
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (M.D.C.); (A.S.); (S.D.N.); (R.R.); (G.D.P.)
| | - Annamaria Sila
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (M.D.C.); (A.S.); (S.D.N.); (R.R.); (G.D.P.)
| | - Sara De Nucci
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (M.D.C.); (A.S.); (S.D.N.); (R.R.); (G.D.P.)
| | - Roberta Rinaldi
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (M.D.C.); (A.S.); (S.D.N.); (R.R.); (G.D.P.)
| | - Michele Linsalata
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (B.D.); (A.I.); (M.L.)
| | - Mirco Vacca
- Department of Soil, Plant and Food Science, University of Bari Aldo Moro, 70126 Bari, Italy; (G.C.); (M.V.); (C.A.A.); (M.D.A.)
| | - Carmen Aurora Apa
- Department of Soil, Plant and Food Science, University of Bari Aldo Moro, 70126 Bari, Italy; (G.C.); (M.V.); (C.A.A.); (M.D.A.)
| | - Maria De Angelis
- Department of Soil, Plant and Food Science, University of Bari Aldo Moro, 70126 Bari, Italy; (G.C.); (M.V.); (C.A.A.); (M.D.A.)
| | - Gianluigi Giannelli
- Scientific Direction, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy;
| | - Giovanni De Pergola
- Center of Nutrition for the Research and the Care of Obesity and Metabolic Diseases, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (M.D.C.); (A.S.); (S.D.N.); (R.R.); (G.D.P.)
| | - Francesco Russo
- Functional Gastrointestinal Disorders Research Group, National Institute of Gastroenterology IRCCS “S. de Bellis”, 70013 Castellana Grotte, Italy; (G.R.); (B.D.); (A.I.); (M.L.)
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Liu HY, Lee CH, Hsu CN, Tain YL. Maternal High-Fat Diet Controls Offspring Kidney Health and Disease. Nutrients 2023; 15:2698. [PMID: 37375602 DOI: 10.3390/nu15122698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/04/2023] [Accepted: 06/08/2023] [Indexed: 06/29/2023] Open
Abstract
A balanced diet during gestation is critical for fetal development, and excessive intake of saturated fats during gestation and lactation is related to an increased risk of offspring kidney disease. Emerging evidence indicates that a maternal high-fat diet influences kidney health and disease of the offspring via so-called renal programming. This review summarizes preclinical research documenting the connection between a maternal high-fat diet during gestation and lactation and offspring kidney disease, as well as the molecular mechanisms behind renal programming, and early-life interventions to offset adverse programming processes. Animal models indicate that offspring kidney health can be improved via perinatal polyunsaturated fatty acid supplementation, gut microbiota changes, and modulation of nutrient-sensing signals. These findings reinforce the significance of a balanced maternal diet for the kidney health of offspring.
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Affiliation(s)
- Hsi-Yun Liu
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Chen-Hao Lee
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
| | - Chien-Ning Hsu
- Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
- School of Pharmacy, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - You-Lin Tain
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
- Institute for Translational Research in Biomedicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan
- College of Medicine, Chang Gung University, Taoyuan 333, Taiwan
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Köse S, Ahan RE, Köksaldı İÇ, Olgaç A, Kasapkara ÇS, Şeker UÖŞ. Multiplexed cell-based diagnostic devices for detection of renal biomarkers. Biosens Bioelectron 2023; 223:115035. [PMID: 36571991 DOI: 10.1016/j.bios.2022.115035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/10/2022] [Accepted: 12/21/2022] [Indexed: 12/25/2022]
Abstract
The number of synthetic biology-based solutions employed in the medical industry is growing every year. The whole cell biosensors being one of them, have been proven valuable tools for developing low-cost, portable, personalized medicine alternatives to conventional techniques. Based on this concept, we targeted one of the major health problems in the world, Chronic Kidney Disease (CKD). To do so, we developed two novel biosensors for the detection of two important renal biomarkers: urea and uric acid. Using advanced gene expression control strategies, we improved the operational range and the response profiles of each biosensor to meet clinical specifications. We further engineered these systems to enable multiplexed detection as well as an AND-logic gate operating system. Finally, we tested the applicability of these systems and optimized their working dynamics inside complex medium human blood serum. This study could help the efforts to transition from labor-intensive and expensive laboratory techniques to widely available, portable, low-cost diagnostic options.
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Affiliation(s)
- Sıla Köse
- UNAM-Institute of Materias Science and Nanotechnology, National Nanotechnology Research Center, Bilkent University, 06800, Ankara, Turkey
| | - Recep Erdem Ahan
- UNAM-Institute of Materias Science and Nanotechnology, National Nanotechnology Research Center, Bilkent University, 06800, Ankara, Turkey
| | - İlkay Çisil Köksaldı
- UNAM-Institute of Materias Science and Nanotechnology, National Nanotechnology Research Center, Bilkent University, 06800, Ankara, Turkey
| | - Asburçe Olgaç
- Dr Sami Ulus Children's Training and Research Hospital, Ankara, Turkey
| | - Çiğdem Seher Kasapkara
- Ankara Yildirim Beyazit University, Department of Internal Medicine, Children's Health and Disease Section, Ankara, Turkey
| | - Urartu Özgür Şafak Şeker
- UNAM-Institute of Materias Science and Nanotechnology, National Nanotechnology Research Center, Bilkent University, 06800, Ankara, Turkey.
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Probiotics-Supplemented Low-Protein Diet for Microbiota Modulation in Patients with Advanced Chronic Kidney Disease (ProLowCKD): Results from a Placebo-Controlled Randomized Trial. Nutrients 2022; 14:nu14081637. [PMID: 35458199 PMCID: PMC9025298 DOI: 10.3390/nu14081637] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 04/05/2022] [Accepted: 04/11/2022] [Indexed: 02/01/2023] Open
Abstract
The probiotics-supplemented low-protein diet in chronic kidney disease (ProLowCKD) was a single-centre, double-blind, placebo-controlled, randomised trial that was conducted to investigate whether the association between a low protein diet (LPD) and a new formulation of probiotics (Bifidobacterium longum and Lactobacillus reuteri) was effective at reducing traditional uremic, microbiota-derived, and proatherogenic toxins in sixty patients affected by advanced CKD. After 2 months of a LPD—a reduction in blood urea nitrogen (52 ± 17 vs. 46 ± 15 mg/dL, p = 0.003), total cholesterol (185 ± 41 vs. 171 ± 34 mg/dL, p = 0.001), and triglycerides (194 ± 148 vs. 161 ± 70 mg/dL, p = 0.03) was observed; 57 subjects were then randomized to receive probiotics or a placebo for the subsequent 3 months. A total of 27 patients in the placebo group showed increased serum values of total cholesterol (169 ± 36 vs. 185 ± 40 mg/dL, p = 0.01), LDL cholesterol (169 ± 36 vs. 185 ± 40 mg/dL, p = 0.02), lipoprotein-associated phospholipase A2 (155.4 ± 39.3 vs. 167.5 ± 51.4 nmol/mL/min, p = 0.006), and indoxyl-sulphate (30.1 ± 17.6 vs. 34.5 ± 20.2 μM, p = 0.026), while the 24 subjects in the probiotics group showed a trend in the reduction of microbiota toxins. A reduction of antihypertensive and diuretic medications was possible in the probiotics group. This study shows that associating probiotics to LPD may have an additional beneficial effect on the control and modulation of microbiota-derived and proatherogenic toxins in CKD patients.
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The Beneficial Effects of Probiotics via Autophagy: A Systematic Review. BIOMED RESEARCH INTERNATIONAL 2021; 2021:2931580. [PMID: 34901266 PMCID: PMC8664546 DOI: 10.1155/2021/2931580] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 01/11/2023]
Abstract
Probiotics are living microorganisms increasingly used to treat or modulate different diseases or disorders because of their benefits and also low adverse reaction, and their positive and protective effects on various cells and tissues have been reported. The mechanisms by which probiotics exert their beneficial effects in different cells and tissues were investigated, and autophagy is one of the main mechanisms to induce their positive effects. Autophagy is a conserved process that occurs in all eukaryotic cells and plays an essential role in homeostasis and cell survival by degrading damaged and dysfunctional intracellular organelles. On the other hand, the role of autophagy is diverse in different tissues and situations, and cell death derived from autophagy has been observed in some cells. This search was done in PubMed, WOS, and Scopus using the keywords probiotic, microbiota, and autophagy. The search strategy was focused on the in vitro and animal model studies, and the included filters were English language publications and full-text articles (by June 2020). Studies that investigated other underlying mechanisms except autophagy were excluded. Among more than 105 papers, 24 studies were considered eligible for more evaluation. The obtained results indicated that most studies were performed on intestinal cell lines or tissue compared with other types of cell lines and tissue. This review article discusses our current understanding of the probiotic effects through autophagy in different cell lines and tissues that would be a useful guide to daily and clinical usage of these living microorganisms, but despite promising results of this systematic review, further studies need to assess this issue. This systematic review has demonstrated that autophagy is an effective mechanism in inducing beneficial effects of probiotics in different tissues.
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Predictive and Preventive Mucosal Communications in Particulate Matter Exposure-Linked Renal Distress. J Pers Med 2021; 11:jpm11020118. [PMID: 33670188 PMCID: PMC7916923 DOI: 10.3390/jpm11020118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 02/04/2021] [Accepted: 02/08/2021] [Indexed: 12/25/2022] Open
Abstract
Despite research into the epidemiological link between exposure to particulate matter (PM) and renal disorder, there is limited information available on the etiological complexity and molecular mechanisms. Among the early responsive tissues to PM exposure, the mucosal barrier of the airway and alimentary tract may be a crucial source of pathologic mediators leading to inflammatory renal diseases, including chronic kidney disease (CKD). Given that harmful responses and products in mucosa exposed to PM may enter the circulation and cause adverse outcomes in the kidney, the aim of the present review was to address the impact of PM exposure on the mucosal barrier and the vicious feedback cycle in the mucosal environment. In addition to the PM-induced alteration of mucosal barrier integrity, the microbial community has a pivotal role in the xenobiotic metabolism and individual susceptibility to PM toxicity. The dysbiosis-induced deleterious metabolites of PM and nutrients are introduced systemically via a disrupted mucosal barrier, contributing to renal injuries and pathologic severity. In contrast, the progress of mucosa-associated renal disease is counteracted by endogenous protective responses in the mucosa. Along with direct elimination of the toxic mediators, modulators of the mucosal microbial community should provide a promising platform for mucosa-based personalized interventions against renal disorders caused by air pollution.
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Li H, Qiu F, Tian F, Shi X, Gao A, Song L, Liu J. Changes of miR-155 expression in serum of uremic patients before and after treatment and risk factors analysis. Exp Ther Med 2020; 20:3352-3360. [PMID: 32855708 DOI: 10.3892/etm.2020.9067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 05/20/2020] [Indexed: 02/06/2023] Open
Abstract
The aim of the present study was to investigate the changes of miR-155 expression in the serum of uremic patients before and after treatment and analyze the risk factors of efficacy. A total of 116 uremic patients admitted to the People's Hospital of Chengyang (Qingdao, China) were enrolled in the study as the uremia group, and were treated by hemodialysis combined with hemoperfusion, and 127 healthy subjects who underwent health examination during the same period were selected as the normal group. Reverse transcription quantitative PCR was used to detect the serum miR-155 levels of all the subjects in the two groups before treatment and those of uremia patients after treatment. The changes of clinically related indicators and inflammatory factors in uremic patients before and after treatment and their correlation with miR-155 were investigated. The risk factors affecting the efficacy of treatment were analyzed. Serum miR-155 levels in the uremia group were higher than those in the normal group (P<0.001); the miR-155 level in patients after treatment was significantly lower than that before treatment (P<0.001), and it was positively correlated with efficacy (r=0.6873, P<0.05). The serum miR-155 level in the invalid group was higher than that in the effective group, and the sensitivity and specificity of miR-155 for predicting the efficacy before treatment were 64.71 and 87.88%, respectively. After treatment, the sensitivity and specificity of miR-155 for evaluating the efficacy were 76.47 and 88.89%, respectively. Clinically related indicators and inflammatory factor levels in uremic patients decreased significantly after treatment, and the expression levels before and after treatment were significantly correlated with miR-155. Clinically related indicators, inflammatory factors and miR-155 were all risk factors affecting efficacy. The expression level of miR-155 in serum was significantly upregulated. Findings of this study suggest that monitoring miR-155 may reflect the efficacy and inflammatory state effectively.
