Renal Division, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, United States.
Servicio de Nefrología, Hospital del Mar, Barcelona, Spain.
Front Immunol. 2021 Jun 2;12:624821. doi: 10.3389/fimmu.2021.624821. eCollection 2021.
Kidney disease affects 10% of the world population and is associated with increased mortality. Steroid-resistant nephrotic syndrome (SRNS) is a leading cause of end-stage kidney disease in children, often failing standard immunosuppression. Here, we report the results of a prospective study to investigate the immunological impact and safety of a gluten-free and dairy-free (GF/DF) diet in children with SRNS. The study was organized as a four-week summer camp implementing a strict GF/DF diet with prospective collection of blood, urine and stool in addition to whole exome sequencing WES of DNA of participants. Using flow cytometry, proteomic assays and microbiome metagenomics, we show that GF/DF diet had a major anti-inflammatory effect in all participants both at the protein and cellular level with 4-fold increase in T regulatory/T helper 17 cells ratio and the promotion of a favorable regulatory gut microbiota. Overall, GF/DF can have a significant anti-inflammatory effect in children with SRNS and further trials are warranted to investigate this potential dietary intervention in children with SRNS.
肾病影响了世界上 10%的人口，并与死亡率的增加有关。类固醇耐药性肾病综合征（SRNS）是儿童终末期肾病的主要原因，常对标准免疫抑制治疗无效。在这里，我们报告了一项前瞻性研究的结果，该研究旨在调查无谷蛋白和无乳制品（GF/DF）饮食对 SRNS 儿童的免疫影响和安全性。该研究组织为为期四周的夏令营，参与者在夏令营期间严格执行 GF/DF 饮食，前瞻性收集血液、尿液和粪便样本，并对参与者的 DNA 进行全外显子组测序（WES）。通过流式细胞术、蛋白质组学检测和微生物组宏基因组学，我们表明 GF/DF 饮食在所有参与者中均具有显著的抗炎作用，在蛋白质和细胞水平上均可使 T 调节/T 辅助 17 细胞比例增加 4 倍，并促进有益的调节性肠道微生物群。总的来说，GF/DF 饮食对 SRNS 儿童可能具有显著的抗炎作用，需要进一步的临床试验来研究这种潜在的饮食干预措施在 SRNS 儿童中的应用。
