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共生元补充对血液透析患者尿毒症毒素、氧化应激和炎症的影响-一项非对照前瞻性单臂研究的结果。

The Effect of Synbiotic Supplementation on Uremic Toxins, Oxidative Stress, and Inflammation in Hemodialysis Patients-Results of an Uncontrolled Prospective Single-Arm Study.

机构信息

Department of Propaedeutics of Internal Diseases, Medical Faculty, Medical University of Plovdiv, 4000 Plovdiv, Bulgaria.

Hemodialysis Unit, University Hospital "Kaspela", 4000 Plovdiv, Bulgaria.

出版信息

Medicina (Kaunas). 2023 Jul 28;59(8):1383. doi: 10.3390/medicina59081383.

Abstract

: Numerous studies to date have shown that the development of dysbiotic gut microbiota is a characteristic finding in chronic kidney disease (CKD). A number of uremic toxins progressively accumulate in the course of CKD, some of them generated by the intestinal microbiome, such as indoxyl sulfate (IS) and p-cresyl sulfate (p-CS). They are found to be involved in the pathogenesis of certain complications of uremic syndrome, including low-grade chronic inflammation and oxidative stress. The aim of the present study is to research the serum concentration of IS and p-CS in end stage renal disease (ESRD) patients undergoing conventional hemodialysis, as well as to study the possibilities of influencing some markers of inflammation and oxidative stress after taking a synbiotic. : Thirty patients with end-stage renal disease (ESRD) undergoing hemodialysis treatment who were taking a synbiotic in the form of La-14 2 × 10 (CFU)/g and prebiotic fructooligosaccharides were included in the study. Serum levels of total IS, total p-CS, Interleukin-6 (IL-6), and Malondialdehyde (MDA) were measured at baseline and after 8 weeks. . The baseline values of the four investigated indicators in the patients were significantly higher-p-CS (29.26 ± 58.32 pg/mL), IS (212.89 ± 208.59 ng/mL), IL-6 (13.84 ± 2.02 pg/mL), and MDA (1430.33 ± 583.42 pg/mL), compared to the results obtained after 8 weeks of intake, as we found a significant decrease in the parameters compared to the baseline-p-CS (6.40 ± 0.79 pg/mL, = 0.041), IS (47.08 ± 3.24 ng/mL, < 0.001), IL-6 (9.14 ± 1.67 pg/mL, < 0.001), and MDA (1003.47 ± 518.37 pg/mL, < 0.001). : The current study found that the restoration of the intestinal microbiota in patients with CKD significantly decreases the level of certain uremic toxins. It is likely that this favorably affects certain aspects of CKD, such as persistent low-grade inflammation and oxidative stress.

摘要

: 迄今为止,大量研究表明,肠道共生失调微生物群的发展是慢性肾脏病 (CKD) 的特征性发现。在 CKD 的发展过程中,一些尿毒症毒素逐渐积累,其中一些是由肠道微生物组产生的,如吲哚硫酸酯 (IS) 和对甲酚硫酸酯 (p-CS)。它们被发现与尿毒症综合征的某些并发症的发病机制有关,包括低度慢性炎症和氧化应激。本研究旨在研究接受常规血液透析的终末期肾病 (ESRD) 患者的血清 IS 和 p-CS 浓度,并研究服用合生素后影响某些炎症和氧化应激标志物的可能性。 : 本研究纳入了 30 名接受血液透析治疗的终末期肾病 (ESRD) 患者,他们服用了以 La-14 2×10(CFU)/g 和益生元低聚果糖形式存在的合生素。在基线和 8 周后测量血清总 IS、总 p-CS、白细胞介素-6 (IL-6) 和丙二醛 (MDA) 的水平。. 患者的四项研究指标的基线值明显更高-p-CS(29.26±58.32 pg/mL)、IS(212.89±208.59 ng/mL)、IL-6(13.84±2.02 pg/mL)和 MDA(1430.33±583.42 pg/mL),与 8 周后摄入后的结果相比,我们发现与基线相比,这些参数显著降低-p-CS(6.40±0.79 pg/mL, = 0.041)、IS(47.08±3.24 ng/mL, < 0.001)、IL-6(9.14±1.67 pg/mL, < 0.001)和 MDA(1003.47±518.37 pg/mL, < 0.001)。 : 目前的研究发现,CKD 患者肠道微生物群的恢复显著降低了某些尿毒症毒素的水平。这可能会对 CKD 的某些方面产生有利影响,例如持续的低度慢性炎症和氧化应激。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fc3b/10456308/6da5d5308d07/medicina-59-01383-g001.jpg

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