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Affiliation(s)
- Hao Li
- Department of Nephrology, The People's Hospital of Chengyang, Qingdao, Shandong 266109, P.R. China
| | - Fangxin Qiu
- Department of Nephrology, The People's Hospital of Chengyang, Qingdao, Shandong 266109, P.R. China
| | - Fang Tian
- Department of Nephrology, The People's Hospital of Chengyang, Qingdao, Shandong 266109, P.R. China
| | - Xinzheng Shi
- Department of Nephrology, The People's Hospital of Chengyang, Qingdao, Shandong 266109, P.R. China
| | - Aiqin Gao
- Department of Nephrology, The People's Hospital of Chengyang, Qingdao, Shandong 266109, P.R. China
| | - Lei Song
- Intensive Care Unit, The People's Hospital of Chengyang, Qingdao, Shandong 266109, P.R. China
| | - Junliang Liu
- Intensive Care Unit, The People's Hospital of Chengyang, Qingdao, Shandong 266109, P.R. China
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Ahlawat S, Asha, Sharma KK. Gut-organ axis: a microbial outreach and networking. Lett Appl Microbiol 2020; 72:636-668. [PMID: 32472555 DOI: 10.1111/lam.13333] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 05/05/2020] [Accepted: 05/20/2020] [Indexed: 12/13/2022]
Abstract
Human gut microbiota (GM) includes a complex and dynamic population of microorganisms that are crucial for well-being and survival of the organism. It has been reported as diverse and relatively stable with shared core microbiota, including Bacteroidetes and Firmicutes as the major dominants. They are the key regulators of body homeostasis, involving both intestinal and extra-intestinal effects by influencing many physiological functions such as metabolism, maintenance of barrier homeostasis, inflammation and hematopoiesis. Any alteration in GM community structures not only trigger gut disorders but also influence other organs and cause associated diseases. In recent past, the GM has been defined as a 'vital organ' with its involvement with other organs; thus, establishing a link or a bi- or multidirectional communication axis between the organs via neural, endocrine, immune, humoral and metabolic pathways. Alterations in GM have been linked to several diseases known to humans; although the exact interaction mechanism between the gut and the organs is yet to be defined. In this review, the bidirectional relationship between the gut and the vital human organs was envisaged and discussed under several headings. Furthermore, several disease symptoms were also revisited to redefine the communication network between the gut microbes and the associated organs.
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Affiliation(s)
- S Ahlawat
- Laboratory of Enzymology and Recombinant DNA Technology, Department of Microbiology, Maharshi Dayanand University, Rohtak, Haryana, India
| | - Asha
- Laboratory of Enzymology and Recombinant DNA Technology, Department of Microbiology, Maharshi Dayanand University, Rohtak, Haryana, India
| | - K K Sharma
- Laboratory of Enzymology and Recombinant DNA Technology, Department of Microbiology, Maharshi Dayanand University, Rohtak, Haryana, India
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Roth-Stefanski CT, Dolenga C, Nakao LS, Pecoits-Filho R, de Moraes TP, Moreno-Amaral AN. Pilot Study of Probiotic Supplementation on Uremic Toxicity and Inflammatory Cytokines in Chronic Kidney Patients. CURRENT NUTRITION & FOOD SCIENCE 2020. [DOI: 10.2174/1573401315666190215111402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background:
Bacterial metabolism contributes to the generation of uremic toxins in patients
with chronic kidney disease (CKD). It has been investigated the use of probiotics in the reduction
of uremic toxins intestinal production.
Objective:
The aim of this pilot study was to evaluate the effect of probiotic supplementation on reducing
the production of uremic toxins and the inflammatory profile of CKD patients.
Methods:
We performed a randomized, blind, placebo-controlled, crossover study on patients with
CKD stages 3 and 4. The intervention was a probiotic formulation composed of Lactobacillus
acidophilus strains given orally three times a day for 3 months. Changes in uremic toxins
(p-Cresylsulfate and Indoxyl Sulfate) and serum inflammatory cytokines were the primary endpoints.
Results:
Of the 44 patients randomized, 25 completed the study (mean age 51 ± 9.34, 64% female,
mean eGFR 36 ± 14.26 mL/min/1.73m², mean BMI 28.5 ± 5.75 kg/m²). At 3 months, there were no
significant changes in any of the studied biomarkers including p-cresylsulfate (p = 0.57), Indoxyl sulfate
(p = 0.08) and interleukin-6 (p = 0.55).
Conclusion:
Lactobacillus acidophilus strains given as probiotic were not able to reduce serum levels
of uremic toxins and biomarkers of inflammation in CKD patients in stage 3 and 4.
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Affiliation(s)
- Cristina T. Roth-Stefanski
- Department of Postgraduate in Health Science (PPGCS), Medical School, Pontifical Catholic University of Parana, Rua Imaculada Conceicao, 1155, Curitiba, Brazil
| | - Carla Dolenga
- Basic Pathology Department, UFPR, Curitiba/PR, Brazil
| | - Lia S. Nakao
- Basic Pathology Department, UFPR, Curitiba/PR, Brazil
| | - Roberto Pecoits-Filho
- Department of Postgraduate in Health Science (PPGCS), Medical School, Pontifical Catholic University of Parana, Rua Imaculada Conceicao, 1155, Curitiba, Brazil
| | - Thyago P. de Moraes
- Department of Postgraduate in Health Science (PPGCS), Medical School, Pontifical Catholic University of Parana, Rua Imaculada Conceicao, 1155, Curitiba, Brazil
| | - Andrea N. Moreno-Amaral
- Department of Postgraduate in Health Science (PPGCS), Medical School, Pontifical Catholic University of Parana, Rua Imaculada Conceicao, 1155, Curitiba, Brazil
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The Effects of Low-Nickel Diet Combined with Oral Administration of Selected Probiotics on Patients with Systemic Nickel Allergy Syndrome (SNAS) and Gut Dysbiosis. Nutrients 2020; 12:nu12041040. [PMID: 32283870 PMCID: PMC7230804 DOI: 10.3390/nu12041040] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 12/15/2022] Open
Abstract
Background: Nickel (Ni) oral consumption may elicit systemic reactions in patients affected by systemic nickel allergy syndrome (SNAS), including gastrointestinal symptoms, which in turn are associated with gut dysbiosis. We evaluated the effects of a low-Ni diet alone or in combination with the oral consumption of appropriate probiotics on Ni-sensitivity and urinary dysbiosis markers in SNAS patients. Methods: n = 51 patients with SNAS and concomitant intestinal dysbiosis were enrolled in the study. According to the urinary indican/skatole levels, quantified through a colorimetric and a high-performance liquid chromatographic method, respectively, patients were assigned to a dysbiosis type/grade and followed a low-Ni diet for three months. Along with the diet, 22 patients also consumed probiotics based on the dysbiosis type. In particular, a Lactobacilli- or Bifidobacteria-containing formulation was administered to patients with fermentative or putrefactive dysbiosis, respectively, while a broad-spectrum probiotic formulation containing both Lactobacilli and Bifidobacteria was administered to patients with mixed dysbiosis. After three months, patients were invited to repeat the Ni-stimulation and the dysbiosis tests. Results: The fermentative dysbiosis group represented the largest group followed by the mixed dysbiosis group, while only two patients had putrefactive dysbiosis. Overall, at three months of treatment in general (diet alone with or without probiotics), the Ni-sensitivity and dysbiosis levels were strongly ameliorated. The association of a low-Ni diet with a specific probiotic oral supplementation was significantly more effective in decreasing dysbiosis levels or reaching eubiosis than with diet alone. Conclusion: Our results, while confirming the benefits of a low-Ni diet in SNAS patients, strongly support that appropriate adjuvant treatment with probiotics significantly helps to improve intestinal dysbiosis or restore a healthy microbiota.
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Rahbar Saadat Y, Niknafs B, Hosseiniyan Khatibi SM, Ardalan M, Majdi H, Bahmanpoor Z, Abediazar S, Zununi Vahed S. Gut microbiota; an overlooked effect of phosphate binders. Eur J Pharmacol 2019; 868:172892. [PMID: 31870830 DOI: 10.1016/j.ejphar.2019.172892] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 12/06/2019] [Accepted: 12/19/2019] [Indexed: 12/18/2022]
Abstract
Hyperphosphatemia is a mineral bone-disease that increases cardiovascular complications and all-cause mortality in chronic kidney disease (CKD) patients. Oral phosphate binders absorb the dietary phosphate to prevent its high plasma levels. Moreover, they can adsorb some uremic toxins and decrease inflammation. A few recent studies highlight an ignored effect of phosphate binders on gut microbiota. Phosphorous is a major nutrient for survival and reproduction of bacteria and its intestinal concentration may impact the activity and composition of the gut microbiota. CKD is a state of an altered gut microbiome and bacterial-derived uremic toxins stimulate cardiovascular disease and systemic inflammation. The identification of the impact of phosphate binders on gut opens a new era in nephrology and fill the existing gap in interpretation of beneficial effects of phosphate binders. This review aims to highlight the impact of oral phosphate binders on the gut microbiome in CKD.
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Affiliation(s)
- Yalda Rahbar Saadat
- Nutrition Research Center, Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahram Niknafs
- Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | | | - Hasan Majdi
- Department of Medical Nanotechnology, Faculty of Advanced Medical Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Zahra Bahmanpoor
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sima Abediazar
- Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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13
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Chen W, Wang Z, Ren Y, Zhang L, Sun L, Man Y, Zhou Z. Silencing of keratin 1 inactivates the Notch signaling pathway to inhibit renal interstitial fibrosis and glomerular sclerosis in uremia. J Cell Physiol 2019; 235:1674-1688. [DOI: 10.1002/jcp.29087] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Accepted: 06/06/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Wen Chen
- Department of Nephrology Linyi People's Hospital Linyi China
| | - Zhi‐Kui Wang
- Department of Nephrology Linyi People's Hospital Linyi China
| | - Yue‐Qin Ren
- Department of Nephrology Linyi People's Hospital Linyi China
| | - Lei Zhang
- Department of Nephrology Linyi People's Hospital Linyi China
| | - Li‐Na Sun
- Department of Nephrology Linyi People's Hospital Linyi China
| | - Yu‐Lin Man
- Department of Nephrology Linyi People's Hospital Linyi China
| | - Zhong‐Qi Zhou
- Department of Nephrology Linyi People's Hospital Linyi China
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Vitetta L, Llewellyn H, Oldfield D. Gut Dysbiosis and the Intestinal Microbiome: Streptococcus thermophilus a Key Probiotic for Reducing Uremia. Microorganisms 2019; 7:microorganisms7080228. [PMID: 31370220 PMCID: PMC6723445 DOI: 10.3390/microorganisms7080228] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 07/27/2019] [Accepted: 07/29/2019] [Indexed: 12/15/2022] Open
Abstract
In the intestines, probiotics can produce antagonistic effects such as antibiotic–like compounds, bactericidal proteins such as bacteriocins, and encourage the production of metabolic end products that may assist in preventing infections from various pathobionts (capable of pathogenic activity) microbes. Metabolites produced by intestinal bacteria and the adoptions of molecular methods to cross-examine and describe the human microbiome have refreshed interest in the discipline of nephology. As such, the adjunctive administration of probiotics for the treatment of chronic kidney disease (CKD) posits that certain probiotic bacteria can reduce the intestinal burden of uremic toxins. Uremic toxins eventuate from the over manifestation of glucotoxicity and lipotoxicity, increased activity of the hexosamine and polyol biochemical and synthetic pathways. The accumulation of advanced glycation end products that have been regularly associated with a dysbiotic colonic microbiome drives the overproduction of uremic toxins in the colon and the consequent local pro-inflammatory processes. Intestinal dysbiosis associated with significant shifts in abundance and diversity of intestinal bacteria with a resultant and maintained uremia promoting an uncontrolled mucosal pro-inflammatory state. In this narrative review we further address the efficacy of probiotics and highlighted in part the probiotic bacterium Streptococcus thermophilus as an important modulator of uremic toxins in the gut of patients diagnosed with chronic kidney disease. In conjunction with prudent nutritional practices it may be possible to prevent the progression of CKD and significantly downregulate mucosal pro-inflammatory activity with the administration of probiotics that contain S. thermophilus.
