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Ahmad Fadzuli NI, Lim SM, Neoh CF, Majeed ABA, Tan MP, Khor HM, Tan AH, Ramasamy K. Faecal intestinal permeability and intestinal inflammatory markers in older adults with age-related disorders: A systematic review and meta-analysis. Ageing Res Rev 2024; 101:102506. [PMID: 39306247 DOI: 10.1016/j.arr.2024.102506] [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: 05/28/2024] [Revised: 08/30/2024] [Accepted: 09/12/2024] [Indexed: 09/28/2024]
Abstract
This systematic review and meta-analysis appraised previous findings to uncover potential faecal intestinal permeability and intestinal inflammatory markers in older adults. A comprehensive literature search led to the identification of ten eligible studies with findings of potential faecal intestinal permeability (zonulin and alpha-1-antitrypsin) and intestinal inflammatory markers [calprotectin, lactoferrin and neutrophil gelatinase-associated lipocalin (NGAL)]. Most of the cases (n > 2) [Parkinson's disease (PD) and Alzheimer's disease (AD)] exhibited higher faecal alpha-1-antitrypsin, zonulin and calprotectin levels. The present meta-analysis confirmed significantly higher faecal alpha-1-antitrypsin in older persons with PD compared to non-PD [MD = 22.92 mg/dL; 95 % CI = 14.02-31.81, p < 0.00001; I2 = 0 % (p = 0.73)]. There was, however, no significant difference in faecal zonulin between PD and non-PD individuals [MD = 26.88 ng/mL; 95 % CI = -29.26-83.01, p = 0.35; I2 = 94 % (p < 0.0001)]. Meanwhile, faecal calprotectin was higher in older adults with GI symptoms, multiple system atrophy (MSA) or PD than the healthy controls [MD = 9.51 μg/g; 95 % CI = 0.07-18.95, p = 0.05; I2 = 84 % (p < 0.00001)]. Altogether, faecal calprotectin appears to be a potential intestinal inflammatory marker whereas previous findings on faecal alpha-1-antitrypsin as an intestinal permeability marker remain limited and require further validation.
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Affiliation(s)
- Nurul Izzati Ahmad Fadzuli
- Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Cawangan Selangor, Kampus Puncak Alam, Bandar Puncak Alam, Selangor Darul Ehsan 42300, Malaysia
| | - Siong Meng Lim
- Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Cawangan Selangor, Kampus Puncak Alam, Bandar Puncak Alam, Selangor Darul Ehsan 42300, Malaysia
| | - Chin Fen Neoh
- Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Cawangan Selangor, Kampus Puncak Alam, Bandar Puncak Alam, Selangor Darul Ehsan 42300, Malaysia
| | - Abu Bakar Abdul Majeed
- Brain Degeneration and Therapeutics Group, Faculty of Pharmacy, University Teknologi MARA (UiTM) Cawangan Selangor, Kampus Puncak Alam, Selangor Darul Ehsan, Selangor Darul Ehsan 42300, Malaysia
| | - Maw Pin Tan
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Hui Min Khor
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Ai Huey Tan
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Kalavathy Ramasamy
- Collaborative Drug Discovery Research (CDDR) Group, Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Cawangan Selangor, Kampus Puncak Alam, Bandar Puncak Alam, Selangor Darul Ehsan 42300, Malaysia.
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Głogowski T, Wojtaszek E, Malyszko J. Iron status and anemia control are related to peritoneal membrane properties in peritoneally dialyzed patients. Front Med (Lausanne) 2023; 10:1148094. [PMID: 37484854 PMCID: PMC10359623 DOI: 10.3389/fmed.2023.1148094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 06/19/2023] [Indexed: 07/25/2023] Open
Abstract
Background Characteristics of peritoneal membrane is unique and individually different in peritoneal dialysis patients. Relationship between specific nature of peritoneal transport, anemia and inflammation has not yet been extensively studied. We attempted to outline the complex interplay of several biomarkers of iron status and their association with peritoneal transport, degree of inflammation and residual renal function. Methods A total of 58 patients treated with peritoneal dialysis either CAPD or APD for at least 3 months were enrolled in this study. Full blood count, traditional markers of iron status (transferrin saturation-TSAT and ferritin), serum erythroferrone-ERFE, soluble transferrin receptor (sTfR), hepcidin, zonulin, growth differentiation factor -15 (GDF15), IL-16, hsCRP and hypoxia-inducible factor-α (HIF-1-α; in serum and dialysate) were measured using commercially available tests. We also performed Peritoneal Equilibrium Test and assessed GFR level. Results Hb levels above 10 g/dL was found in 74% of patients. Hb levels positively correlated with residual renal function and nutritional status. Adequate iron status was diagnosed in 69% of subjects, only in 9% of patients, criteria for absolute iron deficiency were met. Serum ERFE correlated inversely with hepcidin levels but was not associated with erythropoietin stimulating agent dose. Peritoneal transport had strong correlation with dialysate sTfR (p < 0.05), dialysate hepcidin (p < 0.05), dialysate GDF15 (p < 0.01) and dialysate zonulin (p < 0.001) levels, as well as serum IL6 (p = 0.03), serum hs-CRP (p = 0.04) and dialysate hs-CRP (p = 0.04). Conclusion Residual kidney function contributes considerably to better control of anemia. Various degree of inflammation is inherent to PD patients. Additionally, fast-average peritoneal transport is associated with greater degree of inflammation and higher concentration of markers of iron status, GDF15 and zonulin in dialysate. This finding may indicate more effective clearance of higher-range middle molecules in fast-average transporters. The role of ERFE as a marker of erythropoiesis in PD patients requires further investigation.
