Hsu Chien-Ning, Tain You-Lin
Department of Pharmacy, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 833, Taiwan.
School of Pharmacy, Kaohsiung Medical University, Kaohsiung 807, Taiwan.
Int J Mol Sci. 2022 Apr 2;23(7):3954. doi: 10.3390/ijms23073954.
The gut-kidney interaction implicating chronic kidney disease (CKD) has been the focus of increasing interest in recent years. Gut microbiota-targeted therapies could prevent CKD and its comorbidities. Considering that CKD can originate in early life, its treatment and prevention should start in childhood or even earlier in fetal life. Therefore, a better understanding of how the early-life gut microbiome impacts CKD in later life and how to develop ideal early interventions are unmet needs to reduce CKD. The purpose of the current review is to summarize (1) the current evidence on the gut microbiota dysbiosis implicated in pediatric CKD; (2) current knowledge supporting the impact of the gut-kidney axis in CKD, including inflammation, immune response, alterations of microbiota compositions, short-chain fatty acids, and uremic toxins; and (3) an overview of the studies documenting early gut microbiota-targeted interventions in animal models of CKD of developmental origins. Treatment options include prebiotics, probiotics, postbiotics, etc. To accelerate the transition of gut microbiota-based therapies for early prevention of CKD, an extended comprehension of gut microbiota dysbiosis implicated in renal programming is needed, as well as a greater focus on pediatric CKD for further clinical translation.
涉及慢性肾脏病（CKD）的肠道-肾脏相互作用近年来一直是人们日益关注的焦点。针对肠道微生物群的疗法可以预防CKD及其合并症。鉴于CKD可能始于生命早期，其治疗和预防应在儿童期甚至胎儿期更早开始。因此，更好地了解生命早期的肠道微生物群如何影响后期生活中的CKD，以及如何开展理想的早期干预措施，是减少CKD尚未满足的需求。本综述的目的是总结：（1）目前关于小儿CKD中肠道微生物群失调的证据；（2）目前支持肠道-肾脏轴在CKD中的影响的知识，包括炎症、免疫反应、微生物群组成的改变、短链脂肪酸和尿毒症毒素；（3）对记录在发育起源的CKD动物模型中早期肠道微生物群靶向干预的研究的概述。治疗选择包括益生元、益生菌、后生元等。为了加速基于肠道微生物群的疗法向早期预防CKD的转变，需要更深入地理解与肾脏编程相关的肠道微生物群失调，以及更加关注小儿CKD以便进一步进行临床转化。