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Affiliation(s)
- Luis Vitetta
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney NSW 2006, Australia.
- Medlab Clinical, Sydney NSW 2015, Australia.
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15
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Wang XF, Zhang BH, Lu XQ, Wang RQ. DLX5 gene regulates the Notch signaling pathway to promote glomerulosclerosis and interstitial fibrosis in uremic rats. J Cell Physiol 2019; 234:21825-21837. [PMID: 31297803 DOI: 10.1002/jcp.28032] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Accepted: 11/30/2018] [Indexed: 01/31/2023]
Abstract
Uremia largely results from the accumulation of organic waste products normally cleared by the kidneys, which commonly accompanies kidney failure and chronic kidney disease. However, genetic investigations in a uremia remain largely unclear. This study aimed to determine the expression patterns of distal-less homeobox 5 (DLX5) in uremia rat model and further to study its effects on glomerulosclerosis and interstitial fibrosis. Uremic expression chip was applied to screen differentially expressed genes in uremia. Next, we used small interfering RNA-mediated RNA interference to specifically silence DLX5 in experimental uremic rats to understand the regulatory mechanism of DLX5. To understand effect of Notch1 signaling pathway in uremia, we also treated experimental uremic rats with γ-secretase inhibitor (GSI), an inhibitor of Notch1 signaling pathway. The expression of fibronectin (FN), laminin (LN), transforming growth factor-β1 (TGF-β1), Hes1, Hes5, and Jagged2 was determined. The semiquantitative assessment was applied to verify the effects of DLX5 on glomerulosclerosis. In the uremic expression chip, we found that DLX5 was upregulated in uremia samples, and considered to regulate the Notch signaling pathway. We found that small interfering RNA-mediated DLX5 inhibition or Notch1 signaling pathway inhibitory treatment relieved and delayed the kidney injury and glomerulosclerosis in uremia. Meanwhile, inhibition of DLX5 or Nothch1 signaling pathway reduced expression of FN, LN, Nothch1, TGF-β1, Hes1, Hes5, and Jagged2. Intriguingly, we discovered that Notch1 signaling pathway was inhibited after silencing DLX5. In conclusion, these findings highlight that DLX5 regulates Notch signaling, which may, in turn, promote complications of uremia such as kidney fibrosis, providing a novel therapeutic target for treating uremia.
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Affiliation(s)
- Xin-Fang Wang
- Department of Blood Purification, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Bei-Hao Zhang
- Department of Blood Purification, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Xiao-Qing Lu
- Department of Blood Purification, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
| | - Rui-Qiang Wang
- Department of Nephrology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People's Republic of China
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Bryniarski MA, Hamarneh F, Yacoub R. The role of chronic kidney disease-associated dysbiosis in cardiovascular disease. Exp Biol Med (Maywood) 2019; 244:514-525. [PMID: 30682892 PMCID: PMC6547008 DOI: 10.1177/1535370219826526] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
IMPACT STATEMENT Negative alterations, or dysbiosis, in the intestinal microbial community balance in response to chronic kidney disease is emerging as a substantial and important factor in inducing and exacerbating multiple comorbid conditions. Patients with renal insufficiency experience a substantial increase in cardiovascular risk, and recent evidence is shedding light on the close interaction between microbiome dysbiosis and increased cardiovascular events in this population. Previous association and recent causality studies utilizing experimental animal models have enriched our understanding and confirmed the impact of microbial community imbalance on cardiac health in both the general population and in patients with renal impairment.
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Affiliation(s)
- Mark A Bryniarski
- Department of Pharmaceutical Sciences, School of Pharmacy and Pharmaceutical Sciences, University at Buffalo, Buffalo, NY 14214, USA
| | - Fares Hamarneh
- University College Dublin School of Medicine and Medical Science, Dublin, Ireland
- Department of Internal Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
| | - Rabi Yacoub
- Department of Internal Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY 14203, USA
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Effects of Probiotics on Inflammation and Uremic Toxins Among Patients on Dialysis: A Systematic Review and Meta-Analysis. Dig Dis Sci 2019; 64:469-479. [PMID: 30099652 DOI: 10.1007/s10620-018-5243-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2018] [Accepted: 08/06/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND/OBJECTIVES We performed this systematic review and meta-analysis to evaluate effects of probiotics on inflammation, uremic toxins, and gastrointestinal (GI) symptoms in end-stage renal disease (ESRD) patients. METHODS A literature search was conducted utilizing MEDLINE, EMBASE, and Cochrane Database from inception through October 2017. We included studies that assessed assessing effects of probiotics on inflammatory markers, protein-bound uremic toxins (PBUTs), and GI symptoms in ESRD patients on dialysis. Effect estimates from the individual study were extracted and combined utilizing random effect, generic inverse variance method of DerSimonian and Laird. The protocol for this meta-analysis is registered with PROSPERO; No. CRD42017082137. RESULTS Seven clinical trials with 178 ESRD patients were enrolled. There was a significant reduction in serum C-reactive protein (CRP) from baseline to post-probiotic course (≥ 2 months after treatment) with standardized mean difference (SMD) of - 0.42 (95% CI - 0.68 to - 0.16, p = 0.002). When compared to control, patients who received probiotics also had a significant higher degree of reduction in CRP level with SMDs of - 0.37 (95% CI - 0.72 to 0.03, p = 0.04). However, there were no significant changes in serum TNF-alpha or albumin with SMDs of - 0.32 (95% CI - 0.92 to 0.28, p = 0.29) and 0.16 (95% CI - 0.20 to 0.53, p = 0.39), respectively. After probiotic course, there were also significant decrease in PBUTs and improvement in overall GI symptoms (reduction in GI symptom scores) with SMDs of - 0.61 (95% CI - 1.16 to - 0.07, p = 0.03) and - 1.04 (95% CI - 1.70 to - 0.38, p = 0.002), respectively. CONCLUSION Our study demonstrates potential beneficial effects of probiotics on inflammation, uremic toxins, and GI Symptoms in ESRD patients. Future large-scale clinical studies are required to assess its benefits on other important clinical outcomes including patient mortality.
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Yang H, Xiang Y, Robinson K, Wang J, Zhang G, Zhao J, Xiao Y. Gut Microbiota Is a Major Contributor to Adiposity in Pigs. Front Microbiol 2018; 9:3045. [PMID: 30619136 PMCID: PMC6296290 DOI: 10.3389/fmicb.2018.03045] [Citation(s) in RCA: 49] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2018] [Accepted: 11/26/2018] [Indexed: 12/19/2022] Open
Abstract
Different breeds of pigs vary greatly in their propensity for adiposity. Gut microbiota is known to play an important role in modulating host physiology including fat metabolism. However, the relative contribution of gut microbiota to lipogenic characteristics of pigs remains elusive. In this study, we transplanted fecal microbiota of adult Jinhua and Landrace pigs, two breeds of pigs with distinct lipogenic phenotypes, to antibiotic-treated mice. Our results indicated that, 4 weeks after fecal transplantation, the mice receiving Jinhua pigs' "obese" microbiota (JM) exhibited a different intestinal bacterial community structure from those receiving Landrace pigs' "lean" microbiota (LM). Notably, an elevated ratio of Firmicutes to Bacteroidetes and a significant diminishment of Akkermansia were observed in JM mice relative to LM mice. Importantly, mouse recipients resembled their respective porcine donors in many of the lipogenic characteristics. Similar to Jinhua pig donors, JM mice had elevated lipid and triglyceride levels and the lipoprotein lipase activity in the liver. Enhanced expression of multiple key lipogenic genes and reduced angiopoietin-like 4 (Angptl4) mRNA expression were also observed in JM mice, relative to those in LM mice. These results collectively suggested that gut microbiota of Jinhua pigs is more capable of enhancing lipogenesis than that of Landrace pigs. Transferability of the lipogenic phenotype across species further indicated that gut microbiota plays a major role in contributing to adiposity in pigs. Manipulation of intestinal microbiota will, therefore, have a profound impact on altering host metabolism and adipogenesis, with an important implication in the treatment of human overweight and obesity.
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Affiliation(s)
- Hua Yang
- Institute of Quality and Standards for Agro-Products, Zhejiang Academy of Agricultural Sciences, Hangzhou, China
| | - Yun Xiang
- Institute of Animal Husbandry and Veterinary Medicine, Jinhua Academy of Agricultural Sciences, Jinhua, China
| | - Kelsy Robinson
- Department of Animal and Food Sciences, Oklahoma State University, Stillwater, OK, United States
| | - Junjun Wang
- Beijing Advanced Innovation Center for Food Nutrition and Human Health and State Key Laboratory of Animal Nutrition, China Agricultural University, Beijing, China
| | - Guolong Zhang
- Department of Animal and Food Sciences, Oklahoma State University, Stillwater, OK, United States
| | - Jiangchao Zhao
- Department of Animal Science, Division of Agriculture, University of Arkansas, Fayetteville, AR, United States
| | - Yingping Xiao
- Institute of Quality and Standards for Agro-Products, Zhejiang Academy of Agricultural Sciences, Hangzhou, China
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Wu M, Cai X, Lin J, Zhang X, Scott EM, Li X. Association between fibre intake and indoxyl sulphate/P-cresyl sulphate in patients with chronic kidney disease: Meta-analysis and systematic review of experimental studies. Clin Nutr 2018; 38:2016-2022. [PMID: 30274900 DOI: 10.1016/j.clnu.2018.09.015] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 08/26/2018] [Accepted: 09/11/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND OBJECTIVE Indoxyl sulphate (IS) and p-cresyl sulphate (PCS), which are difficult to excrete adequately out of the body, are closely related to the progression of chronic kidney disease (CKD) and various deuteropathy. Better than peritoneal dialysis (PD) and haemodialysis (HD), dietary fibre has been considered to reduce IS and PCS levels. In view of the absence of formal recommendations on fibre intake in CKD nutritional guidelines, we conducted this meta-analysis to assess the effects of dietary fibre on IS and PCS for CKD patients. METHODS The effects were pooled and expressed in terms of weighted mean difference (WMD) with 95% confidence interval (95% CI). Q test and I2 statistics were used to assess the heterogeneity. RESULTS A total of 12 relevant estimates from 7 reports, including 203 CKD patients, showed that dietary fibre significantly reduced their PCS level (WMD = -16.160, 95% CI: -23.824, -8.495). CONCLUSIONS The meta-analysis produced a strong corroboration that dietary fibre intake does have a good therapeutic effect on patients with CKD. The conclusions need to be validated by randomised controlled experiments (RCT) with better design, larger samples, longer course of treatment and higher quality.
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Affiliation(s)
- Mengyin Wu
- Department of Epidemiology & Biostatistics, Zhejiang University, Hangzhou, China
| | - Xianlei Cai
- Department of Gastrointestinal Surgery, Ningbo Medical Center Lihuili Hospital, Ningbo, China
| | - Jingjing Lin
- Department of Epidemiology & Biostatistics, Zhejiang University, Hangzhou, China
| | - Xinhan Zhang
- Department of Epidemiology & Biostatistics, Zhejiang University, Hangzhou, China
| | - E Marian Scott
- Department of Mathematics and Statistics, University of Glasgow, Glasgow, UK.
| | - Xiuyang Li
- Department of Epidemiology & Biostatistics, Zhejiang University, Hangzhou, China.