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Chen Z, Wu S, Zeng Y, Chen Z, Li X, Li J, He L, Chen M. FuZhengHuaYuJiangZhuTongLuoFang Prescription Modulates Gut Microbiota and Gut-Derived Metabolites in UUO Rats. Front Cell Infect Microbiol 2022; 12:837205. [PMID: 35669118 PMCID: PMC9165620 DOI: 10.3389/fcimb.2022.837205] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/14/2022] [Indexed: 12/14/2022] Open
Abstract
Background Alteration of intestinal flora and metabolites is closely related to chronic kidney disease (CKD) across early to advanced stages. FuZhengHuaYuJiangZhuTongLuoFang prescription (FZHY) is a Chinese herb that has been proven to effectively treat CKD, but the underlying mechanism is not clear. Methods Rats were subjected to intragastric treatment with FZHY 7, 14, and 21 days after unilateral ureteral obstruction (UUO) surgery, and kidney tissue, colon tissue, serum, and stool samples were collected. Results FZHY treatment effectively ameliorated UUO-induced renal function loss, renal injury and renal fibrosis, and colon tissue damage and fibrosis on day 7. The results of 16S flora analysis (day 7) showed that, compared with the UUO group, both the FZHY group and the sham group showed decreased levels of g_Monoglobus, g_Papillibacter, g_Eubacterium_nodatum, and g_Family_XIII_AD3011. Additionally, FZHY obviously induced the reduction of serum citrulline, glycoursodeoxycholic acid, 23-nordeoxycholic acid, 7-ketodeoxycholic acid, kahweol, lipoid B4, 4-(3,4-dihydro-2H-1,5-benzodioxepin-7-yl)-2-methyl-1,3-thiazole, taurolithocholic acid sodium salt, indoline-2-carboxylic acid, 5(S),15(S)-diHETE, and others and the increase of bilirubin, asparagine, and others, which were positively associated with the above four candidate bacteria. Moreover, FZHY increased the levels of ZO-1, occludin, and claudin-1 in the colonic mucosa and reduced the levels of CRP, TNF-α, IL-6, and IL-1 in the serum and LN, FN, Col-I, and Col-III in the tubulointerstitium of UUO rats on day 7. Conclusion Our study revealed that FZHY reduced kidney damage at the early stage of CKD by regulating the above four candidate bacteria biomarkers and gut-derived harmful metabolites, inhibiting the inflammation response and tubulointerstitial fibrosis, providing deep insight into CKD therapeutic strategy.
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Affiliation(s)
- Ziwei Chen
- Department of Nephrology, Affiliated Integrated Traditional Chinese Medicine (TCM) and Western Medicine Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu Integrated Traditional Chinese Medicine (TCM) and Western Medicine Hospital, Chengdu First People's Hospital, Chengdu, China
| | - Shaobo Wu
- Department of Nephrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Yu Zeng
- Department of Clinical Laboratory, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Zejun Chen
- Department of Nephrology, Affiliated Integrated Traditional Chinese Medicine (TCM) and Western Medicine Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu Integrated Traditional Chinese Medicine (TCM) and Western Medicine Hospital, Chengdu First People's Hospital, Chengdu, China
| | - Xueying Li
- Department of Nephrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Jing Li
- Department of Nephrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Long He
- Department of Nephrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ming Chen
- Department of Nephrology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
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Novak B, Lopes Hasuda A, Ghanbari M, Mayumi Maruo V, Bracarense APFRL, Neves M, Emsenhuber C, Wein S, Oswald IP, Pinton P, Schatzmayr D. Effects of Fusarium metabolites beauvericin and enniatins alone or in mixture with deoxynivalenol on weaning piglets. Food Chem Toxicol 2021; 158:112719. [PMID: 34843867 DOI: 10.1016/j.fct.2021.112719] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 11/22/2021] [Accepted: 11/25/2021] [Indexed: 01/16/2023]
Abstract
The impact of the Fusarium-derived metabolites beauvericin, enniatin B and B1 (EB) alone or in combination with deoxynivalenol (DON) was investigated in 28-29 days old weaning piglets over a time period of 14 days. The co-application of EB and DON (EB + DON) led to a significant decrease in the weight gain of the animals. Liver enzyme activities in plasma were significantly decreased at day 14 in piglets receiving the EB + DON-containing diet compared to piglets receiving the control diet. All mycotoxin-contaminated diets led to moderate to severe histological lesions in the jejunum, the liver and lymph nodes. Shotgun metagenomics revealed a significant effect of EB-application on the gut microbiota. Our results provide novel insights into the harmful impact of emerging mycotoxins alone or with DON on the performance, gut health and immunological parameters in pigs.
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Affiliation(s)
- Barbara Novak
- BIOMIN Research Center, Technopark 1, 3430, Tulln, Austria.
| | - Amanda Lopes Hasuda
- Laboratory of Animal Pathology, State University of Londrina, P.O. Box 10.011, Londrina, PR, 86057-970, Brazil; Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, 31027, Toulouse, France.
| | - Mahdi Ghanbari
- BIOMIN Research Center, Technopark 1, 3430, Tulln, Austria.
| | - Viviane Mayumi Maruo
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, 31027, Toulouse, France; Universidade Federal do Tocantins, Araguaína, 77824-838, Brazil.
| | - Ana Paula F R L Bracarense
- Laboratory of Animal Pathology, State University of Londrina, P.O. Box 10.011, Londrina, PR, 86057-970, Brazil.
| | - Manon Neves
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, 31027, Toulouse, France.
| | | | - Silvia Wein
- BIOMIN Research Center, Technopark 1, 3430, Tulln, Austria.
| | - Isabelle P Oswald
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, 31027, Toulouse, France.
| | - Philippe Pinton
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS, 31027, Toulouse, France.
