School of Pharmacy, Zhejiang Chinese Medical University, Hangzhou, China.
Department of Nephrology, Shaanxi Traditional Chinese Medicine Hospital, Xi'an, China.
Br J Pharmacol. 2024 Jan;181(1):162-179. doi: 10.1111/bph.16219. Epub 2023 Sep 19.
Membranous nephropathy (MN) is an immune-mediated glomerular disease in adults. Antibody- and antigen-bonding mechanisms have been largely clarified, but the subepithelium immune complex deposition-mediated downstream molecular mechanisms are currently unresolved. Increasing evidence has suggested that gut microbiota contribute to MN pathogenesis.
In this study, we identified alterations in faecal gut microbiota and serum metabolites that mediate an aryl hydrocarbon receptor (AhR) mechanism in cationic bovine serum albumin (CBSA)-induced MN rats and in patients with idiopathic MN (IMN).
Impaired renal function correlated with the relative abundance of reduced faecal probiotics, Lactobacillus and Bifidobacterium, and altered serum levels of tryptophan-produced indole derivatives (TPIDs) in MN rats. Further results showed that reduced relative abundance of five probiotics, namely Lactobacillus johnsonii, Lactobacillus murinus, Lactobacillus vaginalis, Lactobacillus reuteri and Bifidobacterium animalis, positively correlated with decreased levels of indole-3-pyruvic acid, indole-3-aldehyde and tryptamine and negatively correlated with increased levels of indole-3-lactic acid and indole-3-acetic acid in serum of MN rats. Altered five probiotics and five TPIDs also were observed in patients with IMN. Further studies showed that MN rats exhibited a significant increase in intrarenal mRNA expression of AhR and its target genes CYP1A1, CYP1A2 and CYP1B1, which were accompanied by protein expression of down-regulated cytoplasmic AhR, but up-regulated nuclear AhR, in MN rats and IMN patients.
Activation of the intrarenal AhR signalling pathway may involve five TPIDs. These data suggest that gut microbiota could influence MN through TPIDs that engage host receptors.
膜性肾病(MN)是一种成人免疫介导的肾小球疾病。抗体和抗原结合机制已基本阐明,但目前尚未明确上皮下免疫复合物沉积介导的下游分子机制。越来越多的证据表明,肠道微生物群有助于 MN 的发病机制。
在这项研究中,我们鉴定了阳离子牛血清白蛋白(CBSA)诱导的 MN 大鼠和特发性 MN(IMN)患者粪便肠道微生物群和血清代谢物的改变,这些改变介导了芳香烃受体(AhR)机制。
肾功能受损与粪便益生菌、乳杆菌和双歧杆菌的相对丰度降低以及 MN 大鼠血清中色氨酸产生的吲哚衍生物(TPID)水平改变相关。进一步的结果表明,五种益生菌(约翰逊乳杆菌、鼠乳杆菌、阴道乳杆菌、雷特氏乳杆菌和动物双歧杆菌)的相对丰度降低,与血清中吲哚-3-丙酮酸、吲哚-3-醛和色胺水平降低呈正相关,与吲哚-3-乳酸和吲哚-3-乙酸水平升高呈负相关。IMN 患者也观察到五种益生菌和五种 TPID 的改变。进一步的研究表明,MN 大鼠表现出明显的肾内 AhR 及其靶基因 CYP1A1、CYP1A2 和 CYP1B1 的 mRNA 表达增加,同时伴有 MN 大鼠和 IMN 患者细胞质 AhR 下调、核 AhR 上调的蛋白表达。
肾内 AhR 信号通路的激活可能涉及五种 TPID。这些数据表明,肠道微生物群可能通过与宿主受体结合的 TPID 影响 MN。