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20
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Simeoni M, Citraro ML, Cerantonio A, Deodato F, Provenzano M, Cianfrone P, Capria M, Corrado S, Libri E, Comi A, Pujia A, Abenavoli L, Andreucci M, Cocchi M, Montalcini T, Fuiano G. An open-label, randomized, placebo-controlled study on the effectiveness of a novel probiotics administration protocol (ProbiotiCKD) in patients with mild renal insufficiency (stage 3a of CKD). Eur J Nutr 2018; 58:2145-2156. [PMID: 30076458 PMCID: PMC6647244 DOI: 10.1007/s00394-018-1785-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 07/17/2018] [Indexed: 12/16/2022]
Abstract
Purpose Gut dysbiosis has been described in advanced, but not in initial stages of CKD. Considering the relevant impact of gut dysbiosis on renal and cardiovascular risk, its diagnosis and treatment are clinically relevant. Methods We designed, open-label, placebo-controlled intervention study (ProbiotiCKD) to evaluate gut microbiota metabolism in a cohort of KDIGO CKD patients (n = 28) at baseline and after a randomly assigned treatment with probiotics or placebo. Gut microbiota status was evaluated on:. Results Basal mean fecal Lactobacillales and Bifidobacteria concentrations were abnormally low in both groups, while urinary indican and 3-MI levels were, indicating a mixed (fermentative and putrefactive) dysbiosis. After treatment, mean fecal Lactobacillales and Bifidobacteria concentrations were increased, only in the probiotics group (p < 0.001). Conversely, mean urinary indican and 3-MI levels only in the group treated with probiotics (p < 0.001). Compared to placebo group, significant improvements of C-reactive protein (p < 0.001), iron (p < 0.001), ferritin (p < 0.001), transferrin saturation (p < 0.001), β2-microglobulin (p < 0.001), serum iPTH and serum calcium were observed only in the probiotics group. Conclusions ProbiotiCKD is the first intervention study demonstrating that an intestinal mixed dysbiosis is present even in early CKD stage and can be effectively corrected by the novel mode of administration of high-quality probiotics with improvement of inflammatory indices, iron status and iPTH stabilization.
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Affiliation(s)
- Mariadelina Simeoni
- Nephrology Unit, Department of Surgical and Medical Science, 'Magna Graecia' University Hospital, Viale Europa, Germaneto Area, 88100, Catanzaro, CZ, Italy.
| | - Maria Lucia Citraro
- Nephrology Unit, Department of Surgical and Medical Science, 'Magna Graecia' University Hospital, Viale Europa, Germaneto Area, 88100, Catanzaro, CZ, Italy
| | - Annamaria Cerantonio
- Nephrology Unit, Department of Surgical and Medical Science, 'Magna Graecia' University Hospital, Viale Europa, Germaneto Area, 88100, Catanzaro, CZ, Italy
| | - Francesca Deodato
- Nephrology Unit, Department of Surgical and Medical Science, 'Magna Graecia' University Hospital, Viale Europa, Germaneto Area, 88100, Catanzaro, CZ, Italy
| | - Michele Provenzano
- Nephrology Unit, Department of Surgical and Medical Science, 'Magna Graecia' University Hospital, Viale Europa, Germaneto Area, 88100, Catanzaro, CZ, Italy
| | - Paola Cianfrone
- Nephrology Unit, Department of Surgical and Medical Science, 'Magna Graecia' University Hospital, Viale Europa, Germaneto Area, 88100, Catanzaro, CZ, Italy
| | - Maria Capria
- Nephrology Unit, Department of Surgical and Medical Science, 'Magna Graecia' University Hospital, Viale Europa, Germaneto Area, 88100, Catanzaro, CZ, Italy
| | - Silvia Corrado
- Nephrology Unit, Department of Surgical and Medical Science, 'Magna Graecia' University Hospital, Viale Europa, Germaneto Area, 88100, Catanzaro, CZ, Italy
| | - Emanuela Libri
- Nephrology Unit, Department of Surgical and Medical Science, 'Magna Graecia' University Hospital, Viale Europa, Germaneto Area, 88100, Catanzaro, CZ, Italy
| | - Alessandro Comi
- Nephrology Unit, Department of Surgical and Medical Science, 'Magna Graecia' University Hospital, Viale Europa, Germaneto Area, 88100, Catanzaro, CZ, Italy
| | - Arturo Pujia
- Clinical Nutrition Unit, 'Magna Graecia' University Hospital, 88100, Catanzaro, CZ, Italy
| | - Ludovico Abenavoli
- Digestive Physiopathology Unit, 'Magna Graecia' University Hospital, 88100, Catanzaro, CZ, Italy
| | - Michele Andreucci
- Nephrology Unit, Department of Surgical and Medical Science, 'Magna Graecia' University Hospital, Viale Europa, Germaneto Area, 88100, Catanzaro, CZ, Italy
| | - Massimo Cocchi
- "Paolo Sotgiu" Institute for Research in Quantitative and Quantum Psychiatry and Cardiology, LUdeS, Lugano, Switzerland
| | - Tiziana Montalcini
- Clinical Nutrition Unit, 'Magna Graecia' University Hospital, 88100, Catanzaro, CZ, Italy
| | - Giorgio Fuiano
- Nephrology Unit, Department of Surgical and Medical Science, 'Magna Graecia' University Hospital, Viale Europa, Germaneto Area, 88100, Catanzaro, CZ, Italy
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Pei M, Wei L, Hu S, Yang B, Si J, Yang H, Zhai J. Probiotics, prebiotics and synbiotics for chronic kidney disease: protocol for a systematic review and meta-analysis. BMJ Open 2018; 8:e020863. [PMID: 30056379 PMCID: PMC6067341 DOI: 10.1136/bmjopen-2017-020863] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 05/07/2018] [Accepted: 06/08/2018] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION There is a growing interest in probiotic, prebiotic and synbiotic supplements for patients with chronic kidney disease (CKD). However, a systematic review and evaluation is lacking. The purpose of the present study is to assess the efficacy and safety of probiotics, prebiotics and synbiotics for non-dialysis or non-renal transplant patients with CKD. METHODS AND ANALYSIS An extensive literature search will be undertaken to identify potentially eligible studies from electronic databases including PubMed (1946 to present), EMBASE (1974 to present), Web of Science (1900 to present) and the Cochrane Central Register of Controlled Trials (CENTRAL, all years). No language restriction will be applied to the search. Both parallel and crossover randomised controlled trials will be included. The risk of bias of each included study will be assessed using the Cochrane Risk of Bias Tool. The primary outcome measures are uraemic toxins. Secondary outcomes include kidney function, adverse cardiovascular events, all-cause mortality, cause-specific death, progression to end-stage kidney disease, quality of life, gastrointestinal function and adverse events. Data will be synthesised using appropriate statistical methods. The quality of evidence for each outcome will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. ETHICS AND DISSEMINATION No ethical approval is required as no primary data will be collected. We will publish findings from this systematic review in a peer-reviewed scientific journal, and the data set will be made freely available. PROSPERO REGISTRATION NUMBER CRD42017079177.
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Affiliation(s)
- Ming Pei
- Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Lijuan Wei
- Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Shouci Hu
- Graduate College, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Bo Yang
- Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jinhua Si
- Library, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Hongtao Yang
- Department of Nephrology, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jingbo Zhai
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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Patra A, Mandal S, Samanta A, Chandra Mondal K, Nandi DK. Therapeutic potential of probiotic Lactobacillus plantarum AD3 on acetaminophen induced uremia in experimental rats. CLINICAL NUTRITION EXPERIMENTAL 2018. [DOI: 10.1016/j.yclnex.2018.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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23
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Krumbeck JA, Walter J, Hutkins RW. Synbiotics for Improved Human Health: Recent Developments, Challenges, and Opportunities. Annu Rev Food Sci Technol 2018; 9:451-479. [PMID: 29350558 DOI: 10.1146/annurev-food-030117-012757] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Research on combining pro- and prebiotics as synbiotics to enhance human and animal health has accelerated in the past 10 years, including many clinical trials that have assessed a diverse range of synbiotic formulations. In this review, we summarize these studies as well as the commercial applications of synbiotics that are available. In particular, we critically assess the claimed health benefits of synbiotic applications and the ecological and therapeutic factors to consider when designing synbiotics and discuss the implications of these concepts for future research in this field.
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Affiliation(s)
- Janina A Krumbeck
- School of Biological Sciences, University of Nebraska, Lincoln, Nebraska 68588, USA
| | - Jens Walter
- Department of Biological Sciences, University of Alberta, Edmonton, Alberta, Canada T6G 2R3.,Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada T6G 2P5
| | - Robert W Hutkins
- Department of Food Science and Technology, University of Nebraska, Lincoln, Nebraska 68588, USA;
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24
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Gut microbiota in cardiovascular disease and heart failure. Clin Sci (Lond) 2018; 132:85-91. [PMID: 29326279 DOI: 10.1042/cs20171090] [Citation(s) in RCA: 58] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2017] [Revised: 11/15/2017] [Accepted: 11/20/2017] [Indexed: 02/07/2023]
Abstract
Accumulating evidence supports a relationship between the complexity and diversity of the gut microbiota and host diseases. In addition to alterations in the gut microbial composition, the metabolic potential of gut microbiota has been identified as a contributing factor in the development of diseases. Recent technological developments of molecular and biochemical analyses enable us to detect and characterize the gut microbiota via assessment and classification of its genomes and corresponding metabolites. These advances have provided emerging data supporting the role of gut microbiota in various physiological activities including host metabolism, neurological development, energy homeostasis, and immune regulation. Although few human studies have looked into the causative associations and underlying pathophysiology of the gut microbiota and host disease, a growing body of preclinical and clinical evidence supports the theory that the gut microbiota and its metabolites have the potential to be a novel therapeutic and preventative target for cardiovascular and metabolic diseases. In this review, we highlight the interplay between the gut microbiota and its metabolites, and the development and progression of hypertension, heart failure, and chronic kidney disease.
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Stadlbauer V, Horvath A, Ribitsch W, Schmerböck B, Schilcher G, Lemesch S, Stiegler P, Rosenkranz AR, Fickert P, Leber B. Structural and functional differences in gut microbiome composition in patients undergoing haemodialysis or peritoneal dialysis. Sci Rep 2017; 7:15601. [PMID: 29142271 PMCID: PMC5688134 DOI: 10.1038/s41598-017-15650-9] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 10/31/2017] [Indexed: 01/28/2023] Open
Abstract
Complications of end-stage renal disease (ESRD) are critically related to inflammation. The gut microbiome is a key driver of inflammation. Since dialysis modalities may differently influence the gut microbiome, we aimed to compare the effects of haemodialysis (HD) and peritoneal dialysis (PD) on patients' gut microbiome composition and function. We therefore studied faecal microbiome composition and function as well as inflammation and gut permeability in 30 patients with ESRD (15 HD, 15 PD) and compared to 21 healthy controls. We found an increase in potentially pathogenic species and a decrease in beneficial species in patients on HD and to a lesser extend in patients on PD when compared to controls. These changes in taxonomic composition also resulted in differences in predicted metagenome functions of the faecal microbiome. In HD but not in PD, changes in microbiome composition were associated with an increase in c-reactive protein (CRP) but not with intestinal inflammation or gut permeability. In conclusion microbiome composition in ESRD differs from healthy controls but also between modes of dialysis. These differences are associated with systemic inflammation and cannot completely be explained by dialysis vintage. The mode of renal replacement therapy seems to be an important driver of dysbiosis in ESRD.