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Zhao J, Ning X, Liu B, Dong R, Bai M, Sun S. Specific alterations in gut microbiota in patients with chronic kidney disease: an updated systematic review. Ren Fail 2021; 43:102-112. [PMID: 33406960 PMCID: PMC7808321 DOI: 10.1080/0886022x.2020.1864404] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Emerging evidence demonstrates that gut dysbiosis is implicated in the pathogenesis of chronic kidney disease (CKD) with underlying mechanisms involving mucosal and/or systematic immunity or metabolic disorders. However, the profile of gut microbiota in patients with CKD has not been completely explored. METHODS Databases from their date of inception to 31 March 2020 were systematically searched for case-control or cross-sectional studies comparing the gut microbial profiles in adult patients with CKD or end-stage renal disease (ESRD) with those in healthy controls. Quantitative analysis of alterations in gut microbial profiles was conducted. RESULTS Twenty-five studies with a total of 1436 CKD patients and 918 healthy controls were included. The present study supports the increased abundance of, phylum Proteobacteria and Fusobacteria, genus Escherichia_Shigella, Desulfovibrio, and Streptococcus, while lower abundance of genus Roseburia, Faecalibacterium, Pyramidobacter, Prevotellaceae_UCG-001, and Prevotella_9 in patients with CKD; and increased abundance of phylum Proteobacteria, and genus Streptococcus and Fusobacterium, while lower abundance of Prevotella, Coprococcus, Megamonas, and Faecalibacterium in patients with ESRD. Moreover, higher concentrations of trimethylamine-N-oxide and p-cresyl sulfate and lower concentrations of short-chain fatty acids were observed. Gut permeability in patients with CKD was not determined due to the heterogeneity of selected parameters. CONCLUSIONS Specific alterations of gut microbial parameters in patients with CKD were identified. However, a full picture of the gut microbiota could not be drawn from the data due to the differences in methodology, and qualitative and incomplete reporting of different studies.
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Affiliation(s)
- Jin Zhao
- Department of Nephrology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Xiaoxuan Ning
- Department of Geriatrics, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Baojian Liu
- Department of Nephrology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Ruijuan Dong
- Department of Nephrology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Ming Bai
- Department of Nephrology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
| | - Shiren Sun
- Department of Nephrology, Xijing Hospital, The Fourth Military Medical University, Xi'an, China
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Zapora-Kurel A, Kuźma Ł, Zakrzewska M, Żórawski M, Dobrzycki S, Twardowska-Kawalec M, Małyszko J. Novel Iron Parameters in Patients with Type 2 Diabetes Mellitus in Relation to Kidney Function. J Clin Med 2021; 10:jcm10163732. [PMID: 34442028 PMCID: PMC8397038 DOI: 10.3390/jcm10163732] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 08/12/2021] [Accepted: 08/20/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND/AIMS Anemia of chronic disease is a common feature in diabetes and chronic kidney disease. Hepcidin is the key element involved in iron metabolism; however, studies on new indices of iron status are still ongoing. The aim of the study was to assess novel iron parameters in patients with type 2 diabetes mellitus in relation to kidney function. METHODS The study included 80 type 2 diabetic patients and 23 healthy volunteers. Standard laboratory measurements were used to measure the iron status, complete blood count, creatinine, the estimated glomerular filtration rate (eGFR), serum lipids, and brain natriuretic peptides (BNPs). Commercially available kits were used to measure hepcidin-25, the soluble transferrin receptor (sTfR), growth differentiation factor-15 (GDF-15), and hypoxia-inducible factor-1 alpha. RESULTS Anemia was present in 65% of the studied patients. The control group was found to have significantly higher hepcidin, sTfR, and GDF-15, and lower hemoglobin and iron. When compared with patients with eGFR values ≥60 mL/min/1.73 m2 and <60 mL/min/1.73 m2, we found that patients with higher eGFR had higher hemoglobin, ferritin, and HIF-1 alpha, lower BNP, and were younger. We found that levels of HIF-1 alpha are negligible in the studied population and were related to age only in patients with eGFR values ≥60 mL/min/1.73 m2. CONCLUSION A comprehensive assessment of iron status is rarely performed. Novel biomarkers of iron metabolism are not generally related to kidney function. Whether the assessment of HIF-1 alpha would be a marker of efficient anemia therapy with HIF-prolyl hydroxylase inhibitors is still a matter for further study.
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Affiliation(s)
- Agnieszka Zapora-Kurel
- 2nd Department of Nephrology with Hypertension and Dialysis, Medical University of Bialystok, 15-089 Bialystok, Poland; (A.Z.-K.); (M.Z.)
| | - Łukasz Kuźma
- Department of Invasive Cardiology, Medical University of Bialystok, 15-089 Bialystok, Poland; (L.K.); (S.D.)
| | - Magdalena Zakrzewska
- 2nd Department of Nephrology with Hypertension and Dialysis, Medical University of Bialystok, 15-089 Bialystok, Poland; (A.Z.-K.); (M.Z.)
| | - Marcin Żórawski
- Department of Clinical Medicine, Medical University of Bialystok, 15-089 Bialystok, Poland;
| | - Sławomir Dobrzycki
- Department of Invasive Cardiology, Medical University of Bialystok, 15-089 Bialystok, Poland; (L.K.); (S.D.)
