Nephrology Division, Ghent University Hospital and Ghent University, 9000 Ghent, Belgium.
First Division of Nephrology, Department of Translational Medical Sciences, School of Medicine, University of Campania "Luigi Vanvitelli", 80131 Naples, Italy.
Toxins (Basel). 2020 Apr 11;12(4):245. doi: 10.3390/toxins12040245.
Several of the uremic toxins, which are difficult to remove by dialysis, originate from the gut bacterial metabolism. This opens opportunities for novel targets trying to decrease circulating levels of these toxins and their pathophysiological effects. The current review focuses on immunomodulatory effects of these toxins both at their side of origin and in the circulation. In the gut end products of the bacterial metabolism such as p-cresol, trimethylamine and HS affect the intestinal barrier structure and function while in the circulation the related uremic toxins stimulate cells of the immune system. Both conditions contribute to the pro-inflammatory status of patients with chronic kidney disease (CKD). Generation and/or absorption of these toxin precursors could be targeted to decrease plasma levels of their respective uremic toxins and to reduce micro-inflammation in CKD.
几种难以通过透析清除的尿毒症毒素来源于肠道细菌代谢。这为试图降低这些毒素及其病理生理作用的循环水平的新靶点提供了机会。本综述重点介绍了这些毒素在其起源部位和循环中的免疫调节作用。在肠道中，细菌代谢的终产物如对甲酚、三甲胺和 HS 会影响肠道屏障的结构和功能，而在循环中，相关的尿毒症毒素会刺激免疫系统的细胞。这两种情况都导致慢性肾脏病（CKD）患者的炎症状态。针对这些毒素前体的产生和/或吸收，可以降低其各自尿毒症毒素的血浆水平，并减少 CKD 中的微炎症。