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Affiliation(s)
- Vanessa Stadlbauer
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
| | - Angela Horvath
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Division of Transplantation Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Werner Ribitsch
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Bianca Schmerböck
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Division of Transplantation Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
- Center of Biomarker Research in Medicine (CBmed), Graz, Austria
| | - Gernot Schilcher
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Intensive Care Unit, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Sandra Lemesch
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Philipp Stiegler
- Division of Transplantation Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
| | - Alexander R Rosenkranz
- Clinical Division of Nephrology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Peter Fickert
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Bettina Leber
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
- Division of Transplantation Surgery, Department of Surgery, Medical University of Graz, Graz, Austria
- Center of Biomarker Research in Medicine (CBmed), Graz, Austria
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27
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The impact of gut microbiota on kidney function and pathogenesis. Biomed Pharmacother 2017; 93:412-419. [DOI: 10.1016/j.biopha.2017.06.066] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Revised: 06/17/2017] [Accepted: 06/19/2017] [Indexed: 12/25/2022] Open
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Sun Z, Wang J, Weng M, Tang J, Wang J, Xu J, Lin L, Yuan H. Role of Small Interfering RNA Silencing Protein Kinase C‐α Gene on the Occurrence of Ultrafiltration Failure in Peritoneal Dialysis Rats. J Cell Biochem 2017; 118:4607-4616. [PMID: 28485503 DOI: 10.1002/jcb.26125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Accepted: 05/08/2017] [Indexed: 11/07/2022]
Affiliation(s)
- Zhi‐Wei Sun
- Department of Hepatobiliary SurgeryThe First People's Hospital of Yunnan ProvinceKunhua Hospital Affiliated to Kunming University of Science and TechnologyKunming650031P. R. China
| | - Jian Wang
- Department of NephrologyThe First People's Hospital of Yunnan ProvinceKunhua Hospital Affiliated to Kunming University of Science and TechnologyKunming650031P. R. China
| | - Min Weng
- Department of NutritionThe First Affiliated Hospital of Kunming Medical UniversityKunming650032P. R. China
| | - Jian‐Zhong Tang
- Department of Hepatobiliary SurgeryThe First People's Hospital of Yunnan ProvinceKunhua Hospital Affiliated to Kunming University of Science and TechnologyKunming650031P. R. China
| | - Jun‐Feng Wang
- Department of Hepatobiliary SurgeryThe First People's Hospital of Yunnan ProvinceKunhua Hospital Affiliated to Kunming University of Science and TechnologyKunming650031P. R. China
| | - Jian Xu
- Department of NephrologyThe First People's Hospital of Yunnan ProvinceKunhua Hospital Affiliated to Kunming University of Science and TechnologyKunming650031P. R. China
| | - Ling Lin
- Department of Geriatric CardiologyThe First Affiliated Hospital of Kunming Medical UniversityKunming650032P. R. China
| | - Hong‐Ling Yuan
- Department of NephrologyThe First Affiliated Hospital of Kunming Medical UniversityKunming650032P. R. China
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Zeng YQ, Dai Z, Lu F, Lu Z, Liu X, Chen C, Qu P, Li D, Hua Z, Qu Y, Zou C. Emodin via colonic irrigation modulates gut microbiota and reduces uremic toxins in rats with chronic kidney disease. Oncotarget 2017; 7:17468-78. [PMID: 27003359 PMCID: PMC4951226 DOI: 10.18632/oncotarget.8160] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 03/01/2016] [Indexed: 11/25/2022] Open
Abstract
Gut microbiota plays a dual role in chronic kidney disease (CKD) and is closely linked to production of uremic toxins. Strategies of reducing uremic toxins by targeting gut microbiota are emerging. It is known that Chinese medicine rhubarb enema can reduce uremic toxins and improve renal function. However, it remains unknown which ingredient or mechanism mediates its effect. Here we utilized a rat CKD model of 5/6 nephrectomy to evaluate the effect of emodin, a main ingredient of rhubarb, on gut microbiota and uremic toxins in CKD. Emodin was administered via colonic irrigation at 5ml (1mg/day) for four weeks. We found that emodin via colonic irrigation (ECI) altered levels of two important uremic toxins, urea and indoxyl sulfate (IS), and changed gut microbiota in rats with CKD. ECI remarkably reduced urea and IS and improved renal function. Pyrosequencing and Real-Time qPCR analyses revealed that ECI resumed the microbial balance from an abnormal status in CKD. We also demonstrated that ten genera were positively correlated with Urea while four genera exhibited the negative correlation. Moreover, three genera were positively correlated with IS. Therefore, emodin altered the gut microbiota structure. It reduced the number of harmful bacteria, such as Clostridium spp. that is positively correlated with both urea and IS, but augmented the number of beneficial bacteria, including Lactobacillus spp. that is negatively correlated with urea. Thus, changes in gut microbiota induced by emodin via colonic irrigation are closely associated with reduction in uremic toxins and mitigation of renal injury.
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Affiliation(s)
- Yu-Qun Zeng
- Department of Nephrology, The Second Clinical College, Guangzhou University of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong, P.R. China
| | - Zhenhua Dai
- Section of Immunology, The Second Clinical College, Guangzhou University of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong, P.R. China
| | - Fuhua Lu
- Department of Nephrology, The Second Clinical College, Guangzhou University of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong, P.R. China
| | - Zhaoyu Lu
- Department of Nephrology, The Second Clinical College, Guangzhou University of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong, P.R. China
| | - Xusheng Liu
- Department of Nephrology, The Second Clinical College, Guangzhou University of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong, P.R. China
| | - Cha Chen
- Department of Laboratory Medicine, The Second Clinical College, Guangzhou University of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong, P.R. China
| | - Pinghua Qu
- Department of Laboratory Medicine, The Second Clinical College, Guangzhou University of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong, P.R. China
| | - Dingcheng Li
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, United States of America
| | - Zhengshuang Hua
- State Key Laboratory of Biocontrol, Key Laboratory of Biodiversity Dynamics and Conservation of Guangdong Higher Education Institutes, College of Ecology and Evolution, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Yanni Qu
- State Key Laboratory of Biocontrol, Key Laboratory of Biodiversity Dynamics and Conservation of Guangdong Higher Education Institutes, College of Ecology and Evolution, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Chuan Zou
- Department of Nephrology, The Second Clinical College, Guangzhou University of Chinese Medicine and Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, Guangdong, P.R. China
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Abstract
Recent years have brought interesting insights into the human gut microbiota and have highlighted its increasingly recognized impact on cardiovascular (CV) diseases, including heart failure (HF). Changes in composition of gut microbiota, called dysbiosis, can trigger systemic inflammation, which is known to be involved in the pathophysiology of HF. Trimethylamine N-oxide (TMAO), which is derived from gut microbiota metabolites of specific dietary nutrients, has emerged as a key contributor to cardiovascular disease pathogenesis. Elevated TMAO levels have been reported to be associated with poor outcomes in patients with both HF and chronic kidney disease (CKD). Dysbiosis of gut microbiota can contribute to higher levels of TMAO and the generation of uremic toxins, progressing to both HF and CKD. Therefore, this bidirectional relationship between HF and CKD through gut microbiota may be a novel therapeutic target for the cardiorenal syndrome. However, the mechanisms by which gut microbiota could influence the development of heart failure are still unknown, and there are still some questions regarding the causative effects of TMAO and the underlying mechanistic link that explains how TMAO might directly or indirectly promote CV diseases including HF. Further studies are warranted to clarify the function of TMAO on the pathophysiology of cardiorenal syndrome and the handling of TMAO levels by the kidneys.
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Shang W, Shen Y, Gao S, Feng G, Feng Y, Wang Z, Zhang X. Comparison of HLA-A, -B and -DRB1 Loci Polymorphism between Kidney Transplants of Uremia Patients and Healthy Individuals in Central China. PLoS One 2016; 11:e0165426. [PMID: 27780235 PMCID: PMC5079547 DOI: 10.1371/journal.pone.0165426] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 10/11/2016] [Indexed: 11/18/2022] Open
Abstract
Chronic kidney disease is becoming a global public health problem, which will usually cause uremia at the end stage of chronic kidney failure. So far, kidney transplant is the most effective and proper therapy for uremia, however, the short supply of matched donor kidney has been a persistent bottleneck for transplantation. HLA matching of HLA-A, -B and -DRB1 loci is very important for the allocation of kidney transplants. In this study, we investigated genotypes of HLA-A, -B and -DRB1 loci based on 1,464 uremia patients and 10,000 unrelated healthy individuals in Henan province of China, and compared the frequency distribution of these HLA alleles and corresponding haplotypes between patient and healthy groups. We detected 23 HLA-A, 49 HLA-B and 17 HLA-DRB1 alleles in total. The predominant alleles of HLA-A, -B and -DRB1 loci in patients are the same as those in healthy group. The seven most frequent alleles account for about 87%, 50%, and 77% at HLA-A, -B and -DRB1 loci, respectively. The haplotypes (combinations of HLA-A, -B, and -DRB1) with significantly different frequency between patients and controls mostly account for less than 1%. Overall, this suggests that HLA matching is not a potential difficulty for kidney transplant of uremia patients. However, three of the top seven frequent HLA-DRB1 alleles have a significantly different distribution in patients and controls, while only one alleles for HLA-B and zero for HLA-A loci. These HLA-DRB1 alleles may be closely associated with uremia. This study sheds new lights on the composition and difference of HLA genotypes in uremia patients and healthy populations in Central China that can serve as a guide to HLA matching for kidney transplants and a resource for HLA typing-related studies.
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Affiliation(s)
- Wenjun Shang
- The Department of Kidney Transplantation, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yuefeng Shen
- Shanghai Key Laboratory of Signaling and Disease Research, the School of Life Sciences and Technology, Tongji University, Shanghai, China
| | - Shilin Gao
- The Department of Kidney Transplantation, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Guiwen Feng
- The Department of Kidney Transplantation, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Yonghua Feng
- The Department of Kidney Transplantation, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
| | - Zhigang Wang
- The Department of Kidney Transplantation, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, China
- * E-mail: (ZW); (XZ)
| | - Xiaobai Zhang
- Shanghai Key Laboratory of Signaling and Disease Research, the School of Life Sciences and Technology, Tongji University, Shanghai, China
- * E-mail: (ZW); (XZ)
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32
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Khoury T, Tzukert K, Abel R, Abu Rmeileh A, Levi R, Ilan Y. The gut-kidney axis in chronic renal failure: A new potential target for therapy. Hemodial Int 2016; 21:323-334. [DOI: 10.1111/hdi.12486] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Revised: 08/06/2016] [Indexed: 12/26/2022]
Affiliation(s)
- Tawfik Khoury
- Department of Medicine, Gastroenterology and Liver Units; Jerusalem Israel
| | - Keren Tzukert
- Department of Nephrology; Hebrew University-Hadassah Medical Center; Jerusalem Israel
| | - Roy Abel
- Department of Nephrology; Hebrew University-Hadassah Medical Center; Jerusalem Israel
| | - Ayman Abu Rmeileh
- Department of Medicine, Gastroenterology and Liver Units; Jerusalem Israel
| | - Ronen Levi
- Department of Nephrology; Hebrew University-Hadassah Medical Center; Jerusalem Israel
| | - Yaron Ilan
- Department of Medicine, Gastroenterology and Liver Units; Jerusalem Israel
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33
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Wang F, Jiang YS, Liu F. The influence of mutant lactobacilli on serum creatinine and urea nitrogen concentrations and renal pathology in 5/6 nephrectomized rats. Ren Fail 2016; 38:1441-1447. [PMID: 27605310 DOI: 10.1080/0886022x.2016.1227617] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES To explore the capacity of mutant lactobacilli to remove creatinine (Cr) and urea nitrogen (UN) via the gastrointestinal tract and its effects on renal pathology in the 5/6 nephrectomized rat model of chronic renal failure. METHODS Sixty Sprague-Dawley rats were randomly divided into a Sham group, a Model group, a wide-type Lactobacilli group (L.B group), and a Mutant Lactobacilli group (Mut-L.B group). The rats in the Model, LB and Mut-L.B groups underwent 5/6 nephrectomy. Eight weeks after administration, 24-h urine, orbital blood and digestive secretions were collected to analyze Cr and UN levels. Pathological changes in nephridial tissues were observed by hematoxylin and eosin and Masson trichrome staining, and the expression of TGF-β1 and FN was detected by immunohistochemistry. RESULTS There were no significant differences in urinary Cr and UN levels among the Sham, L.B and Mut-L.B groups (p > .05), while serum and digestive Cr and UN levels were significantly decreased in the Mut-L.B group (p < .01). Furthermore, renal tubular injury and interstitial fibrosis were significantly reduced and TGF-β1 and FN expression was decreased (p < .05) in the Mut-L.B group. CONCLUSION Mutant lactobacilli decreased serum Cr and UN levels, reduced the expression of TGF-β1 and FN in renal tissues and alleviated renal interstitial injury and fibrosis in a rat model of chronic renal failure in a mechanism that may involve decomposition and not just excretion of small molecule toxins in the gastrointestinal tract.