| | | | - Jolanta Małyszko
- Department of Nephrology, Dialysis and Internal Medicine, Medical University of Warsaw, 02-091 Warsaw, Poland;
- Correspondence: ; Tel.: +48-22-599-2660
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Carpes LS, Nicoletto BB, Canani LH, Rheinhemer J, Crispim D, Souza GC. Could serum zonulin be an intestinal permeability marker in diabetes kidney disease? PLoS One 2021; 16:e0253501. [PMID: 34170951 PMCID: PMC8232531 DOI: 10.1371/journal.pone.0253501] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Accepted: 06/06/2021] [Indexed: 12/31/2022] Open
Abstract
Zonulin is a protein associated with the tight junction complex opening at the intestinal epithelium, previously linked to obesity, cardiovascular diseases, type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD). However, its role in CKD has not been totally elucidated. This study aimed to evaluate zonulin levels in subjects with diabetic kidney disease (DKD). This case-control study included two cases groups: 1) Advanced DKD cases: T2DM patients with estimated glomerular filtration rate (eGFR) <60ml/min/1.73m2; 2) Albuminuric T2DM cases: diabetic patients with urinary albumin excretion (UAE) >30mg/g creatinine, but with eGFR>60ml/min/1.73m2. Two control groups were also included: 1) T2DM controls: patients with T2DM without impaired kidney function; 2) Non-T2DM controls: subjects without T2DM and normal renal function. Serum levels of zonulin were measured by ELISA. Eighty-six individuals were included. Zonulin levels was different among study groups (P = 0.003). T2DM controls presented higher zonulin levels than non-T2DM controls [(131.35 (83.0–170.5) vs. 87.25 (54.7–111.8), P = 0.018] and advanced DKD cases [63.72 (45.03–106.0); P = 0.007]. Zonulin showed a positive correlation with eGFR (r = 0.222; P = 0.040), total cholesterol (r = 0.299; P = 0.034), LDL (r = 0.258; P = 0.021), and negative with albuminuria (r = -0.243; P = 0.024) and body fat (r = -0.271; P = 0.014). In the multivariate logistic regression analyses, zonulin levels were independently associated to renal outcomes [OR 0.99 (0.98–0.99, P = 0.012)] after 5-year inclusion. In conclusion, increased zonulin levels in patients with TD2M without renal disease suggest an impaired intestinal permeability. Moreover, its association with renal outcomes could indicate its use as a disease monitoring marker. However, the mechanisms behind this association should be better understood.
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Affiliation(s)
- Larissa Salomoni Carpes
- Faculty of Medicine, Post Graduate Program in Food, Nutrition and Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | | - Luis Henrique Canani
- Faculty of Medicine, Post Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Jakeline Rheinhemer
- Faculty of Medicine, Post Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Daisy Crispim
- Faculty of Medicine, Post Graduate Program in Medical Sciences: Endocrinology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Endocrine Division, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Gabriela Corrêa Souza
- Faculty of Medicine, Post Graduate Program in Food, Nutrition and Health, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
- Food and Nutrition Research Center, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- * E-mail:
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Adda-Rezig H, Carron C, Pais de Barros JP, Choubley H, Charron É, Rérole AL, Laheurte C, Louvat P, Gaiffe É, Simula-Faivre D, Deckert V, Lagrost L, Saas P, Ducloux D, Bamoulid J. New Insights on End-Stage Renal Disease and Healthy Individual Gut Bacterial Translocation: Different Carbon Composition of Lipopolysaccharides and Different Impact on Monocyte Inflammatory Response. Front Immunol 2021; 12:658404. [PMID: 34163471 PMCID: PMC8215383 DOI: 10.3389/fimmu.2021.658404] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 05/18/2021] [Indexed: 12/12/2022] Open
Abstract
Chronic kidney disease induces disruption of the intestinal epithelial barrier, leading to gut bacterial translocation. Here, we appreciated bacterial translocation by analyzing circulating lipopolysaccharides (LPS) using two methods, one measuring only active free LPS, and the other quantifying total LPS as well as LPS lipid A carbon chain length. This was done in end-stage renal disease (ESRD) patients and healthy volunteers (HV). We observed both higher LPS concentration in healthy volunteers and significant differences in composition of translocated LPS based on lipid A carbon chain length. Lower LPS activity to mass ratio and higher concentration of high-density lipoproteins were found in HV, suggesting a better plasma capacity to neutralize LPS activity. Higher serum concentrations of soluble CD14 and pro-inflammatory cytokines in ESRD patients confirmed this hypothesis. To further explore whether chronic inflammation in ESRD patients could be more related to LPS composition rather than its quantity, we tested the effect of HV and patient sera on cytokine secretion in monocyte cultures. Sera with predominance of 14-carbon chain lipid A-LPS induced higher secretion of pro-inflammatory cytokines than those with predominance of 18-carbon chain lipid A-LPS. TLR4 or LPS antagonists decreased LPS-induced cytokine production by monocytes, demonstrating an LPS-specific effect. Thereby, septic inflammation observed in ESRD patients may be not related to higher bacterial translocation, but to reduced LPS neutralization capacity and differences in translocated LPS subtypes.
