Division of Nephrology and Hypertension, Departments of Medicine and Physiology & Biophysics, University of California, Irvine, California 92868, USA.
Curr Opin Nephrol Hypertens. 2012 Nov;21(6):587-92. doi: 10.1097/MNH.0b013e328358c8d5.
Chronic kidney disease (CKD) is associated with oxidative stress and inflammation which contribute to progression of kidney disease and its numerous complications. Until recently, little attention had been paid to the role of the intestine and its microbial flora in the pathogenesis of CKD-associated inflammation. This article is intended to provide an over view of the impact of uremia on the structure and function of the gut and its microbial flora and their potential link to the associated systemic inflammation.
Recent studies conducted in the author's laboratories have demonstrated marked disintegration of the colonic epithelial barrier structure and significant alteration of the colonic bacterial flora in humans and animals with advanced CKD. The observed disruption of the intestinal epithelial barrier complex can play an important part in the development of systemic inflammation by enabling influx of endotoxin and other noxious luminal contents into the systemic circulation. Similarly via disruption of the normal symbiotic relationship and production, absorption and retention of noxious products, alteration of the microbial flora can contribute to systemic inflammation and uremic toxicity. In fact recent studies have documented the role of colonic bacteria as the primary source of several well known pro-inflammatory/pro-oxidant uremic toxins as well as many as-yet unidentified retained compounds.
CKD results in disruption of the intestinal barrier structure and marked alteration of its microbial flora - events that play a major role in the pathogenesis of inflammation and uremic toxicity.
慢性肾脏病（CKD）与氧化应激和炎症有关，这些因素导致肾脏疾病及其许多并发症的进展。直到最近，人们对肠道及其微生物菌群在 CKD 相关炎症发病机制中的作用还关注甚少。本文旨在概述尿毒症对肠道结构和功能及其微生物菌群的影响，以及它们与相关系统性炎症的潜在联系。
作者实验室最近进行的研究表明，在晚期 CKD 患者中，肠道上皮屏障结构明显解体，肠道细菌菌群发生重大改变。观察到的肠道上皮屏障复合体的破坏可能通过使内毒素和其他有害腔内容物进入全身循环，在系统性炎症的发展中发挥重要作用。同样，通过破坏正常的共生关系以及有害物质的产生、吸收和保留，微生物菌群的改变也可能导致系统性炎症和尿毒症毒性。事实上，最近的研究已经证明了结肠细菌作为几种众所周知的促炎/促氧化剂尿毒症毒素以及许多尚未确定的保留化合物的主要来源的作用。
CKD 导致肠道屏障结构破坏和微生物菌群明显改变，这些事件在炎症和尿毒症毒性的发病机制中起主要作用。