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Affiliation(s)
- Fang Wang
- a Division of Nephrology , Ningbo Medical Center Lihuili Eastern Hospital, Taipei Medical University Ningbo Medical Center , Ningbo , PR China
| | - Yun-Sheng Jiang
- b Division of Nephrology , The Second Xiangya Hospital, Research Institute of Nephrology, Central South University , Changsha , PR China
| | - Fang Liu
- c Division of Health Management Center , Xiangya Hospital, Central South University , Changsha , PR China
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Tayebi-Khosroshahi H, Habibzadeh A, Niknafs B, Ghotaslou R, Yeganeh Sefidan F, Ghojazadeh M, Moghaddaszadeh M, Parkhide S. The effect of lactulose supplementation on fecal microflora of patients with chronic kidney disease; a randomized clinical trial. J Renal Inj Prev 2016; 5:162-7. [PMID: 27689115 PMCID: PMC5040005 DOI: 10.15171/jrip.2016.34] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 07/16/2016] [Indexed: 12/29/2022] Open
Abstract
Introduction: Lactulose is a prebiotic with bifidogenic and urea reduction effects. It can improve Bifidobacteria and Lactobacilli counts in healthy humans and it may possibly have similar effects in chronic kidney disease (CKD) patients.
Objectives: To investigate the effect of lactulose on fecal microflora of patients with CKD.
Patients and Methods: Thirty-two patients with stages 3 and 4 of CKD (43.8% male with mean age of 58.09±12.75 years) were randomly assigned to intervention (n=16) and control (n=16) groups. Patients in intervention group received 30 mm lactulose syrup three times a day for an 8-week period. Control group received placebo 30 mm three times a day. A fecal sample was obtained from all patients at the beginning and at the end of the study and Bifidobacteria and Lactobacilli was counted.
Results: Creatinine (Cr) significantly decreased in intervention group (3.90±1.43 to 3.60±1.44, P=0.003) and increased in control group (3.87±2.08 to 4.11±1.99, P=0.03). Although Bifidobacterial and Lactobacilli counts were similar before intervention, they were significantly higher at the end of the study in lactulose group (P=0.01 and P=0.04, respectively). Lactulose led to significant increase in fecal Bifidobacterial counts (3.61±0.54 to 4.90±0.96, P<0.001) and Lactobacilli counts (2.79±1.00 to 3.87±1.13, P<0.001), while the change in placebo group was not significant.
Conclusion: Lactulose administration will increase Bifidobacteria and Lactobacillus counts in patients with CKD.
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Affiliation(s)
| | - Afshin Habibzadeh
- Medical Education Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Bahram Niknafs
- Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Ghotaslou
- Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Morteza Ghojazadeh
- Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Sahar Parkhide
- Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Vitetta L. Lactobacillus acidophilus Restores Functionality in Uremic Macrophages: Plausible or Lacking Evidence? Dig Dis Sci 2016; 61:1417-9. [PMID: 26888768 DOI: 10.1007/s10620-016-4084-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- Luis Vitetta
- Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
- Medlab Clinical, Sydney, NSW, Australia.
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36
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Vasylyeva TL, Singh R. Gut Microbiome and Kidney Disease in Pediatrics: Does Connection Exist? Front Microbiol 2016; 7:235. [PMID: 26973613 PMCID: PMC4776082 DOI: 10.3389/fmicb.2016.00235] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2015] [Accepted: 02/15/2016] [Indexed: 01/01/2023] Open
Abstract
Child development is a unique and continuous process that is impacted by genetics and environmental factors. Gut microbiome changes with development and depends on the stage of gut maturation, nutrition, and overall health. In spite of emerging data and active study in adults, the gut-renal axis in pediatrics has not been well considered and investigated. This review will focus on the current knowledge of gut microbiota impacts on kidney disease with extrapolation to the pediatric population.
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Affiliation(s)
- Tetyana L. Vasylyeva
- Department of Pediatrics, Texas Tech University Health Sciences Center, AmarilloTX, USA
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37
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Vitetta L, Hall S, Coulson S. Metabolic Interactions in the Gastrointestinal Tract (GIT): Host, Commensal, Probiotics, and Bacteriophage Influences. Microorganisms 2015; 3:913-32. [PMID: 27682125 PMCID: PMC5023274 DOI: 10.3390/microorganisms3040913] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2015] [Revised: 11/25/2015] [Accepted: 12/07/2015] [Indexed: 12/25/2022] Open
Abstract
Life on this planet has been intricately associated with bacterial activity at all levels of evolution and bacteria represent the earliest form of autonomous existence. Plants such as those from the Leguminosae family that form root nodules while harboring nitrogen-fixing soil bacteria are a primordial example of symbiotic existence. Similarly, cooperative activities between bacteria and animals can also be observed in multiple domains, including the most inhospitable geographical regions of the planet such as Antarctica and the Lower Geyser Basin of Yellowstone National Park. In humans bacteria are often classified as either beneficial or pathogenic and in this regard we posit that this artificial nomenclature is overly simplistic and as such almost misinterprets the complex activities and inter-relationships that bacteria have with the environment as well as the human host and the plethora of biochemical activities that continue to be identified. We further suggest that in humans there are neither pathogenic nor beneficial bacteria, just bacteria embraced by those that tolerate the host and those that do not. The densest and most complex association exists in the human gastrointestinal tract, followed by the oral cavity, respiratory tract, and skin, where bacteria—pre- and post-birth—instruct the human cell in the fundamental language of molecular biology that normally leads to immunological tolerance over a lifetime. The overall effect of this complex output is the elaboration of a beneficial milieu, an environment that is of equal or greater importance than the bacterium in maintaining homeostasis.
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Affiliation(s)
- Luis Vitetta
- Medlab Clinical Ltd., Sydney 2015 Australia.
- Sydney Medical School, University of Sydney, Sydney 2006, Australia.
| | - Sean Hall
- Medlab Clinical Ltd., Sydney 2015 Australia.
| | - Samantha Coulson
- Medlab Clinical Ltd., Sydney 2015 Australia.
- Sydney Medical School, University of Sydney, Sydney 2006, Australia.
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Zheng K, Tan J, Zhu W, Wu W, Yang S, Cai J, Gao X, Wu Z, Wu C, He F. Expression levels of Notch1 and Delta-like 4 in peripheral lymphocytes and their relationship with T helper 17 (Th17) cells in renal transplant recipients. Transpl Immunol 2015; 33:13-9. [PMID: 26070613 DOI: 10.1016/j.trim.2015.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 05/27/2015] [Accepted: 05/27/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study aimed to investigate the role of the Notch1/Delta-like 4 signaling pathway and its relationship with T helper 17 (Th17) cells in the peripheral transplantation immune of renal transplant recipients. METHODS Fifty-two kidney transplant recipients in our hospital were selected and divided into the acute rejection group (AR), renal tubular necrosis (ATN) group, and stable renal function group, according to their postoperative recovery. Flow cytometry was used to detect the expression of Notch1 and Delta-like 4 in peripheral lymphocytes and the presence of Th17 cells in the kidney of transplant recipients. RESULTS The expression levels of Notch1 and Delta-like 4 and level of Th17 cells among the three groups before surgery and at postoperative day 1 showed no significant differences (P>0.05). At 3, 7, and 14d after surgery, these three factors in the AR group were significantly higher than in the stable renal function group (P<0.01) and ATN group (P<0.01), where the levels in the latter two groups were similar. Upon the occurrence of acute rejection, the Notch1 and Delta-like 4 expression and Th17 cell ratio were significantly increased (P<0.01) but gradually decreased after anti-rejection therapy. Notch1 and Delta-like 4 were significantly positively correlated with Th17 cells (r=0.893, P<0.01 and r=0.893, P<0.01, respectively). CONCLUSION The detection of Notch1 and Delta-like 4 expression in peripheral blood lymphocytes of renal transplant recipients can serve as a positive indicator for evaluating the diagnosis and treatment efficacy of the AR reaction.
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Affiliation(s)
- Kai Zheng
- Organ Transplant Institute, Fuzhou General Hospital, Fuzhou 350025, China.
| | - Jianming Tan
- Organ Transplant Institute, Fuzhou General Hospital, Fuzhou 350025, China
| | - Wenping Zhu
- Organ Transplant Institute, Fuzhou General Hospital, Fuzhou 350025, China
| | - Weizhen Wu
- Organ Transplant Institute, Fuzhou General Hospital, Fuzhou 350025, China
| | - Shunliang Yang
- Organ Transplant Institute, Fuzhou General Hospital, Fuzhou 350025, China
| | - Jinquan Cai
- Organ Transplant Institute, Fuzhou General Hospital, Fuzhou 350025, China
| | - Xia Gao
- Organ Transplant Institute, Fuzhou General Hospital, Fuzhou 350025, China
| | - Zhixian Wu
- Organ Transplant Institute, Fuzhou General Hospital, Fuzhou 350025, China
| | - Chenguang Wu
- Organ Transplant Institute, Fuzhou General Hospital, Fuzhou 350025, China
| | - Fuqiang He
- Organ Transplant Institute, Fuzhou General Hospital, Fuzhou 350025, China
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Kaysen GA, Johansen KL, Chertow GM, Dalrymple LS, Kornak J, Grimes B, Dwyer T, Chassy AW, Fiehn O. Associations of Trimethylamine N-Oxide With Nutritional and Inflammatory Biomarkers and Cardiovascular Outcomes in Patients New to Dialysis. J Ren Nutr 2015; 25:351-6. [PMID: 25802017 DOI: 10.1053/j.jrn.2015.02.006] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 02/04/2015] [Accepted: 02/12/2015] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES Trimethylamine N-oxide (TMAO) is a product of metabolism of phosphatidylcholine (lecithin) and carnitine by the intestinal microbiome. Elevated serum concentrations of TMAO have been linked to adverse cardiovascular outcomes in the general population. We examined correlates of serum TMAO and the relations among serum TMAO concentrations, all-cause mortality, and cardiovascular mortality and hospitalizations in a nationally derived cohort of patients new to hemodialysis (HD). METHODS We quantified serum TMAO by liquid chromatography and online tandem mass spectrometry and assessed nutritional and cardiovascular risk factors in 235 patients receiving HD and measured TMAO in pooled serum from healthy controls. We analyzed time to death and time to cardiovascular death or hospitalization using Cox proportional hazards regression. RESULTS Serum TMAO concentrations of patients undergoing HD (median, 43 μM/L; 25th-75th percentile, 28-67 μM/L) were elevated compared with those with normal or near-normal kidney function (1.41 ± 0.49 μM/L). TMAO was directly correlated with serum albumin (Spearman rank correlation, 0.24; 95% CI, 0.12-0.35; P <.001), prealbumin (Spearman rank correlation, 0.19; 95% CI, 0.07-0.31; P = .003), and creatinine (Spearman rank correlation, 0.21; 95% CI, 0.08-0.33; P = .002) and inversely correlated with log C-reactive protein (Spearman rank correlation, -0.18; 95% CI, -0.30 to -0.06; P = .005). Higher serum concentrations of TMAO were not significantly associated with time to death (Spearman rank correlation, 0.84; CI, 0.65-1.09; P = .19) or time to cardiovascular hospitalization or cardiovascular death (Spearman rank correlation, 0.88; CI, 0.57-1.35; P = .55). CONCLUSIONS Serum TMAO concentrations were markedly elevated and correlated directly with biochemical markers of nutritional status and inversely with markers of inflammation in patients receiving HD. There was no significant association between serum TMAO concentrations and all-cause mortality, cardiovascular death, or hospitalizations. In patients receiving dialysis-in contrast with the general population-adverse vascular effects of TMAO may be counterbalanced by associations with nutritional or inflammatory status.