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Affiliation(s)
- Hanane Adda-Rezig
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Hôte Greffon-Tumeur/Ingénierie Cellulaire et Génique, Fédération Hospitalo-Universitaire INCREASE, LabEx LipSTIC, Besançon, France
| | - Clémence Carron
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Hôte Greffon-Tumeur/Ingénierie Cellulaire et Génique, Fédération Hospitalo-Universitaire INCREASE, LabEx LipSTIC, Besançon, France
| | | | - Hélène Choubley
- INSERM, Univ. Bourgogne Franche-Comté, LNC UMR1231, LabEx LipSTIC, Dijon, France
| | - Émilie Charron
- INSERM, Univ. Bourgogne Franche-Comté, LNC UMR1231, LabEx LipSTIC, Dijon, France
| | - Anne-Laure Rérole
- INSERM, Univ. Bourgogne Franche-Comté, LNC UMR1231, LabEx LipSTIC, Dijon, France
| | - Caroline Laheurte
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Hôte Greffon-Tumeur/Ingénierie Cellulaire et Génique, Fédération Hospitalo-Universitaire INCREASE, LabEx LipSTIC, Besançon, France.,EFS Bourgogne Franche-Comté, Plateforme de BioMonitoring, Besançon, France
| | - Pascale Louvat
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Hôte Greffon-Tumeur/Ingénierie Cellulaire et Génique, Fédération Hospitalo-Universitaire INCREASE, LabEx LipSTIC, Besançon, France.,EFS Bourgogne Franche-Comté, Plateforme de BioMonitoring, Besançon, France
| | - Émilie Gaiffe
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Hôte Greffon-Tumeur/Ingénierie Cellulaire et Génique, Fédération Hospitalo-Universitaire INCREASE, LabEx LipSTIC, Besançon, France.,INSERM CIC1431, University Hospital of Besançon, Clinical Investigation Center in Biotherapy, Fédération Hospitalo-Universitaire INCREASE, LabEx LipSTIC, Besançon, France
| | - Dominique Simula-Faivre
- University Hospital of Besançon, Department of Nephrology, Dialysis, and Renal Transplantation, Besançon, France
| | - Valérie Deckert
- INSERM, Univ. Bourgogne Franche-Comté, LNC UMR1231, LabEx LipSTIC, Dijon, France
| | - Laurent Lagrost
- INSERM, Univ. Bourgogne Franche-Comté, LNC UMR1231, LabEx LipSTIC, Dijon, France
| | - Philippe Saas
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Hôte Greffon-Tumeur/Ingénierie Cellulaire et Génique, Fédération Hospitalo-Universitaire INCREASE, LabEx LipSTIC, Besançon, France.,EFS Bourgogne Franche-Comté, Plateforme de BioMonitoring, Besançon, France.,INSERM CIC1431, University Hospital of Besançon, Clinical Investigation Center in Biotherapy, Fédération Hospitalo-Universitaire INCREASE, LabEx LipSTIC, Besançon, France
| | - Didier Ducloux
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Hôte Greffon-Tumeur/Ingénierie Cellulaire et Génique, Fédération Hospitalo-Universitaire INCREASE, LabEx LipSTIC, Besançon, France.,INSERM CIC1431, University Hospital of Besançon, Clinical Investigation Center in Biotherapy, Fédération Hospitalo-Universitaire INCREASE, LabEx LipSTIC, Besançon, France.,University Hospital of Besançon, Department of Nephrology, Dialysis, and Renal Transplantation, Besançon, France
| | - Jamal Bamoulid
- Univ. Bourgogne Franche-Comté, INSERM, EFS BFC, UMR1098, RIGHT Interactions Hôte Greffon-Tumeur/Ingénierie Cellulaire et Génique, Fédération Hospitalo-Universitaire INCREASE, LabEx LipSTIC, Besançon, France.,University Hospital of Besançon, Department of Nephrology, Dialysis, and Renal Transplantation, Besançon, France
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9
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Yu J, Shen Y, Zhou N. Advances in the role and mechanism of zonulin pathway in kidney diseases. Int Urol Nephrol 2021; 53:2081-2088. [PMID: 33428167 DOI: 10.1007/s11255-020-02756-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 12/15/2020] [Indexed: 10/22/2022]
Abstract
The intestinal barrier is the first line of defense against foreign antigens. Tight junctions play an important role in maintaining the function of the intestinal wall. Zonulin is the only physiological protein discovered in recent years that can reversibly regulate tight junctions in human body. It changes the permeability of intestinal epithelial cells by regulating the state of tight junctions. Increased intestinal permeability can lead to abnormal activation of intestinal mucosal immune and bacterial translocation, then inducing systemic inflammation. It has already been reported that zonulin plays an important pathogenic role in a variety of diseases by regulating tight junctions leading to an abnormal increase of intestinal permeability. However, the research on the pathogenic role and mechanism of zonulin pathway in kidney disease is still in its infancy. Therefore, we reviewed the progress on pathophysiological characteristics of zonulin as well as the pathogenesis of zonulin in kidney disease in this paper.
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Affiliation(s)
- Jie Yu
- Department of Nephrology, Beijing Children's Hospital, Capital Medical University, Beijing, China.,National Center for Children's Health (Beijing), Beijing, China
| | - Ying Shen
- Department of Nephrology, Beijing Children's Hospital, Capital Medical University, Beijing, China.,National Center for Children's Health (Beijing), Beijing, China.,Key Laboratory of Chronic Kidney Disease and Blood Purification in Childhood (Beijing), Beijing, China.,Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China
| | - Nan Zhou
- Department of Nephrology, Beijing Children's Hospital, Capital Medical University, Beijing, China. .,National Center for Children's Health (Beijing), Beijing, China. .,Key Laboratory of Chronic Kidney Disease and Blood Purification in Childhood (Beijing), Beijing, China. .,Key Laboratory of Major Diseases in Children, Ministry of Education, Beijing, China.
