University of Limoges, Inserm U1248, Pharmacology & Transplantation, Limoges, France.
Department of pharmacology, toxicology and pharmacovigilance, Centre Hospitalier Universitaire (CHU) Limoges, Limoges, France.
Front Endocrinol (Lausanne). 2022 Jul 7;13:898878. doi: 10.3389/fendo.2022.898878. eCollection 2022.
Post-transplant diabetes mellitus (PTDM) is one of the most common and deleterious comorbidities after solid organ transplantation (SOT). Its incidence varies depending on the organs transplanted and can affect up to 40% of patients. Current research indicates that PTDM shares several common features with type 2 diabetes mellitus (T2DM) in non-transplant populations. However, the pathophysiology of PTDM is still poorly characterized. Therefore, ways should be sought to improve its diagnosis and therapeutic management. A clear correlation has been made between PTDM and the use of immunosuppressants. Moreover, immunosuppressants are known to induce gut microbiota alterations, also called intestinal dysbiosis. Whereas the role of intestinal dysbiosis in the development of T2DM has been well documented, little is known about its impacts on PTDM. Functional alterations associated with intestinal dysbiosis, especially defects in pathways generating physiologically active bacterial metabolites (e.g., short-chain fatty acids, trimethylamine N-oxide, indole and kynurenine) are known to favour several metabolic disorders. This publication aims at discussing the potential role of intestinal dysbiosis and dysregulation of bacterial metabolites associated with immunosuppressive therapy in the occurrence of PTDM.
移植后糖尿病（PTDM）是实体器官移植（SOT）后最常见和最具危害性的合并症之一。其发病率因移植器官的不同而有所差异，最高可达 40%的患者。目前的研究表明，PTDM 与非移植人群中的 2 型糖尿病（T2DM）具有一些共同特征。然而，PTDM 的病理生理学仍未得到充分描述。因此，应寻求改善其诊断和治疗管理的方法。PTDM 与免疫抑制剂的使用之间存在明确的相关性。此外，已知免疫抑制剂会引起肠道微生物群的改变，也称为肠道菌群失调。虽然肠道菌群失调在 T2DM 发展中的作用已得到充分证实，但对于其对 PTDM 的影响知之甚少。与肠道菌群失调相关的功能改变，特别是产生生理活性细菌代谢物（如短链脂肪酸、三甲胺 N-氧化物、吲哚和犬尿氨酸）的途径缺陷，已知会促进多种代谢紊乱。本出版物旨在讨论肠道菌群失调和与免疫抑制治疗相关的细菌代谢物失调在 PTDM 发生中的潜在作用。