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Affiliation(s)
- George A Kaysen
- Department of Medicine, University of California, Davis, Davis, California; Department of Biochemistry and Molecular Medicine, University of California, Davis, Davis California.
| | - Kirsten L Johansen
- San Francisco Department of Veterans Affairs Medical Center, San Francisco, California; Department of Medicine, University of California, San Francisco, San Francisco, California
| | - Glenn M Chertow
- Department of Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Lorien S Dalrymple
- Department of Medicine, University of California, Davis, Davis, California
| | - John Kornak
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Barbara Grimes
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California
| | - Tjien Dwyer
- Department of Medicine, University of California, Davis, Davis, California
| | - Alexander W Chassy
- Department of Molecular and Cellular Biology and Genome Center University of California, Davis, Davis California
| | - Oliver Fiehn
- Department of Molecular and Cellular Biology and Genome Center University of California, Davis, Davis California
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Andrade-Oliveira V, Amano MT, Correa-Costa M, Castoldi A, Felizardo RJF, de Almeida DC, Bassi EJ, Moraes-Vieira PM, Hiyane MI, Rodas ACD, Peron JPS, Aguiar CF, Reis MA, Ribeiro WR, Valduga CJ, Curi R, Vinolo MAR, Ferreira CM, Câmara NOS. Gut Bacteria Products Prevent AKI Induced by Ischemia-Reperfusion. J Am Soc Nephrol 2015; 26:1877-88. [PMID: 25589612 DOI: 10.1681/asn.2014030288] [Citation(s) in RCA: 333] [Impact Index Per Article: 37.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 10/02/2014] [Indexed: 02/06/2023] Open
Abstract
Short-chain fatty acids (SCFAs) are fermentation end products produced by the intestinal microbiota and have anti-inflammatory and histone deacetylase-inhibiting properties. Recently, a dual relationship between the intestine and kidneys has been unraveled. Therefore, we evaluated the role of SCFA in an AKI model in which the inflammatory process has a detrimental role. We observed that therapy with the three main SCFAs (acetate, propionate, and butyrate) improved renal dysfunction caused by injury. This protection was associated with low levels of local and systemic inflammation, oxidative cellular stress, cell infiltration/activation, and apoptosis. However, it was also associated with an increase in autophagy. Moreover, SCFAs inhibited histone deacetylase activity and modulated the expression levels of enzymes involved in chromatin modification. In vitro analyses showed that SCFAs modulated the inflammatory process, decreasing the maturation of dendritic cells and inhibiting the capacity of these cells to induce CD4(+) and CD8(+) T cell proliferation. Furthermore, SCFAs ameliorated the effects of hypoxia in kidney epithelial cells by improving mitochondrial biogenesis. Notably, mice treated with acetate-producing bacteria also had better outcomes after AKI. Thus, we demonstrate that SCFAs improve organ function and viability after an injury through modulation of the inflammatory process, most likely via epigenetic modification.
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Affiliation(s)
- Vinicius Andrade-Oliveira
- Laboratory of Transplantation Immunobiology, Department of Immunology, Institute of Biomedical Sciences IV, University of São Paulo, São Paulo, Brazil
| | - Mariane T Amano
- Laboratory of Transplantation Immunobiology, Department of Immunology, Institute of Biomedical Sciences IV, University of São Paulo, São Paulo, Brazil
| | - Matheus Correa-Costa
- Laboratory of Transplantation Immunobiology, Department of Immunology, Institute of Biomedical Sciences IV, University of São Paulo, São Paulo, Brazil
| | - Angela Castoldi
- Laboratory of Transplantation Immunobiology, Department of Immunology, Institute of Biomedical Sciences IV, University of São Paulo, São Paulo, Brazil
| | | | | | - Enio J Bassi
- Laboratory of Transplantation Immunobiology, Department of Immunology, Institute of Biomedical Sciences IV, University of São Paulo, São Paulo, Brazil
| | - Pedro M Moraes-Vieira
- Laboratory of Transplantation Immunobiology, Department of Immunology, Institute of Biomedical Sciences IV, University of São Paulo, São Paulo, Brazil
| | - Meire I Hiyane
- Laboratory of Transplantation Immunobiology, Department of Immunology, Institute of Biomedical Sciences IV, University of São Paulo, São Paulo, Brazil
| | - Andrea C D Rodas
- Laboratory of Transplantation Immunobiology, Department of Immunology, Institute of Biomedical Sciences IV, University of São Paulo, São Paulo, Brazil
| | - Jean P S Peron
- Neuroimmune Interactions Laboratory, Department of Immunology, Institute of Biomedical Sciences IV, University of São Paulo, São Paulo, Brazil
| | - Cristhiane F Aguiar
- Laboratory of Transplantation Immunobiology, Department of Immunology, Institute of Biomedical Sciences IV, University of São Paulo, São Paulo, Brazil
| | - Marlene A Reis
- Division of Pathology, Universidade Federal do Triângulo Mineiro, Uberaba, Brazil
| | - Willian R Ribeiro
- Department of Pharmacy and Biotechnology, Universidade Anhanguera de São Paulo UNIAN-SP, São Paulo, Brazil
| | - Claudete J Valduga
- Department of Pharmacy and Biotechnology, Universidade Anhanguera de São Paulo UNIAN-SP, São Paulo, Brazil
| | - Rui Curi
- Department of Physiology and Biophysics, Institute of Biomedical Sciences IV, University of São Paulo, São Paulo, Brazil; and
| | - Marco Aurelio Ramirez Vinolo
- Department of Genetics, Evolution and Bioagents, Institute of Biology, University of Campinas-UNICAMP, São Paulo, Brazil
| | - Caroline M Ferreira
- Department of Physiology and Biophysics, Institute of Biomedical Sciences IV, University of São Paulo, São Paulo, Brazil; and
| | - Niels Olsen Saraiva Câmara
- Laboratory of Transplantation Immunobiology, Department of Immunology, Institute of Biomedical Sciences IV, University of São Paulo, São Paulo, Brazil; Nephrology Division, Federal University of São Paulo, São Paulo, Brazil;
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Gastrointestinal Tract Commensal Bacteria and Probiotics: Influence on End-Organ Physiology. PROGRESS IN DRUG RESEARCH. FORTSCHRITTE DER ARZNEIMITTELFORSCHUNG. PROGRES DES RECHERCHES PHARMACEUTIQUES 2015; 70:1-33. [PMID: 26462363 DOI: 10.1007/978-3-0348-0927-6_1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Bacteria represent the earliest form of independent life on this planet. Bacterial development has included cooperative symbiosis with plants (e.g., Leguminosae family and nitrogen fixing bacteria in soil) and animals (e.g., the gut microbiome). It is generally agreed upon that the fusion of two prokaryotes evolutionarily gave rise to the eukaryotic cell in which mitochondria may be envisaged as a genetically functional mosaic, a relic from one of the prokaryotes. This is expressed by the appearance of mitochondria in eukaryotic cells (an alpha-proteobacteria input), a significant endosymbiotic evolutionary event. As such, the evolution of human life has been complexly connected to bacterial activities. Hence, microbial colonization of mammals has been a progressively driven process. The interactions between the human host and the microbiome inhabiting the gastrointestinal tract (GIT) for example, afford the human host the necessary cues for the development of regulated signals that in part are induced by reactive oxygen species (ROS). This regulated activity then promotes immunological tolerance and metabolic regulation and stability, which then helps establish control of local and extraintestinal end-organ (e.g., kidneys) physiology. Pharmacobiotics, the targeted administration of live probiotic cultures, is an advancing area of potential therapeutics, either directly or as adjuvants. Hence the continued scientific understanding of the human microbiome in health and disease may further lead to fine tuning the targeted delivery of probiotics for a therapeutic gain.
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Lisowska-Myjak B. Uremic toxins and their effects on multiple organ systems. Nephron Clin Pract 2014; 128:303-11. [PMID: 25531673 DOI: 10.1159/000369817] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Nearly all body organs and systems are affected by the toxicity of uremic compounds retained in the course of renal dysfunction. Knowledge about the origin, chemical structure and composition of the retained endogenous substances responsible for these symptoms is far from complete. Organic retention solutes present a great variety of properties which makes their accurate classification extremely difficult. Their potential toxicity remains to be elucidated with meticulous observation of clearly formulated rules guiding the process. Toxicity assessment is a complex process because not just one but several retained compounds may be simultaneously involved in the same biological and metabolic processes. The search for new uremic compounds and combining them into panels of substances involved in the same pathophysiological processes seems to offer a novel approach to identifying and explaining any so far unexplored specific effects of endogenous compounds on the body organs and systems.
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Affiliation(s)
- Barbara Lisowska-Myjak
- Department of Biochemistry and Clinical Chemistry, Medical University of Warsaw, Warsaw, Poland
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Xing SC, Meng DM, Chen Y, Jiang G, Liu XS, Li N, Yan YY, Li CG. Study on the diversity of Bacteroides and Clostridium in patients with primary gout. Cell Biochem Biophys 2014; 71:707-15. [PMID: 25344643 DOI: 10.1007/s12013-014-0253-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To analyze the diversity of both Bacteroides and Clostridium in patients with primary gout and the difference from that of normal individuals. And to investigate the relationship between the primary gout and the intestinal flora. Fecal samples of 90 cases with the primary gout and 94 cases normal comparison group were selected, together with the cases that match the filter criteria. The DNA is extracted from the feces. 16S rRNA specific primers of both Bacteroides and Clostridium were adopted for the PCR amplification. The molecular fingerprints of Bacteroides and Clostridium in both the primary gout group and the normal control group were obtained through DGGE and subjected for further analysis on both the diversity and the similarity. Compared with normal individuals, the number of bands and Shannon-Weaver (H') of Bacteroides in patients with primary gout was not reduced, but significantly decreased in Clostridium. Furthermore, the intra-group and inter-group similarity of both Bacteroides and Clostridium were lower. The primary gout has caused the structural change of both Bacteroides and Clostridium, inducing the low similarity, especially for Clostridium. It has statistic significance. The gut predominant flora may play an important role in the development of primary gout.
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Affiliation(s)
- Shi-Chao Xing
- The Affiliated Hospital of Qingdao University, Qingdao, 266003, Shandong, China,
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Vitetta L, Hall S, Linnane AW. Live probiotic cultures and the gastrointestinal tract: symbiotic preservation of tolerance whilst attenuating pathogenicity. Front Cell Infect Microbiol 2014; 4:143. [PMID: 25360420 PMCID: PMC4197767 DOI: 10.3389/fcimb.2014.00143] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2014] [Accepted: 09/22/2014] [Indexed: 01/12/2023] Open
Abstract
Bacteria comprise the earliest form of independent life on this planet. Bacterial development has included co-operative symbiosis with plants (e.g., Leguminosae family and nitrogen fixing bacteria in soil) and animals (e.g., the gut microbiome). A fusion event of two prokaryotes evolutionarily gave rise to the eukaryote cell in which mitochondria may be envisaged as a genetically functional mosaic, a relic from one of the prokaryote cells. The discovery of bacterial inhibitors such chloramphenicol and others has been exploited to highlight mitochondria as arising from a bacterial progenitor. As such the evolution of human life has been complexly connected to bacterial activity. This is embodied, by the appearance of mitochondria in eukaryotes (alphaproteobacteria contribution), a significant endosymbiotic evolutionary event. During the twentieth century there was an increasing dependency on anti-microbials as mainline therapy against bacterial infections. It is only comparatively recently that the essential roles played by the gastrointestinal tract (GIT) microbiome in animal health and development has been recognized as opposed to the GIT microbiome being a toxic collection of micro-organisms. It is now well-documented that the GIT microbiome is comprised of a complex cohort of commensal and potentially pathogenic bacteria. Microbial interactions in the GIT provide the necessary cues for the development of regulated signals [in part by reactive oxygen species (ROS)] that promote immunological tolerance, metabolic regulation and stability, and other factors, which may then help control local and extra-intestinal end organ (e.g., kidneys) physiology. Pharmacobiotics, the administration of live probiotic cultures is an exciting growth area of potential therapeutics, developing together with an increased scientific understanding of GIT microbiome symbiosis in health and disease. Hence probiotic bacteria may provide a therapeutic connect with the GIT microbiome that can rescue mitochondrial dysfunction by linking a biologically plausible cellular signaling program (ROS reliant) between the human host and its microbiome cohort for a continued co-operative symbiosis that maintains homeostasis favorable to both.
