Lazarevic Vladimir, Teta Daniel, Pruijm Menno, Stoermann Catherine, Marangon Nicola, Mareschal Julie, Solano Raquel, Wurzner-Ghajarzadeh Arlene, Gaïa Nadia, Cani Patrice D, Dizdar Oğuzhan S, Herrmann François R, Schrenzel Jacques, Genton Laurence
Genomic Research Laboratory, Geneva University Hospitals and University of Geneva, Geneva, Switzerland.
Nephrology, Hospital of Sion, Sion, Switzerland.
Front Microbiol. 2024 May 21;15:1298432. doi: 10.3389/fmicb.2024.1298432. eCollection 2024.
The gut barrier, comprising gut microbiota, plays a pivotal role in chronic kidney disease (CKD) progression and nutritional status. This study aimed to explore gut barrier alterations in hemodialyzed (HD) patients, non-HD (NHD) CKD patients, and healthy volunteers.
Our cross-sectional study enrolled 22 HD patients, 11 NHD patients, and 11 healthy volunteers. We evaluated fecal microbiota composition (assessed via bacterial 16S rRNA gene sequencing), fecal IgA levels, surrogate markers of gut permeability, serum cytokines, appetite mediators, nutritional status, physical activity, and quality of life.
HD patients exhibited significant alterations in fecal microbiota composition compared to healthy volunteers, with observed shifts in taxa known to be associated with dietary patterns or producing metabolites acting on human host. In comparison to healthy volunteers, individuals with HD patients exhibited elevated levels of inflammatory markers (CRP, IL-6 and TNF-α), glucagon-like peptide-2, and potential anorexigenic markers (including leptin and peptide YY). NHD patients had increased levels of CRP and peptide YY. Overall fecal microbiota composition was associated with height, soft lean mass, resting energy expenditure, handgrip strength, bone mineral content and plasma albumin and TNF-α.
Compared to healthy volunteers, HD patients have an altered fecal microbiota composition, a higher systemic inflammation, and a modification in plasma levels of appetite mediators. While some differences align with previous findings, heterogeneity exists likely due to various factors including lifestyle and comorbidities. Despite limitations such as sample size, our study underscores the multifaceted interplay between gut microbiota, physiological markers, and kidney function, warranting further investigation in larger cohorts.
由肠道微生物群构成的肠道屏障在慢性肾脏病（CKD）进展和营养状况方面发挥着关键作用。本研究旨在探究血液透析（HD）患者、非血液透析（NHD）CKD患者及健康志愿者的肠道屏障改变情况。
我们的横断面研究纳入了22例HD患者、11例NHD患者和11名健康志愿者。我们评估了粪便微生物群组成（通过细菌16S rRNA基因测序进行评估）、粪便免疫球蛋白A水平、肠道通透性替代标志物、血清细胞因子、食欲介质、营养状况、身体活动及生活质量。
与健康志愿者相比，HD患者的粪便微生物群组成出现显著改变，已知与饮食模式相关或产生作用于人类宿主的代谢产物的分类群发生了变化。与健康志愿者相比，HD患者体内的炎症标志物（CRP、IL-6和TNF-α）、胰高血糖素样肽-2以及潜在的厌食标志物（包括瘦素和肽YY）水平升高。NHD患者的CRP和肽YY水平升高。总体粪便微生物群组成与身高、瘦软体重、静息能量消耗、握力、骨矿物质含量以及血浆白蛋白和TNF-α相关。
与健康志愿者相比，HD患者的粪便微生物群组成发生改变，全身炎症水平更高，食欲介质的血浆水平也有所变化。虽然一些差异与先前的研究结果一致，但可能由于包括生活方式和合并症在内的各种因素而存在异质性。尽管存在样本量等局限性，但我们的研究强调了肠道微生物群、生理标志物和肾功能之间的多方面相互作用，值得在更大队列中进一步研究。