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10
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Ramos CI, Armani RG, Canziani MEF, Dalboni MA, Dolenga CJR, Nakao LS, Campbell KL, Cuppari L. Effect of prebiotic (fructooligosaccharide) on uremic toxins of chronic kidney disease patients: a randomized controlled trial. Nephrol Dial Transplant 2020; 34:1876-1884. [PMID: 29939302 DOI: 10.1093/ndt/gfy171] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Accepted: 05/02/2018] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Microbial-derived uremic toxins, p-cresyl sulfate (PCS), indoxyl sulfate (IS) and indole 3-acetic acid (IAA), have been associated with the burden of chronic kidney disease (CKD). Prebiotics have emerged as an alternative to modulate the gut environment and to attenuate toxin production. This trial aims to investigate the effect of a prebiotic fructooligosaccharide (FOS) on uremic toxins of non-dialysis-dependent CKD (NDD-CKD) patients. METHODS A double-blind, placebo-controlled, randomized trial was conducted for 3 months. In all, 50 nondiabetic NDD-CKD patients [estimated glomerular filtration rate (eGFR) <45 mL/min/1.73 m2], aged 18-80 years, were allocated to prebiotic (FOS, 12 g/day) or placebo (maltodextrin, 12 g/day) groups. Primary outcomes were changes in serum (total and free) and urinary (total) PCS. Secondary outcomes included changes in IS, IAA, serum markers of intestinal permeability (zonulin), gut-trophic factors (epidermal growth factor and glucagon-like peptide-2), eGFR, inflammation (high sensitive c-reactive protein and interleukin-6), homeostatic model assessment-insulin resistance, lipid profile and gastrointestinal symptoms. RESULTS From 50 participants (54% men, 57.3 ± 14.6 years and eGFR 21.4 ± 7.6 mL/min/1.73 m2), 46 completed the follow-up. No changes in dietary intake or gastrointestinal symptoms were observed. There was a trend in the difference of serum total ΔPCS (treatment effect adjusted for baseline levels: -12.4 mg/L; 95% confidence interval (-5.6 to 0.9 mg/L; P = 0.07) and serum-free Δ%PCS [intervention -8.6 (-41.5 to 13.9%) versus placebo 3.5 (-28.8 to 85.5%); P = 0.07] between the groups. The trend in the difference of serum total ΔPCS was independent of eGFR and dietary protein:fiber ratio intake. No difference was found in urinary PCS. Aside from the decreased high-density lipoprotein cholesterol in the intervention, no differences were observed in the change of IS, IAA or other secondary outcome between the groups. CONCLUSIONS Our result suggests the potential of FOS in reducing serum total and free PCS in nondiabetic NDD-CKD patients.
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Affiliation(s)
- Christiane Ishikawa Ramos
- Nutrition Program, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Hospital do Rim - Fundação Oswaldo Ramos, São Paulo, Brazil.,Faculty of Health Sciences and Medicine, Bond University, Queensland, Australia
| | - Rachel Gatti Armani
- Hospital do Rim - Fundação Oswaldo Ramos, São Paulo, Brazil.,Division of Nephrology, UNIFESP, São Paulo, Brazil
| | | | - Maria Aparecida Dalboni
- Division of Nephrology, UNIFESP, São Paulo, Brazil.,Post-graduate Program in Medicine, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | | | - Lia Sumie Nakao
- Department of Basic Pathology, Universidade Federal do Paraná (UFPR), Curitiba, Brazil
| | | | - Lilian Cuppari
- Nutrition Program, Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil.,Hospital do Rim - Fundação Oswaldo Ramos, São Paulo, Brazil.,Division of Nephrology, UNIFESP, São Paulo, Brazil
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11
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Banaszkiewicz M, Małyszko J, Vesole DH, Woziwodzka K, Jurczyszyn A, Żórawski M, Krzanowski M, Małyszko J, Batko K, Kuźniewski M, Krzanowska K. New Biomarkers of Ferric Management in Multiple Myeloma and Kidney Disease-Associated Anemia. J Clin Med 2019; 8:jcm8111828. [PMID: 31683939 PMCID: PMC6912471 DOI: 10.3390/jcm8111828] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 02/07/2023] Open
Abstract
Multiple myeloma (MM) is a malignancy of clonal plasma cells accounting for approximately 10% of haematological malignancies. MM mainly affects older patients, more often males and is more frequently seen in African Americans. The most frequent manifestations of MM are anaemia, osteolytic bone lesions, kidney failure and hypercalcemia. The anaemia develops secondary to suppression of erythropoiesis by cytokine networks, similarly to the mechanism of anaemia of chronic disease. The concomitant presence of kidney failure, especially chronic kidney disease (CKD) and MM per se, leading to anaemia of chronic disease (ACD) in combination, provoked us to pose the question about their reciprocal dependence and relationship with specific biomarkers; namely, soluble transferrin receptor (sTfR), growth differentiation factor 15 (GDF15), hepcidin 25 and zonulin. One or more of these are new biomarkers of ferric management may be utilized in the near future as prognostic predictors for patients with MM and kidney failure.
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Affiliation(s)
- Małgorzata Banaszkiewicz
- Departament of Nephrology, Jagiellonian University Medical College, Kopernika 15-15c, 31-501 Cracow, Poland.
| | - Jolanta Małyszko
- Department of Nephrology, Dialysis and Internal Medicine, Warsaw Medical University, Banacha 1a, 02-097 Warsaw, Poland.
| | - David H Vesole
- John Theurer Cancer Center, Hackensack University Medical Center, 92 2nd St, Hackensack, NJ 07601, USA.
| | - Karolina Woziwodzka
- Departament of Nephrology, Jagiellonian University Medical College, Kopernika 15-15c, 31-501 Cracow, Poland.
| | - Artur Jurczyszyn
- Departament of Hematology, Jagiellonian University Medical College, Kopernika 17, 30-501 Cracow, Poland.
| | - Marcin Żórawski
- Departament of Clinical Medicine, Medical University, Szpitalna 37, 15-254 Bialystok, Poland.
| | - Marcin Krzanowski
- Departament of Nephrology, Jagiellonian University Medical College, Kopernika 15-15c, 31-501 Cracow, Poland.
| | - Jacek Małyszko
- Departament of Nephrology, Medical University, Żurawia 14, 15-540 Bialystok, Poland.
| | - Krzysztof Batko
- Departament of Nephrology, Jagiellonian University Medical College, Kopernika 15-15c, 31-501 Cracow, Poland.
| | - Marek Kuźniewski
- Departament of Nephrology, Jagiellonian University Medical College, Kopernika 15-15c, 31-501 Cracow, Poland.
| | - Katarzyna Krzanowska
- Departament of Nephrology, Jagiellonian University Medical College, Kopernika 15-15c, 31-501 Cracow, Poland.