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Affiliation(s)
- Luis Vitetta
- Sydney Medical School, The University of Sydney Sydney, NSW, Australia ; Medlab Sydney, NSW, Australia
| | | | - Anthony W Linnane
- Sydney Medical School, The University of Sydney Sydney, NSW, Australia ; Medlab Sydney, NSW, Australia
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45
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The overarching influence of the gut microbiome on end-organ function: the role of live probiotic cultures. Pharmaceuticals (Basel) 2014; 7:954-89. [PMID: 25244509 PMCID: PMC4190499 DOI: 10.3390/ph7090954] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2014] [Revised: 09/09/2014] [Accepted: 09/10/2014] [Indexed: 12/13/2022] Open
Abstract
At the time of birth, humans experience an induced pro-inflammatory beneficial event. The mediators of this encouraged activity, is a fleet of bacteria that assault all mucosal surfaces as well as the skin. Thus initiating effects that eventually provide the infant with immune tissue maturation. These effects occur beneath an emergent immune system surveillance and antigenic tolerance capability radar. Over time, continuous and regulated interactions with environmental as well as commensal microbial, viral, and other antigens lead to an adapted and maintained symbiotic state of tolerance, especially in the gastrointestinal tract (GIT) the organ site of the largest microbial biomass. However, the perplexing and much debated surprise has been that all microbes need not be targeted for destruction. The advent of sophisticated genomic techniques has led to microbiome studies that have begun to clarify the critical and important biochemical activities that commensal bacteria provide to ensure continued GIT homeostasis. Until recently, the GIT and its associated micro-biometabolome was a neglected factor in chronic disease development and end organ function. A systematic underestimation has been to undervalue the contribution of a persistent GIT dysbiotic (a gut barrier associated abnormality) state. Dysbiosis provides a plausible clue as to the origin of systemic metabolic disorders encountered in clinical practice that may explain the epidemic of chronic diseases. Here we further build a hypothesis that posits the role that subtle adverse responses by the GIT microbiome may have in chronic diseases. Environmentally/nutritionally/and gut derived triggers can maintain microbiome perturbations that drive an abnormal overload of dysbiosis. Live probiotic cultures with specific metabolic properties may assist the GIT microbiota and reduce the local metabolic dysfunctions. As such the effect may translate to a useful clinical treatment approach for patients diagnosed with a metabolic disease for end organs such as the kidney and liver. A profile emerges that shows that bacteria are diverse, abundant, and ubiquitous and have significantly influenced the evolution of the eukaryotic cell.
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Guida B, Germanò R, Trio R, Russo D, Memoli B, Grumetto L, Barbato F, Cataldi M. Effect of short-term synbiotic treatment on plasma p-cresol levels in patients with chronic renal failure: a randomized clinical trial. Nutr Metab Cardiovasc Dis 2014; 24:1043-1049. [PMID: 24929795 DOI: 10.1016/j.numecd.2014.04.007] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Revised: 04/04/2014] [Accepted: 04/23/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIMS In patients with chronic kidney disease (CKD), alterations in gut microbiome are posited to be responsible for gastrointestinal symptoms and generation of p-cresol, a uremic toxin that has been associated with CKD progression and cardiovascular mortality. This pilot study investigated whether Probinul-neutro®, a synbiotic that normalizes intestinal microflora, may lower plasma p-cresol concentrations and reduce gastrointestinal symptoms in non-dialyzed CKD patients. METHODS AND RESULTS This was a double-blind, randomized placebo-controlled trial. Thirty patients on 3-4 CKD stages were randomized to receive either Probinul neutro® or placebo for 4 weeks. Total plasma p-cresol concentration was assessed at baseline, and 15 and 30 days after treatment start. At the same study times, ease and frequency of defecation, upper and lower abdominal pain, stool shape, borborygmi, and flatus were quantified by subjective assessment questionnaires. Compared to baseline total plasma p-cresol median concentrations on 15th and 30th day were significantly lower in patients receiving Probinul-neutro® (2.31 and 0.78 vs. 3.05 μg/ml, p < 0.05; n = 18); no changes of plasma p-cresol concentrations were recorded in placebo-treated patients. No significant changes in gastrointestinal symptoms were observed during the study both in Probinul-neutro®-treated and placebo-treated patients. CONCLUSION Probinul-neutro® lowered total plasma p-cresol concentrations but did not ameliorate gastrointestinal symptoms in non-dialyzed CKD patients. Because high plasma concentrations of p-cresol in early phases of CKD are predictive of progression to end-stage renal disease, the results of our study suggest that synbiotics deserve attention as possible tools to delay CKD progression towards end-stage renal disease (ESRD). CLINICALTRIALSGOV IDENTIFIER NCT02008331.
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Affiliation(s)
- B Guida
- Division of Physiology, Department of Clinical Medicine and Surgery, Federico II University of Naples, Italy.
| | - R Germanò
- Division of Physiology, Department of Clinical Medicine and Surgery, Federico II University of Naples, Italy
| | - R Trio
- Division of Physiology, Department of Clinical Medicine and Surgery, Federico II University of Naples, Italy
| | - D Russo
- Division of Nephrology, Department of Public Health, Federico II University of Naples, Italy
| | - B Memoli
- Division of Nephrology, Department of Public Health, Federico II University of Naples, Italy
| | - L Grumetto
- Department of Pharmaceutical and Toxicological Chemistry, Federico II University of Naples, Italy
| | - F Barbato
- Department of Pharmaceutical and Toxicological Chemistry, Federico II University of Naples, Italy
| | - M Cataldi
- Division of Pharmacology, Department of Neuroscience, Reproductive and Odontostomatologic Sciences, Federico II University of Naples, Italy
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Montemurno E, Cosola C, Dalfino G, Daidone G, De Angelis M, Gobbetti M, Gesualdo L. What Would You Like to Eat, Mr CKD Microbiota? A Mediterranean Diet, please! Kidney Blood Press Res 2014; 39:114-23. [DOI: 10.1159/000355785] [Citation(s) in RCA: 65] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2014] [Indexed: 01/04/2023] Open
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Randomized controlled trial of strain-specific probiotic formulation (Renadyl) in dialysis patients. BIOMED RESEARCH INTERNATIONAL 2014; 2014:568571. [PMID: 25147806 PMCID: PMC4132402 DOI: 10.1155/2014/568571] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2014] [Accepted: 06/30/2014] [Indexed: 01/26/2023]
Abstract
BACKGROUND Primary goal of this randomized, double-blind, placebo-controlled crossover study of Renadyl in end-stage renal disease patients was to assess the safety and efficacy of Renadyl measured through improvement in quality of life or reduction in levels of known uremic toxins. Secondary goal was to investigate the effects on several biomarkers of inflammation and oxidative stress. METHODS Two 2-month treatment periods separated by 2-month washout and crossover, with physical examinations, venous blood testing, and quality of life questionnaires completed at each visit. Data were analyzed with SAS V9.2. RESULTS 22 subjects (79%) completed the study. Observed trends were as follows (none reaching statistical significance): decline in WBC count (-0.51 × 10(9)/L, P = 0.057) and reductions in levels of C-reactive protein (-8.61 mg/L, P = 0.071) and total indoxyl glucuronide (-0.11 mg%, P = 0.058). No statistically significant changes were observed in other uremic toxin levels or measures of QOL. CONCLUSIONS Renadyl appeared to be safe to administer to ESRD patients on hemodialysis. Stability in QOL assessment is an encouraging result for a patient cohort in such advanced stage of kidney disease. Efficacy could not be confirmed definitively, primarily due to small sample size and low statistical power-further studies are warranted.
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Vitetta L, Linnane AW, Gobe GC. From the gastrointestinal tract (GIT) to the kidneys: live bacterial cultures (probiotics) mediating reductions of uremic toxin levels via free radical signaling. Toxins (Basel) 2013; 5:2042-57. [PMID: 24212182 PMCID: PMC3847713 DOI: 10.3390/toxins5112042] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2013] [Revised: 11/04/2013] [Accepted: 11/04/2013] [Indexed: 01/04/2023] Open
Abstract
A host of compounds are retained in the body of uremic patients, as a consequence of progressive renal failure. Hundreds of compounds have been reported to be retention solutes and many have been proven to have adverse biological activity, and recognized as uremic toxins. The major mechanistic overview considered to contribute to uremic toxin overload implicates glucotoxicity, lipotoxicity, hexosamine, increased polyol pathway activity and the accumulation of advanced glycation end-products (AGEs). Until recently, the gastrointestinal tract (GIT) and its associated micro-biometabolome was a neglected factor in chronic disease development. A systematic underestimation has been to undervalue the contribution of GIT dysbiosis (a gut barrier-associated abnormality) whereby low-level pro-inflammatory processes contribute to chronic kidney disease (CKD) development. Gut dysbiosis provides a plausible clue to the origin of systemic uremic toxin loads encountered in clinical practice and may explain the increasing occurrence of CKD. In this review, we further expand a hypothesis that posits that environmentally triggered and maintained microbiome perturbations drive GIT dysbiosis with resultant uremia. These subtle adaptation responses by the GIT microbiome can be significantly influenced by probiotics with specific metabolic properties, thereby reducing uremic toxins in the gut. The benefit translates to a useful clinical treatment approach for patients diagnosed with CKD. Furthermore, the role of reactive oxygen species (ROS) in different anatomical locales is highlighted as a positive process. Production of ROS in the GIT by the epithelial lining and the commensal microbe cohort is a regulated process, leading to the formation of hydrogen peroxide which acts as an essential second messenger required for normal cellular homeostasis and physiological function. Whilst this critical review has focused on end-stage CKD (type 5), our aim was to build a plausible hypothesis for the administration of probiotics with or without prebiotics for the early treatment of kidney disease. We postulate that targeting healthy ROS production in the gut with probiotics may be more beneficial than any systemic antioxidant therapy (that is proposed to nullify ROS) for the prevention of kidney disease progression. The study and understanding of health-promoting probiotic bacteria is in its infancy; it is complex and intellectually and experimentally challenging.
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Affiliation(s)
- Luis Vitetta
- The University of Queensland, School of Medicine, Brisbane, St Lucia QLD 4072, Australia
- Medlab, Sydney, New South Wales, Australia; E-Mail:
- Author to whom correspondence should be addressed; E-Mail:
| | - Anthony W. Linnane
- Medlab, Sydney, New South Wales, Australia; E-Mail:
- Monash University, Melbourne VIC 3800, Australia
| | - Glenda C. Gobe
- Centre for Kidney Disease Research, School of Medicine, Translational Research Institute at Princess Alexandra Hospital, The University of Queensland, Brisbane, St Lucia QLD 4072, Australia; E-Mail:
- Department of Nephrology, Princess Alexandra Hospital, Ipswich Road, Woolloongabba, Brisbane QLD 4102, Australia
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Vitetta L, Alford H. The Pharmacobiotic Potential of the Gastrointestinal Tract Micro-Biometabolome-Probiotic Connect: A Brief Commentary. Drug Dev Res 2013. [DOI: 10.1002/ddr.21091] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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