Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
Non-communicable Diseases Research Center, Fasa University of Medical Sciences, Fasa, Iran.
Am J Med Sci. 2022 Dec;364(6):695-705. doi: 10.1016/j.amjms.2022.05.025. Epub 2022 Jul 20.
Glomerular injury is the major cause of chronic kidney diseases (CKD) worldwide and is characterized by proteinuria. Glomerulonephritis (GN) has a wide spectrum of etiologies, the intensity of glomerular damage, histopathology, and clinical outcomes that can be associated with the landscape of the nephritogenic immune response. Beyond impaired immune responses and genetic factors, recent evidence indicates that microbiota can be contributed to the pathogenesis of GN and patients' outcomes by impacting many aspects of the innate and adaptive immune systems. It is still unknown whether dysbiosis induces GN or it is a secondary effect of the disease. Several factors such as drugs and nutritional problems can lead to dysbiosis in GN patients. It has been postulated that gut dysbiosis activates immune responses, promotes a state of systemic inflammation, and produces uremic toxins contributing to kidney tissue inflammation, apoptosis, and subsequent proteinuric nephropathy. In this review, the impact of gastrointestinal tract (GI) microbiota on the pathogenesis of the primary GN will be highlighted. The application of therapeutic interventions based on the manipulation of gut microbiota with special diets and probiotic supplementation can be effective in GN.
肾小球损伤是全球慢性肾脏病（CKD）的主要病因，其特征是蛋白尿。肾小球肾炎（GN）有广泛的病因、肾小球损伤的强度、组织病理学和临床结果，这些都与肾炎免疫反应的特征有关。除了受损的免疫反应和遗传因素外，最近的证据表明，微生物组通过影响先天和适应性免疫系统的许多方面，可能有助于 GN 的发病机制和患者的预后。目前尚不清楚是菌群失调导致了 GN，还是疾病的继发效应。一些因素，如药物和营养问题，可导致 GN 患者出现菌群失调。有人推测，肠道菌群失调会激活免疫反应，导致全身炎症状态，并产生尿毒症毒素，导致肾脏组织炎症、细胞凋亡和随后的蛋白尿性肾病。在这篇综述中，将强调胃肠道（GI）微生物群对原发性 GN 发病机制的影响。基于特殊饮食和益生菌补充剂来操纵肠道菌群的治疗干预措施的应用可能对 GN 有效。