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12
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Leech B, McIntyre E, Steel A, Sibbritt D. Risk factors associated with intestinal permeability in an adult population: A systematic review. Int J Clin Pract 2019; 73:e13385. [PMID: 31243854 DOI: 10.1111/ijcp.13385] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/04/2019] [Accepted: 06/16/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Increased intestinal permeability (IP) involves the loss of integrity between the cells of the small intestine. IP has been suggested to contribute to the pathogenesis and exacerbation of many chronic diseases. Many potential risk factors for IP are proposed in contemporary literature. The purpose of this review is to identify the most significant risk factors for IP. METHODS A systematic search of literature published up until September 2018 in the PubMed, EMBASE, CINAHL, and Scopus databases was conducted. RESULTS A total of 47 articles met the inclusion criteria. Elevated levels of proinflammatory markers, dyslipidaemia, hyperglycaemia, insulin resistance, anthropometric measurements resembling obesity, advanced disease severity, comorbidity and the consumption of a Western-style diet were identified as the strongest risk factors for altered intestinal integrity. The risk of IP increases when coupled with a multiple disease state or combined with other environmental risk factors. Furthermore, many of the identified risk factors such as anthropometric measurements and biomarkers were external from intestinal health and rather resembled a metabolic-like condition. CONCLUSIONS This review identified a number of potential risk factors for IP, ranging from biomarkers to anthropometric measurements, demographics, dietary intake and chronic diseases. These risk factors warrant the attention of clinicians and other healthcare providers to aid the identification of potential patients at risk of altered IP. Further research needs to examine whether the identified risk factors are homogeneous with the diagnosis of IP or whether the disease state influences the association.
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Affiliation(s)
- Bradley Leech
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Erica McIntyre
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Amie Steel
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - David Sibbritt
- Faculty of Health, Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, Ultimo, New South Wales, Australia
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13
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Calgin MK, Cetinkol Y. Decreased levels of serum zonulin and copeptin in chronic Hepatitis-B patients. Pak J Med Sci 2019; 35:847-851. [PMID: 31258605 PMCID: PMC6572940 DOI: 10.12669/pjms.35.3.144] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background & Objective Liver and intestines are anatomically and physiologically linked. Zonulin is a protein modulating intercellular tight junctions and regulating intestinal permeability. Copeptin was studied as a marker of systemic circulation disorders in research about vasopressin and was associated with liver disease prognosis. Serum zonulin and copeptin levels were measured in patients with diagnosis of chronic hepatitis B (CHB) with the aim of easing antiviral treatment management in clinical applications and to investigate the association with normal population and viral load. Methods Analysis included the serum of 30 CHB patients and 17 controls. HBV-DNA real-time PCR tests were completed. CHB patients were divided into three subgroups according to viral load in serum. Zonulin and copeptin levels were measured using ELISA kits. Results Serum zonulin and copeptin levels were significantly low in CHB patients compared to controls (p<0.001). When CHB subgroups are investigated in terms of serum zonulin and copeptin levels, there was an inverse correlation observed with significant difference (p<0.01, p<0.05). Conclusion The negative correlation between serum zonulin and copeptin with HBV-DNA load revealed in our study shows they may be used to monitor treatment. Zonulin and copeptin assays provide the possibility of developing new approaches to CHB diagnosis and monitoring.
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Affiliation(s)
- Mustafa Kerem Calgin
- Dr. Mustafa Kerem Calgin, Medical Microbiology Department, Ordu University Faculty of Medicine, Ordu, Turkey
| | - Yeliz Cetinkol
- Dr. Yeliz Cetinkol, Medical Microbiology Department, Ordu University Faculty of Medicine, Ordu, Turkey
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14
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Akao T, Morita A, Onji M, Miyake T, Watanabe R, Uehara T, Kawasaki K, Miyaike J, Oomoto M. Low Serum Levels of Zonulin in Patients with HCV-Infected Chronic Liver Diseases. Euroasian J Hepatogastroenterol 2019; 8:112-115. [PMID: 30828551 PMCID: PMC6395477 DOI: 10.5005/jp-journals-10018-1275] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 09/12/2018] [Indexed: 12/29/2022] Open
Abstract
Aim The aim of the study was to assess the implication of Zonulin, a mediator protein synthesized by intestine and the liver,in patients with chronic liver diseases. Materials and methods Twenty-six patients with chronic liver diseases due to hepatitis C virus (HCV) and hepatitis B virus (HBV) were enrolled in this study. Out of total 26 patients, 17 were diagnosed as chronic hepatitis (CH) and 9 were patients with liver cirrhosis (LC). Twenty-four of these patients were infected with hepatitis C virus (HCV) and the rest two by hepatitis B virus (HBV). The study was conducted at Saiseikai-Imabari Hospital, Imabari, Ehime, Japan. Serum levels of Zonulin along with different parameters of liver function test were measured in all patients and comparative analyses were accomplished. Results The serum levels of Zonulin were significantly lower in CH patients compared to controls (p<0.001). Also, the levels of Zonulin were significantly lower in patients with LC compared to CH and normal controls (p<0.001). Further analysis revealed that serum Zonulin was significantly lower in patients with LC having ascites than those without ascites (p <0.05). There was a significant correlation of serum levels of Zonulin with platelet count, cholinesterase, and albumin in patients with chronic liver diseases. Discussion Decreased levels of Zonulin may be related to impaired production of this mediator in the diseased liver. It will be tempting to assess the regulation of Zonulin in the liver, a production site of the mediator. Abbreviations LC: Liver cirrhosis, CH: Chronic hepatitis, HCV: Hepatitis C virus, HBV: Hepatitis B virus, LGS: Leaky gut syndrome How to cite this article: Akao T, Morita A, Onji M, Miyake T, Watanabe R, Uehara T, Kawasaki K, Miyaike J, Oomoto M. Low Serum Levels of Zonulin in Patients with HCV-Infected Chronic Liver Diseases. Euroasian J Hepatogastroenterol, 2018;8(2):112-115.
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Affiliation(s)
- Tomohiro Akao
- Saiseikai Imabari Hospital, Kitamura, Imabari, Ehime, Japan
| | - Ayumi Morita
- Saiseikai Imabari Hospital, Kitamura, Imabari, Ehime, Japan
| | - Morikazu Onji
- Emeritus Professor of Ehime University, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | - Teruki Miyake
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Shitsukawa, Toon, Ehime, Japan
| | | | | | | | - Jiro Miyaike
- Saiseikai Imabari Hospital, Kitamura, Imabari, Ehime, Japan
| | - Masaki Oomoto
- Saiseikai Imabari Hospital, Kitamura, Imabari, Ehime, Japan
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15
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Trachtman H, Gipson DS, Lemley KV, Troost JP, Faul C, Morrison DJ, Vento SM, Ahn DH, Goldberg JD. Plasma Zonulin Levels in Childhood Nephrotic Syndrome. Front Pediatr 2019; 7:197. [PMID: 31157195 PMCID: PMC6532587 DOI: 10.3389/fped.2019.00197] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 04/29/2019] [Indexed: 01/01/2023] Open
Abstract
Objective: We conducted this study to test the hypothesis that plasma zonulin levels are elevated in pediatric patients with nephrotic syndrome compared to healthy controls. Study Design: Plasma zonulin levels were measured by ELISA in 114 children enrolled in the NEPTUNE study. Clinical and laboratory data were retrieved from the NEPTUNE database. Results: The median age of the patients was 10 (IQR = 5 to 14) years, 59 were male, 64 had minimal change disease, 47 focal segmental glomerulosclerosis, median eGFR was 96 (IQR = 80 to 114) ml/min/1.73 m2, and median urine protein:creatinine ratio was 0.5 (IQR = 0.1 to 3.4) (g:g). The plasma zonulin level was 14.2 ± 5.0 vs. 10.2 ± 2.5 ng/ml in healthy adults in a report using the same assay kit, P = 0.0025. These findings were confirmed in an independent cohort of children with nephrotic syndrome compared to healthy age-matched controls, P = 0.01. Zonulin concentrations did not differ in children with minimal change disease vs. focal segmental glomerulosclerosis, frequently relapsing vs. steroid-dependent vs. steroid-resistant clinical course, and were not influenced by the immunosuppressive treatment regimen. There was no relationship between plasma zonulin levels and the absolute or percentage change in proteinuria from enrollment until the time of the zonulin assay. Conclusion: Plasma zonulin levels are elevated in childhood nephrotic syndrome regardless of level of proteinuria or specific treatment. The cause of the high plasma zonulin levels and whether zonulin contributes to glomerular injury requires further study.
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Affiliation(s)
- Howard Trachtman
- Division of Nephrology, Department of Pediatrics, NYU School of Medicine, New York, NY, United States
| | - Debbie S Gipson
- Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, MI, United States
| | - Kevin V Lemley
- Division of Nephrology, Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Jonathan P Troost
- Division of Nephrology, Department of Pediatrics, University of Michigan, Ann Arbor, MI, United States
| | - Christian Faul
- Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, United States
| | | | - Suzanne M Vento
- Division of Nephrology, Department of Pediatrics, NYU School of Medicine, New York, NY, United States
| | - Dong-Hyun Ahn
- Department of Population Health, NYU School of Medicine, New York, NY, United States
| | - Judith D Goldberg
- Department of Population Health, NYU School of Medicine, New York, NY, United States
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16
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Weber GJ, Foster J, Pushpakumar SB, Sen U. Altered microRNA regulation of short chain fatty acid receptors in the hypertensive kidney is normalized with hydrogen sulfide supplementation. Pharmacol Res 2018; 134:157-165. [PMID: 29909116 DOI: 10.1016/j.phrs.2018.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 06/13/2018] [Indexed: 01/08/2023]
Abstract
Hypertension affects nearly one third of the adult US population and is a significant risk factor for chronic kidney disease (CKD). An expanding body of recent studies indicates that gut microbiome has crucial roles in regulating physiological processes through, among other mechanisms, one mode of short chain fatty acids (SCFA) and their target receptors. In addition, these SCFA receptors are potential targets of regulation by host miRNAs, however, the mechanisms through which this occurs is not clearly defined. Hydrogen sulfide (H2S) is an important gasotransmitter involved in multiple physiological processes and is known to alleviate adverse effects of hypertension such as reducing inflammation in the kidney. To determine the role of host microRNAs in regulating short chain fatty acid receptors in the kidney as well as the gut, C57BL/6J wild-type mice were treated with or without Ang-II and H2S donor GYY4137 (GYY) for 4 weeks to assess whether GYY would normalize adverse effects observed in hypertensive mice and whether this was in part due to altered gut microbiome composition. We observed several changes of SCFA receptors, including Olfr78, Gpr41/43 and predicted microRNA regulators in the kidney among the different treatments. Increased expression of inflammatory markers Il6 and Rorc2, along with Tgfβ, were found in the hypertensive kidney. The glomerular filtration rate (GFR) was improved in mice treated with Ang-II + GYY compared with Ang-II only, indicating improved kidney function. The Erysipelotrichia class of bacteria, linked with high fat diets, was enriched in hypertensive animals but reduced with GYY supplementation. These data point towards a role for miRNA regulation of SCFA receptors in hypertensive kidney and are normalized by H2S supplementation.
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Affiliation(s)
- Gregory J Weber
- Department of Physiology, University of Louisville, School of Medicine, Louisville, KY, 40202, United States
| | - Jaleyea Foster
- Department of Physiology, University of Louisville, School of Medicine, Louisville, KY, 40202, United States
| | - Sathnur B Pushpakumar
- Department of Physiology, University of Louisville, School of Medicine, Louisville, KY, 40202, United States
| | - Utpal Sen
- Department of Physiology, University of Louisville, School of Medicine, Louisville, KY, 40202, United States.
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